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 as little as two months. Injection-free treatment options are now the most common treatment method. 

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

Ways the New Treatments Work

There's no one-size-fits-all option. There are 6 different types or genotypes of hepatitis C, and there are more than 50 subtypes. Type 1 is the most common. This is important to understand when you talk to your doctor. Not all medications work on all types. Which medicine is best for you also depends on how much liver scarring (cirrhosis) you have.

Your doctor might might suggest drugs that are direct-acting antivirals. The medications 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, with some as soon as 8 weeks, such as glecaprevir and pibrentasvir (Mavyret). 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 or more.

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Meet the New Meds

Daclatasvir (Daklinza): This drug is approved to treat people with HCV types 1 or 3. It’s a pill you take once a day along with sofosbuvir (Sovaldi) and possibly ribavirin. You might get a headache or feel a little tired. Tell your doctor if you feel super-sluggish. 

Elbasvir and grazoprevir (Zepatier): This once-a-day pill treats HCV types 1 or 4. It may also offer new hope for people with hepatitis 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.

Glecaprevir and pibrentasvir (Mavyret): This medication offers a shorter treatment cycle of 8 weeks for adult patients with all types of HCV who don’t have cirrhosis and who have not been previously treated. The length of treatment is longer for those who are in a different disease stage. The prescribed dosage for this medicine is 3 tablets daily. The most common side effects are headache, fatigue, and nausea.

Ledipasvir and sofosbuvir (Harvoni): This once-a-day pill launched the revolution in hepatitis C treatment. It was the first interferon-free medication 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 or who have compensated cirrhosis, meaning their liver has scarring but they do not have any symptoms from it yet. It is used 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 two ombitasvir, paritaprevir, and ritonavir tablets once a day, and one dasabuvir tablet twice a day. Some people find this clunky, but others say it beats injections. Side effects may include an increase in your liver function blood tests, as well as feeling itchy, weak, tired, or having trouble sleeping. This medicine might cause severe liver damage in people with advanced cirrhosis.

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Simeprevir (Olysio) and sofosbuvir (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.

Sofosbuvir-velpatasvir (Epclusa): This medication treats chronic hepatitis C (genotypes 1-6) both with or without cirrhosis. It is approved for use in combination with ribavirin if the cirrhosis is not compensated, meaning your liver cannot function and you have symptoms of cirrhosis. It typically clears the virus within 12 weeks, even in people with cirrhosis.

Vosevi (Sofosbuvir, Velpatasvir and Voxilaprevir): This is a combination medicine that has been approved to treat adults with chronic HCV, either with no cirrhosis or with compensated cirrhosis, who have already had certain treatments.

What’s On the Horizon?

Drug companies are developing medications that may decrease the length of treatment and increase the effectiveness. It is hoped that this, along with the competition, will help decrease the cost of treatment.

WebMD Medical Reference Reviewed by Melinda Ratini, DO, MS on September 10, 2017

Sources

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