Current Hepatitis C Treatments - Mayo Clinic
New Drug Combo Cures Hepatitis C for 98 Percent
Together, two drugs clear the hepatitis C virus without the severe side effects of older treatments, holding out the promise of a cure.
By Jennifer J. Brown, PhD
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For people in a clinical trial for the new drugs daclatasvir and sofosbuvir (Sovaldi), hepatitis C cure rates were astonishingly high at 98 percent, even for the hardest to treat patients.
This news comes from a paper published today in the New England Journal of Medicine from researchers at Johns Hopkins Infectious Disease Center for Viral Hepatitis in Baltimore.
The high cure rate brings hope to the 3.2 million Americans living with this serious liver disease. “Virtually no one ever talks about liver disease, and it is by all estimates certainly one of the largest diseases facing America,” said Tom Nealon, National Board Chair of the American Liver Foundation. Many people who are at risk have avoided testing or treatment for hep C because they've heard about the severe side effects of interferon injection therapy, and the fact that it is effective only 40 percent of the time.
Hep C causes 17,000 new infections each year in the United States, according to the U.S. Centers for Disease Control and Prevention. The CDC recommends that everyone born between 1945 and 1965 — essentially, all baby boomers — get screened for hep C to help eradicate this dangerous infection, the No. 1 reason for liver transplants today.
Now, with the promise of a more effective treatment, and even a cure, researchers and advocates hope more people will face their fears and get hepatitis C testing and treatment.
“Armed with highly effective and tolerable treatment, we will have the ability to cure hepatitis C in most patients with this chronic infection, which is responsible for more deaths in the U.S. than HIV,” said study investigator Mark Sulkowski, MD of Johns Hopkins University.
A Hep C Treatment That Works Hard to Treat Patients
The new research study included 211 men and women who were infected with one of three types of hepatitis C, genotypes 1, 2, or 3. The hardest patients to treat were those who had persistent infections resistant to standard therapy — interferon, ribavirin and an antiviral drug.
Researchers found that a 24-week course of treatment with the new pills was 98 percent effective at curing hepatitis C genotype 1, at 12 weeks after the end of therapy. For people with hep C genotype 2 the treatment was 92 percent effective, and for genotype 3, 89 percent.
Sovaldi was approved by the FDA to treat hepatitis C in December 2013. This drug controls infection by keeping the hep C virus from making copies of its DNA, and is the first hep C-specific polymerase inhibitor on the market. The second drug, daclatasvir, is an investigational, direct-acting antiviral that causes a rapid drop in patient blood levels of hepatitis C.
Life on Interferon and Ribavirin: Dizzy, Itchy, and Tired
Because of the daunting side effects of older hep C therapies interferon and ribavirin — flu-like symptoms, fatigue and depression — many patients choose not to start, or could not finish, hep C treatment.
“I had many side effects from interferon and ribavirin; Interferon made me depressed, listless, unable to concentrate, exhausted, and that is just the beginning of a long list," said hep C patient and nurse Lucinda K. Porter, RN, who blogs about the disease on Everyday Health. "Ribavirin was actually worse for me. It causes anemia, which leads to fatigue and dizziness. I had a very itchy rash, which meant I took antihistamines, which increased the fatigue. The worst were the anxiety, irritability, and insomnia.”
After unsuccessful therapy with interferon and ribavirin, Porter was finally cured of hepatitis C infection with a different experimental treatment that included Sovaldi.
In addition to the decrease in side effects and the increase in effectiveness, said Dr. Sulkowski, the new combination of daclatasvir and Sovaldi had another important advantage for people like Porter.
“This regimen also offers the potential to remove ribavirin, which causes anemia in many patients," he said, adding that, “We anticipate that this and treatments like it will be widely available in the United States as soon as early 2015." The experimental combo did have some less serious side effects, including headache, nausea, and fatigue.
One big drawback for future patients: It's very expensive. A 12-week treatment course of Sovaldi alone will cost an estimated ,000.
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