It's not often that doctors use terms like "revolutionary" and "groundbreaking" when they talk about medications. But that's exactly what they're doing -- and with much enthusiasm -- when they talk about today's treatments for hep C.
"There is no question, we're amid a revolution in hepatitis C treatment," says William D. Carey, MD, a senior hepatologist at Cleveland Clinic in Ohio. "There is nothing in my 40 years of professional life that comes close to this."
The goal of your treatment is to get rid of the hepatitis C in your body. You're considered cured if you don't have any virus in your blood 6 months after you stop taking medicine.
A turning point in finding a cure came when doctors began treating the disease with interferon in the 1990s. The drug boosts your immune system, your body's defense against germs, to help it fight off the hep C virus.
Next came the use of ribavirin, another drug that fights the virus. You take it with interferon to improve treatment. Thanks to this combo, the cure rate jumped from less than 5% in the 1980s to about 50% by the early 2000s.
But interferon and ribavirin can give you side effects, including muscle aches, fever, nausea, anxiety, and trouble sleeping. You also need to take them for up to 48 weeks to see results.
In 2011, the FDA approved two new drugs: boceprevir (Victrelis) and telaprevir (Incivek). They stop the virus from making a copy of itself.
Combining telaprevir or boceprevir with interferon and ribavirin pushed success rates as high as 70%. But the drug combination still wasn't ideal.
"Adding that third drug increased the side effects tremendously," says Anna Lok, MD.
The New Standard in Hepatitis C Treatment
In 2013 and 2014, the FDA approved four new drug products:
Your treatment will depend on many things including what type of hepatitis C virus you have. In the U.S., the most common type is genotype 1, followed by genotypes 2 and 3. Genotypes 4,5 and 6 are very rare in the U.S.
Ledipasvir-sofosbuvir is the first combination pill used to treat hepatitis virus genotype 1 and can be taken without interferon and ribavirin.