With the recent FDA approval of a new drug and studies that indicate the effectiveness of new drug combinations for the treatment of Hepatitis C, it appears that we are well on our way to revolutionizing treatment of this potentially deadly liver disease. The need for a new, more effective treatment is significant. The Centers for Disease Control and Prevention estimates that approximately 3.2 million Americans currently suffer from chronic Hepatitis C and that 17,000 Americans are infected with Hepatitis C each year. The virus kills more Americans each year than AIDS and is the leading cause of liver transplants.
Acute Hepatitis C is a short-term illness that occurs within the first six months after someone is exposed to the Hepatitis C virus. Approximately 15 to 25 percent of those exposed to Hepatitis C are able to fight off the virus without treatment; the other 75 to 85 percent aren’t so fortunate. They develop a “chronic,” or lifelong, infection. Over time, the infection can lead to serious health problems such as liver damage, cirrhosis, liver failure or liver cancer. Unfortunately, because the disease often causes no noticeable symptoms until two or three decades after infection, the liver can be severely damaged before the virus is detected.
Traditionally, treatment for chronic Hepatitis C has included a weekly injection of interferon and a daily tablet of ribavirin. The regimen is arduous, taking a year or more to fight back the virus and causing sometimes intolerable side effects such as flulike symptoms, fatigue, anemia and depression. Further, the treatments are only effective for about 75 percent of patients.
Imagine going a year or more feeling like you have the flu because of the medicine you’re taking – by weekly injection – only to find out that the medicine hasn’t accomplished its goal. That has been the case for far too many patients.
It is good to know that better treatment methods are on the way. As reflected in two recent studies, the recently FDA-approved drug sofosbuvir (brand name Sovaldi) makes treatment faster (typically 12-24 weeks instead of 52 weeks), easier (no injections required), and more effective (resolving the virus in 93 to 98 percent of patients). The studies, published in the Jan. 16 issue of the New England Journal of Medicine, looked at treatment of chronic Hepatitis C using sofosbuvir in combination with other drugs.
The first study was conducted by Johns Hopkins researchers; it included 211 patients who took sofosbuvir along with daclatasvir, a drug still in the approval process, for either 12 or 24 weeks. Scientists reported that the drugs proved safe and effective for patients, with a 98 percent cure rate.
In the second study, researchers at Virginia Mason Medical Center in Seattle included 571 patients with hepatitis C, some that had never been treated and others that had been unsuccessfully treated with interferon injections and ribavirin. Patients were given various combinations of sofosbuvir and other antiviral pills for a period of eight, 12 or 24 weeks. Within 24 weeks more than 93 percent of patients, even those who had not responded to treatment with interferon, were completely cured.
The results of these studies are promising. Unfortunately, treatment may not be covered by health insurance and its high cost may be prohibitive for many patients. Nevertheless, these developments are encouraging and it is an exciting time in the treatment of Hepatitis C.