What's New in the Treatment of Hepatitis C
Hepatitis C is a viral infection, first discovered in 1989, that attacks the liver. It is typically transmitted through the exchange blood products, by transfusions received before the 1990s or by sharing of syringe needles (accidentally or on purpose). Hepatitis C is rarely sexually transmitted. About eight in ten persons exposed to the virus keep it forever and develop chronic hepatitis C.
Once hepatitis C becomes chronic, it causes a persistent inflammation of the liver. In about one quarter of those with the infection, this inflammation can lead to severe scarring of the liver (cirrhosis) after many years. Cirrhosis can lead to life-threatening complications, which can include chronic fatigue, confusion, bleeding problems, fluid retention, and accumulation of toxins in the body.
Treatment for hepatitis C first emerged in the early 1990’s but was largely ineffective. More effective treatment gradually emerged but cured no more than half of those treated. In the past, treatment always included the use of a drug called interferon. Interferon needs to be self-injected and can cause multiple serious side effects, including a constant feeling of having a bad case of the flu. Treatment duration was twenty-four to forty-eight weeks.
One year ago, several new anti-viral drugs with very few side effects were introduced. When combined with interferon, the cure rate with these new drugs climbed to ninety percent with just twelve to twenty-four weeks of treatment. On October 10th 2014, a combination of two antiviral drugs, given once daily as a single pill, was F.D.A. approved. With this therapy, interferon is no longer needed, and most persons require only eight to twelve weeks of therapy. The cure rate remains at about ninety percent.
We are truly in the midst of a revolution in the treatment of chronic hepatitis C, which represents a remarkable victory for biomedical research. Millions of infected persons who either did not respond to prior treatment options or who declined treatment because of the side effects of interferon can now be effectively and easily cured of the virus.