A Doctor's View on New Hepatitis C Treatments
Read the Comment by Jay W. Marks, MD
There are several clinical drug trials currently underway that suggests soon they may be able to eradicate the hepatitis C virus. Patients currently undergoing treatment for hepatitis C often experience uncomfortable to severe side effects of the hepatitis C treatment drugs, and often suffer a very long treatment period. These new drugs undergoing clinical trials have fewer side effects, have of a shorter treatment duration, and again, can eradicate the hepatitis C virus. So be on the alert for news of approval of these new drugs that just may cure hepatitis C. Read the entire Doctor's View
What medications cure hepatitis C infection?
Interferons and pegylated interferons such as Peg-Intron A, Pegasys, Roferon, and Infergen, were mainstays of treatment for years and produced sustained viral response (SVR, or cure) of up to 50%-80%. These drugs were injected, had many adverse effects, required frequent monitoring, and were often combined with oral ribavirin, which caused anemia. Treatment durations ranged up to 48 weeks.
Direct-acting agents (DAA) are antiviral drugs that act directly on hepatitis C multiplication.
- They are taken by mouth, are well-tolerated, and cure over 90% of patients.
- Treatment time is much shorter.
- The earliest options were sofosbuvir (Sovaldi) and simeprevir (Olysio). These were approved by the Food and Drug Administration (FDA) in 2013.
- Ledipasvir and sofosbuvir (Harvoni) followed as a once-a-day combination pill, in 2014.
- With this combination of DAAs, about 94%-99% of people achieve an SVR (cure) in 12 weeks with few side effects.
- Ombitasvir, paritaprevir and ritonavir co-packaged with dasabuvir tablets (Viekira Pak), is a combination approved in 2014. SVR with this combination is 91%-100%. The combination of elbasvir and grazoprevir (Zepatier) was approved in 2016. SVR with this combination depends on the HCV genotype and whether individual patient factors require the addition of ribavirin. Genotype 1 has a 94%-97% SVR, and SVR is 97%-100% in genotype 4.