New Treatment Options for Hepatitis C in 2014

by Columbia Surgery on February 10, 2014

Most people are aware of the implications of being diagnosed with HIV, but few have any notion how to live with Hepatitis C. Both viruses are spread through some similar means, but for reasons beyond this blog post, HIV is in our usual lexicon, and Hepatitis C (HCV) is not. This is about to change thanks to new research that has and will lead to breakthrough treatments for this disease.

Between four and five million Americans currently have HCV—most were infected in the 1960s through the 1980s. Fifty percent of these HCV infections are caused by intravenous or other drug use (even casual experimentation decades ago), the rest are from blood transfusions, body modifications such as tattoos and piercings, and sexual transmission.

Those with HCV have up to a 37% risk of mortality due to liver failure. Hepatitis C starts insidiously as inflammation and scarring (fibrosis) but then can progress to cirrhosis and liver cancer (hepatocellular carcinoma). Because HCV is asymptomatic, up to 75% of cases aren’t diagnosed until it is too late. Unfortunately our screening procedures don’t work well in targeting populations at risk, because the risks occurred so long ago and may not even be remembered.

But, we are close to a tipping point. Due to the development of new drugs HCV will soon be curable in the vast majority of patients. The decades old therapy of interferon and ribavirin work in some, but require lengthy treatment and have hard-to-tolerate side effects.

To help make more sense of these new drugs, and to better understand the changes that will be coming in the treatment of Hepatitis C, please join Dr. Robert S. Brown, Jr. of the Center of Liver Disease and Transplantation for his webinar New Treatment Options for Hepatitis C in 2014 to be held on February 27th at 1:00 PM/ET.

Topics discussed and questions to be answered include:

  • What is the timeline for DAA treatment therapies? What can HCV patients expect in the next few years?
  • What are the survival rates and treatment costs for HCV?
  • What sub-populations of HCV patients require special attention?
  • What are the results and updates for the latest Hepatitis C clinical trials?
  • What factors should be considered when developing a personal treatment regime for someone affected with HCV?

We are sorry, but this webinar has already occurred. You can listen to an archived copy of this program in the player embedded below this message. Since this a recording, no one is available to answer calls or emails.


The common drugs used to treat HCV and the ways in which they are combined are:

Interferon
  • Interferon does not attack a cancer or virus directly, but boosts the immune systems response to these diseases.
  • There are different types (alpha, beta, lambda & gamma) used to treat different diseases.
  • Many patients cannot tolerate interferon due to side effects and co-morbidities.
Ribavirin
  • Ribavirin affects the reproductive capabilities of the virus through its RNA and DNA.
  • It is a synthetic chemical not found in nature.
  • Ribavirin does not have as many side effects as interferon but is a teratogen, which means it can cause birth defects in a fetus or embryo.
Interferon & Ribavirin
  • Interferon and ribavirin have been used to treat Hepatitis C for almost 20 years.
  • Interferon and ribavirin must be taken for at least 6 months usually up to a year.
  • This drug combination cures less than half of the patients with HCV genotype 1 and 70% of the patients with genotypes 2 & 3.
Boceprevir & Telprevir
  • Developed in May of 2011, boceprevir and telprevir were the first drugs to act directly on the HCV virus (DAA).
  • Boceprevir and teleprevir increased the cure rate for HCV genotype 1 to 70%. (This is the same cure rate for HCV genotypes 2 & 3 using interferon and ribavirin.)
  • A treatment regime with boceprevir or telprevir, with interferon and ribavirin lasts 24-48 weeks.
Sofosbuvir, Interferon & Ribavirin
  • Sofosbuvir was approved as first-in-class nucleotide drug in December 2013.
  • When combined with interferon and ribavirin, sofosbuvir can be used to treat HCV genotype 1 for 12 weeks with a cure rate of 90%.
  • When combined with interferon and ribavirin, sofosbuvir for 12 weeks can also treat some genotype 3 patients. (This is off-label.)
Sofosbuvir & Ribavirin
  • Sofosbuvir & ribavirin for 12-24 weeks cured HCV and allowed the elimination of interferon for the treatment for ~90% of HCV genotype 2 and for many HCV genotype 3 patients.
Sofosbuvir with Simeprevir or NS5A inhibitors
  • The combination of these drug classes together has not been approved for use by the FDA, but will be important since interferon and, likely, ribavirin will no longer be needed.

