The Latest in Hepatitis C Treatments

Hepatitis C is the No. 1 cause of liver cancer and liver transplants. It's brought on by a virus that you can catch if you come into contact with contaminated blood. You could get it from an unclean tattoo needle, for example. Sometimes, it spreads during sex.

It can be cured. But doing so hasn't always been easy or comfortable. For decades, you needed painful shots of a medicine called interferon and a pill called ribavirin. These drugs didn't target the virus making you sick. Instead, they amped up your immune system, so you'd fight it like you do when you get sick with the flu.

But the treatment didn't always remove the virus from the body. Cure rates hovered around 50%. And, people who stuck with the year-long treatment -- not all did -- had to live with chemo-like side effects.

These days there's a revolution underway in hepatitis C virus (HCV) treatment. More and more people are being quickly cured by simply taking a pill, at home, for just a few weeks. Several injection-free options have been approved since 2014, and that list is growing fast.

Here's a closer look at some of the breakthrough drugs and a peek at those on the horizon.

Ways the New Treatments Work

There's no one-size-fits-all option. There are many different types, or "genotypes," of hepatitis C. Type 1 is the most common. This is important to understand when you talk to your doctor. Not all meds work on all types. Which medicine is best for you also depends on how much liver scarring (cirrhosis) you have.

Your doctor might refer to the new drugs as direct-acting antivirals. They zoom in on the virus that’s making you sick. Each drug works in a slightly different way. But, in general, the medicine interferes with proteins in your body that the virus needs to grow or spread.

Most of the time, the new medicines remove all traces of the virus from your blood within 12 weeks. This is called "virus clearance," and it’s what doctors look for to determine if you’re cured. How long you need treatment can vary. It may range from 8 to 24 weeks.

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Meet the New Meds

Daclatasvir (Daklinza): Approval of this drug meant no more shots for the 1 in 10 people infected with HCV type 3. It’s a pill you take once a day along with sofosbuvir (Sovaldi). You might get a headache or feel a little tired. Tell your doctor if you feel super-sluggish. The FDA warns it can sometimes cause a serious slowing of the heart rate, which may require you to get a pacemaker.

Elbasvir and grazoprevir (Zepatier): This once-a-day pill treats HCV types 1, 4, 6. It may also offer new hope for people with hep C who also have cirrhosis, HIV, late-stage kidney disease, and other hard-to-treat health conditions. Like the other antivirals, the side effects are mild. You might have a slight headache, bellyache, or feel tired.

Ledipasvir and sofosbuvir (Harvoni)

This once-a-day pill launched the revolution in hep C treatment. It was the first interferon-free med for people with type 1. A year later, the FDA also gave the thumbs up for people with HCV types 4, 5, and 6 to use it. Side effects are mild. You might feel tired or have a slight headache. Some people have a belly ache, diarrhea, and trouble sleeping.

Ombitasvir, paritaprevir, ritonavir (Technivie)

This drug made a once-a-day pill option available to people with HCV type 4 who don’t have cirrhosis. You can take it with ribavirin, which may boost your chances of a cure. Common side effects are feeling tired or week, stomach upset, itching, and trouble sleeping. It might cause severe liver damage in people with advanced cirrhosis.

Ombitasvir, paritaprevir and ritonavir, with dasabuvir (Viekira Pak)

Doctors say this treatment works well for people with HCV type 1. You can even take it if you have some liver scarring, as long as your liver still can do its job. Your doctor might call this compensated cirrhosis. You take one pill once a day and another pill twice a day. Some people find this clunky, but others say it beats injections. Side effects include feeling itchy, weak, tired, or having trouble sleeping. This medicine might cause severe liver damage in people with advanced cirrhosis.

Simeprevir (Olysio)andsofosbuvir (Sovaldi)

The FDA said these two drugs could be given together to treat people with HCV type 1. Before that, the pills had to be taken with interferon or ribavirin. Sofosbuvir (Sovaldi) can cause fatigue, headache, tummy troubles, and make it hard for you to sleep. Simeprevir (Olysio) may cause dry skin and a rash, and make you more sensitive to sunlight.

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What’s On the Horizon?

Researchers hope to soon have a single pill that can treat all types of hepatitis C. The combo drug sofosbuvir/velpatasvir looks promising. It clears the virus in 12-24 weeks, even in people with cirrhosis.

WebMD Medical Reference Reviewed by David T. Derrer, MD on January 31, 2016

Sources

SOURCES:

Ryan Ford, MD, assistant professor of medicine, Division of Digestive Diseases, Emory University School of Medicine.

William D. Carey, MD, senior hepatologist, Department of Gastroenterology, Cleveland Clinic, Cleveland, Ohio.

HCV Advocate: “A Brief History of Hepatitis C.”

CDC: "Hepatitis C FAQs for Consumers."

Curry, M.P. New England Journal of Medicine, Dec. 31, 2015.

News Release, FDA.

FDA: "FDA Drug Safety Communication: FDA warns of serious liver injury risk with hepatitis C treatments Viekira Pak and Technivie."

Feld, J. NEJM, Nov. 23, 2015.

HCV Advocate. "What is Cirrhosis?"

HCV New Drug Research: “ZEPATIER - Recommended Dosage and Durations, Drug Interactions, Side Effects, Clinical Studies.”

News Release, Gilead.

News Release, Merck.

Up-To-Date: “Direct-acting antivirals for the treatment of hepatitis C virus infection.”

U.S. Department of Veterans Affairs: "Hepatitis C Virus Genotypes and Quasispecies."

FDA: "FDA approves Viekira Pak to treat hepatitis C."

University of Washington: "Sofosbuvir (Sovaldi)."

Zeuzem, S. Annals of Internal Medicine, July 7, 2015.



 

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