Living with a chronic disease like hepatitis C can be depressing and nerve-wracking. It can also interfere with your relationships.
"People with hepatitis C experience a lot of stigma," says Alan Franciscus, executive director of the Hepatitis C Support Project in San Francisco. "It can be really hard."
You may avoid talking to friends or family about the disease because you're worried about how they'll react. You may feel a temptation to pull away from people you care about rather than risk them...
Olysio and Sovaldi are combined with the older drugs interferon and ribavirin. This combination is quickly becoming the new standard for treating hepatitis C.
Before Olysio and Sovaldi became available in 2013, the typical treatment for hepatitis C was a combination of interferon and ribavirin with two antiviral drugs:
Incivek and Victrelis were introduced in 2011. "These drugs interfere with the virus's ability to grow and replicate in the body," says Jonathan M. Fenkel, MD. He's the director of the Jefferson Hepatitis C Center at Jefferson University Hospitals in Philadelphia.
Taking one of these two medications in combination with interferon and ribavirin increased cure rates for people with type 1 hepatitis C (the most common form in the U.S.) from less than 50% to between 68% and 75%.
It also reduced treatment time for many patients. Those who had the virus disappear from their blood quickly enough could stop taking medications after 24 weeks.
But combining Incivek and Victrelis with interferon and ribavirin comes with some serious side effects.
The side effects of interferon and ribavirin include:
Anxiety and depression
Interferon can also cause a lowered white blood cell count, reducing the ability to fight infection.
Incivek and Victrelis "tend to make the anemia caused by interferon and ribavirin even worse," says Ira Jacobson, MD. He is chief of the division of gastroenterology and hepatology at the Joan and Sanford I. Weill Medical College of Cornell University.
"Some patients have ended up taking 12 to 18 pills a day, plus a shot once a week, plus other medications to help control side effects, and sometimes shots for blood count abnormalities," Fenkel says. "It's arduous, but the cure rates have definitely been improved."
The 'New' Standard
Olysio and Sovaldi are now starting to replace Incivek and Victrelis as the combination "partners" with interferon and ribavirin. Both were approved by the FDA at the end of 2013. Sovaldi was also approved to be used without interferon for some types of hepatitis C.