Big changes are under way in the treatment of hepatitis C. New medicines have fewer side effects, and they raise your odds of beating the disease.
Five new drugs are quickly becoming the standard for treating hepatitis C Genotype 1:
- Elbasvir-grazoprevir (Zepatier)
- Ledipasvir-sofosbuvir (Harvoni)
- Ombitasvir, paritaprevir, dasabuvir, ritonavir (Viekira Pak)
- Simeprevir (Olysio)
- Sofosbuvir (Sovaldi)
Simeprevir and sofosbuvir both need to be combined with the older hep C drugs interferon and ribavirin but are now replacing boceprevir and telaprevir as the combination "partners" with interferon and ribavirin. Sofosbuvir can also be used without interferon for some types of the disease.
Elbasvir-grazoprevir and ledipasvir-sofosbuvir can be taken on their own. The Viekira pack means taking two ombitasvir, paritaprevir, ritonavir tablets once daily (in the morning) and one dasabuvir tablet twice daily (morning and evening) for at least 12 weeks. It can be used with or without ribavirin, but it is not recommended in patients with underlying liver disease.
Before the new drugs became available, the typical treatment was a combination of interferon and ribavirin with two other drugs that fight the hep C virus:
- Boceprevir (Victrelis)
- Telaprevir (Incivek)
Telaprevir and boceprevir were introduced in 2011. The drugs interfere with the ability of the hep C virus to grow and multiply in your body, says Jonathan M. Fenkel, MD, director of the Jefferson Hepatitis C Center.
But the combination treatment could lead to some serious side effects from interferon and ribavirin, such as:
- Flu-like symptoms
- Stomach problems
- Skin rashes
- Anxiety and depression
Interferon can also lower your white blood cell count, weakening your ability to fight infection.
Use of the new medications has increased cure rates for people with type 1 hepatitis C (the most common form in the U.S.) from less than 50% to between 80% and 100%. They also have fewer side effects.
It also shortened treatment time for many people. Those who had the virus disappear from their blood quickly enough could stop taking medications as early as 8 weeks and still only after 24 weeks.
With these new treatments, and more on the horizon, experts say it's more important than ever to follow new recommendations to get checked for hepatitis C. In 2013, the U.S. Preventive Services Task Force recommended that all adults born between 1945 and 1965 get a one-time screening test.
"More than two-thirds of the people in the U.S. who have hepatitis C are baby boomers, and most of them don't know they're infected," Fenkel says. "Now that we have more effective therapies, we can treat patients much more easily before there's a lot of damage done to the liver."