New drugs and tests have turned the tide against the Hepatitis C virus (HCV) in the last 8 years.
HCV is a virus that can lead to serious liver damage, including cancer, when left untreated.
It is spread through contact with infected blood and is the number one cause of liver cancer and transplants.
The viral disease that still kills 290,000 people every year is mainly detected when medical tests on patients show liver damage.
For our World Hepatitis C Day special, we take a look at the HCV drugs as listed on the UK National Health Services (NHS) website. They have been approved for use since 2013.
At an early stage, HCV may cause lack of appetite, muscle and joint pain, fever, jaundice, which is a yellowish tone on the skin and eyes, stomach pain, fatigue, nausea, and dark urine.
On the other hand, advanced HCV infection may consist of itchiness, bleeding or bruising easily, confusion, fluid accumulation in the abdomen, weight loss, swelling in the arms and legs, slurred speech and blood vessels taking on a spider-like appearance.
Previous treatment consisted of ribavirin pills and painful interferon injections.
These drugs did not target the virus that caused the illness. Instead, they boosted the immune system to enable the patient’s body to fight off the infection.
However, the treatment did not always manage to clear the virus from the patient’s body. The therapy’s cure rates were averagely reported at around 50 percent.
Additionally, the patients who underwent the one year treatment course had to endure the painful, uncomfortable side effects of the drugs.
Aggressive new therapies and diagnostics have seen the global caseload for the viral disease shrink from 71 million in 2013 to 58 million in 2021.
Thanks to the new generation of drugs developed for HCV, a patient can get cured after a period of 8-12 weeks. The regimen does not require painful interferon injections.
How do the new drugs work?
It is important to realize that there are many different types, or “genotypes,” of Hepatitis C. Not all drugs will work on all types of HCV.
Medics will prescribe drugs for the patients depending on the extent of liver scarring or cirrhosis that he or she may have suffered.
Type 1 is the most common and is known as direct-acting antivirals (DAAs). This type directly attacks the virus that causes disease.
The drugs block the activity of the proteins that help the virus to grow or spread.
DAAs wil usually clear all traces of the virus from the patient’s blood within 12 weeks, although it can stretch up to 24 weeks in some cases.
This is called sustained virologic response (SVR).
Medics will look for it to ascertain that the patient has been cured.
Ledipasvir and sofosbuvir (Harvoni): This tablet is taken once a day, and was the first regimen without the need for additional injections.
One year after its approval, the US Food and Drug Administration gave the green light for medics to also treat patients with HCV types 4, 5, and 6.
Daclatasvir (Daklinza): Approval ended the injection requirement for the 1 in 10 people or 10 percent of people infected with Hepatitis C virus (HCV) types 1 and 3. It is taken once daily with sofosbuvir (Sovaldi).
Elbasvir and grazoprevir (Zepatier): Taken once a day, this pill treats HCV types 1 and 4. It can also provide relief for HCV patients with advanced kidney disease, HIV,cirrhosis and other complicated conditions.
Ritonavir with dasabuvir, ombitasvir and paritaprevir (Viekira Pak) The NHS says this treatment can be effective for people with HCV type 1. Patients with some form of cirrhosis can take it. In people with advanced liver scarring or cirrhosis, this therapy may cause severe liver damage.
Glecaprevir and pibrentasvir (Mavyret): Three pills of this regimen every day can manage all HCV types.
Sofosbuvir and velpatasvir(Epclusa):This pill taken once a day can be used to effectively manage treat all HCV types.
Sofosbuvir, velpatasvir, and voxilaprevir (Vosevi):This can also treat all types of hep C with one pill a day. It is however not advised for people with liver cirrhosis.
According to the NHS, “treatments with direct acting antivirals (DAAs) have very few side effects”. Most people find DAA tablets very easy to take.
“You may feel a little sick and have trouble sleeping to begin with, but this should soon settle down. Your nurse or doctor should be able to suggest things to help ease any discomfort,” reads the website write-up on DAA therapy.
NHS also insists on the need to complete the prescribed dose in order to ensure you get completely cured.
“You need to complete the full course of treatment to ensure you clear the hepatitis C virus from your body,” the document reads.
“If you have any problems with your medicines, speak to your doctor or nurse straight away,” adds the NHS.
Side effects for each type of treatment can vary from person to person.
For a very small number of people, more severe side effects from Hepatitis C treatments may include: depression, skin irritation, anxiety, problems sleeping (insomnia), anorexia, tiredness caused by anaemia
l hair loss and aggressive behaviour
How effective are DAAs?
NHS estimates that DAAs can clear the virus from 9 out of 10 patients or 90 percent of patients with HCV.
The health regulator is however cautioning patients on the need to take precautions against reinfection.
Preventive measures include the avoidance of sharing needles, toothbrushes, tattoo ink and skin cutting instruments with other people, and practising safe sex or abstaining in case of uncertainty.
“Successful treatment does not give you any protection against another Hepatitis C infection. You can still catch it again,” says the NHS.
Meanwhile, there’s no vaccine for Hepatitis C. If treatment does not work, it may be repeated or extended. The physician treating you may also opt for a different combination of medicines.
You can also read Hepatitis C killing thousands despite treatment advances