 

{ 12 comments… read them below or add one }

Jacqueline F. February 12, 2014 at 1:11 am

Thank you for the information HCV. I am scheduled to see a liver specialist here in Georgia. I have a neighbor who started on this new treatment/medicine and she is loosing her teeth. She says this is one of the side effects. I am concerned about side effects because I am a Light Weight where medications are concerned but I want to be cured and this may be the opportunity. I contact HCV in 1982 after a blood transusion during a complicated pregnancy.

Much Appreciation
Jacquie

Jennie February 14, 2014 at 2:44 pm

hello my brother is suffering from hep C, and now it is starting to effect his liver, he doesn’t own a computer but I’m interested in ways of prolonging his life. could you help me?

Best Regards
Jennie

Columbia Surgery February 15, 2014 at 8:55 am

Jacqueline:

Thank you for your question. I’ll send it to Dr. Brown for the show.

If you have the chance, please tune in on the 27th at 1:00 PM. After that, we’ll have a recorded version on our Columbia Surgery YouTube channel at http:www.youtube.com/columbiasurgery

Columbia Surgery February 15, 2014 at 8:56 am

Jennie:

Thank you for your question. I’ll send it to Dr. Brown.

If you have the chance, please tune in for our show. After that, we’ll have a recorded version on our Columbia Surgery YouTube channel at http:www.youtube.com/columbiasurgery as well as an embedded copy here on this page.

Ngangbam L February 15, 2014 at 4:39 pm

I have been treated with peginterferon and rivabirin for 24weeks in 2013 .Am I cured from hep c???

Columbia Surgery February 18, 2014 at 2:53 pm

Ngangbam:

Thanks for your question. I’ll send this to Dr. Brown to be answered during his show on the 27th at 1:00 PM ET. If for some reason you cannot make that time, please bookmark this article or go to our YouTube channel at http://www.youtube.com/columbiasurgery. We’ll have a recorded version available for you to access on-demand.

Claudia February 20, 2014 at 9:43 pm

My brother could not tolerate ribavirin even though it was working. It was destroying his skin. Is there a treatment that doesn’t involve ribavirin? Thank you -

Columbia Surgery February 26, 2014 at 10:41 am

Claudia

Thank you for your question. I’ll be sure to forward it to Dr. Brown to answer during the webinar.

If you have the chance, please tune in tomorrow at 1:00 PM/ET. After that, we’ll have a recorded version on our Columbia Surgery YouTube channel at http://www.youtube.com/columbiasurgery

Claudia March 9, 2014 at 11:58 pm

Hi, I couldn’t download the software to join the webinar live, so I’ve been checking youtube for the recording but can’t locate it. Will it be available soon?

Columbia Surgery March 10, 2014 at 10:49 am

Hi Claudia,

Thank you for your interest in the webinar. I apologize for the delay, but we expect to have the webinar available by week’s end. I will reach out again once it is live. Thank you for your patience. All the best.

Judith March 10, 2014 at 3:12 pm

My husband is in week 22 of triple therapy, Peg, Riba and Victrelis. Can he change to new drug Sofo mid-treatment?

Columbia Surgery March 12, 2014 at 11:15 am

Hi Judith,

Thank you for your question. Unfortunately, this webinar has already occurred. You can watch an archived version of the webinar on our YouTube Channel. We hope this helps provide you and your husband with additional information about the new treatment.

For more information about Hepatitis C or to arrange a consultation with Dr. Brown, call the Center for Liver Disease and Transplantation at 877-LIVERMD (877-548-3763) or visit http://www.livermd.org. Thank you.

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