Hepatitis C Treatment
What is the duration of treatment?
Who should consider a hepatitis C treatment?
All individuals infected with hepatitis C should seek treatment to prevent irreparable liver damage. Many individuals who have the hepatitis C virus are unaware of their infection. The CDC recommends that all Baby Boomers be tested for the hepatitis C virus.
How do hepatitis C treatments work?
There are four primary methods used in hepatitis C treatment. Pegylated interferon alfa-2a or 2b works to fight the virus in conjunction with the body's immune system. Ribavirin acts to stop hepatitis C from multiplying. Direct acting antivirals (DAA) and protease inhibitors work to prevent multiplication of the virus and increase the chance for cure when taken in conjunction with one of the above mentioned medications.
The FDA has approved a new treatment for hepatitis C called Sovaldi®. When used in combination with other antiviral medications it has a very successful cure rate.
What is the duration of hepatitis C treatment?
Pegylated interferon alfa-2a or 2b is administered as an injection under the skin once weekly. It is often taken alongside ribavirin, which is a tablet taken twice daily. Protease inhibitor tablets are taken two or three times per day (every 7-9 hours) and are always taken in conjunction with the other treatments.
The treatment duration for Sovaldi® depends on the genotype of hepatitis C present in individual patients. Patients with hepatitis C genotype 1 and 4 take one Sovaldi® pill and two ribavirin pills per day, plus an injection of peglyated interferon alfa once per week for 12 weeks. Those with hepatitis C genotype 2 take one Sovaldi® pill along with two ribavirin pills per day for 12 weeks. Hepatitis C genotype 4 patients take one Sovaldi® and two ribavirin pills per day for 24 weeks.
How effective is the hepatitis C treatment?
Effectiveness for older and traditional treatments for genotype 1 patients, provide an approximate cure rate of 45-75%. With these same treatments in genotype 2 or 3 patients, a 65-75% cure rate is expected.
Sovaldi® has a higher cure rate. The cure rate of Sovaldi® for genotype 1 is 89%, 93% for genotype 2, 84% for genotype 3 and 96% for genotype 4.
Patients coinfected with HIV and HCV have a decreased incidence of treatment success.
Are there any side effects?
Side effects for traditional hepatitis C treatment include: depression, fatigue, fever, headache, nausea, and general flu-like symptoms.
The newly approved Sovaldi® has reportedly very few side effects. Because Sovaldi® must be taken with traditional treatments, ribravin, peglyated interferon alfa, or both, side effects from these drugs may be present.
Is there anyone who should not have hepatitis C treatment?
Some people are not eligible for hepatitis C treatment, including those who:
- are clinically depressed
- are addicted to alcohol or drugs
- have clinically decompensated liver cirrhosis
- are pregnant or wish to become pregnant
- have significant neuropsychiatric syndromes
- have active autoimmune diseases such as lupus, rheumatoid arthritis, psoriasis, or severe anemia
- have recently had transplant surgery
- are experiencing liver failure
Which medications are used in hepatitis C treatment?
Pegylated interferon alfa-2a or 2b is marketed as Pegasys® or Peg-Intron®. Some names for ribavirin are Copegus®, Rebetol®, Ribasphere®, Vilona®, and Virazole®. Two popular protease inhibitors are boceprevir (Victrelis®), telaprevir (Incivek®, Incivo®) and Sovaldi® (sofosbuvir).
How much does hepatitis C treatment cost?
Insurance sometimes covers hepatitis C treatment; in this event, the patient would be required to pay applicable copayments. Without insurance, estimated charges for hepatitis treatments range from $50,000-100,000 per year.