Hepatitis C: gone for good?
WASHINGTON, February 4, 2014—Dr. Mitchell Shiffman of the Bon Secours Liver Institute of Virginia has declared, “there is no doubt we are on the verge of wiping out Hepatitis C.”
Dr. Arthur Rubens entered into a clinical trial to test a new pill against Hepatitis C (Hep C) saying “taking it was a piece of cake.” After 90 days of treatment, the virus was determined cleared from his body after years of infection.
The leading cause of liver transplants in the U.S., Hep C kills more Americans than AIDS. Remarkably, this seemingly successful effort to eradicate it will make Hep C the first viral epidemic wiped out sans a vaccine.
New drugs with a once-a-day dose are available, replacing the multiple injections—along with their horrific side effects—now required to treat Hep C. If successful, the rate of cure will be substantially increased over the current figures of 70 percent.
The new treatment poses two main drawbacks. One is the up to $100,000 cost for a course of treatment. The other related drawback is the possibility of many individuals who may never have had so much as a hiccup from carrying the Hep C virus turning out to get the treatment, since often the majority of those infected display no symptoms at all. However, if medical insurance is called upon to cover costs, premiums will rise for everyone.
Perhaps the answer lies in not waiting for a victim to become symptomatic prior to treatment.
Currently, about three to four million Americans have Hep C, with the estimates of worldwide infection at about 150 million. These figures represent about three to five times the number of those infected with HIV.
The good news is that about 17,000 newly infected individuals annually is a far cry from the 1980s, when the numbers were about 200,000. The improved figures are attributed to public education of the virus.
As with HIV, Hep C is known to spread from drug abusers sharing needles, blood transfusions and sexual activity. The difference in treatment is that HIV has a latent (unseen) reservoir in the body requiring the victim to continue on medication for life to stop the virus from returning.
With Hep C, there is no reservoir. The virus can be destroyed once and for all. However, the risk of liver cancer and cirrhosis remains increased, particularly if scarring of the liver is pronounced.
Cautious Hep C expert Charles Rice at the Rockefeller University suggests there may be more side effects to the new treatment than currently noted.
“We may be in for some surprises still,” Rice goes on to say, stating that a greater degree of clinical experience will be the tale of the tape.
The Food and Drug Administration (FDA) is set to approve sofosbuvir by December 8. This drug inhibits the virus’s polymerase enzyme, which builds new genomes from RNA to allow viral replication. The new drug appears like the RNA building block, but once adapted into the RNA chain, the virus cannot reproduce itself.
The very people who spread Hep C are not prone to coming in for round after round of painful injections and suffering the side effects. However, they will clearly be more comfortable and friendly about taking some pills.
Hopefully, the dawn of the beginning of the end for Hep C is upon the medical landscape. With the end of suffering, those symptomatic can rejoice.