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What to Expect With New Hepatitis C Treatments


Steven L. Flamm, MD

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New Hepatitis C Treatments Change the Course of the Disease

Raymond Rubin, MD, discusses the dramatic change in hepatitis C treatment in recent years.

Hepatitis C, or hep C—a liver inflammation caused by the hepatitis C virus—is a prevalent health condition in the United States, but many people with the disease don’t even know they have it. However, there's some good news when it comes to hepatitis C: few medical conditions have experienced the exciting treatment breakthroughs in recent years that hepatitis C has.

In my opinion, the development of new "direct-acting" anti-viral medications to treat hepatitis C is one of the biggest advances in medicine of the past 25 years.

In the last few years, a lot has changed in the way we treat hepatitis C. Do you know all the facts?

Medical Reviewer: William C. Lloyd III, MD, FACS Last Review Date: Oct 23, 2015

Before these new drugs came on the scene, the primary treatment for hepatitis C was a medication called  pegylated interferon along with another drug by the name of ribavirin. Treatment typically lasted 6 to 12 months, and the cure rates were poor. With the new direct-acting anti-virals, many people can take just one pill a day for two to three months to treat hepatitis C.

It can’t be overstated how dramatic the differences are between the old and new drugs. Along with a long treatment time, the older therapies with interferon and ribavirin caused severe side effects. In many cases, the side effects were so bad that patients couldn’t tolerate them and would have to discontinue the treatment. And even when patients could finish the treatment, the typical cure rate was about 40 to 50%, so patients who did endure a difficult year of treatment still only had a 50/50 chance of being cured.

Direct-acting anti-virals have completely changed how the disease is treated. Now, patients take a pill for a shorter time period. The side effects are minimal to none. And the cure rates generally exceed 95%. It’s a revolution in medical treatment.

Finding the Best Treatment for You

Doctors base their treatment recommendation on the genotype, or strain, of hepatitis C that the patient has. For example, most people in the United States have genotype 1, but six distinct genotypes of hepatitis C exist.

Fortunately, though, researchers have created direct-acting anti-viral combinations that can treat all six genotypes—and with just one or a small number of pills. The vast majority of patients treated are cured. Several therapies are currently available and additional ones are in trial but should be available later this year.

With direct-acting anti-viral medications for hepatitis C, the most frequent side effects are fatigue and headache—and those are uncommon. In the past, side effects from interferon and ribavirin were extremely common and included nausea, vomiting, muscle pain, fever, chills, irritability, extreme fatigue and weakness, headache, skin rashes and anemia, among others.

Cost was certainly an issue when these new drugs first came on the market in 2011, but in recent years, more drugs have become available so there's been a significant reduction in cost. Now, many of these drugs are more affordable and available through many health insurance plans.

Of course, those disadvantaged for obtaining antiviral therapy for hepatitis C are poor patients, who often have the highest rates of hepatitis C infection. Public aid for these individuals is available in many areas, although patients often cannot overcome the substantial hurdles that some states have for their public aid programs. For instance, in Illinois, you must have advanced liver disease to be eligible for anti-viral therapy. In addition, they have other restrictions and criteria that patients must meet in order to get the medications. However, some drug companies have programs to offer free care for disadvantaged patients.

What Else Should You Know About Hepatitis C?

It’s estimated that 50% of people with hep C don’t even know they have it. This is a major health crisis, as these people are at risk of severe health complications if the disease continues to go untreated.

THIS CONTENT DOES NOT PROVIDE MEDICAL ADVICE. This content is provided for informational purposes and reflects the opinions of the author. It is not a substitute for professional medical advice, diagnosis or treatment. Always seek the advice of a qualified healthcare professional regarding your health. If you think you may have a medical emergency, contact your doctor immediately or call 911.

Steven L. Flamm, MD

Steven L. Flamm, MD, is chief of the Liver Transplantation Program and a professor of medicine at the Northwestern Feinberg School of Medicine in Chicago. View his Healthgrades profile.

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