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Inside Tract - Revolutionary Changes in Treatment of Hepatitis C

Inside Tract Summer 2014

Revolutionary Changes in Treatment of Hepatitis C

Date: June 2, 2014

Patients with hepatitis C have new hope, says Zhiping Li.
Patients with hepatitis C have new hope, says Zhiping Li.

Since its identification 25 years ago, hepatitis C has cost millions of lives around the world. Each year, between 3 and 4 million new infections happen, and more than 350,000 people die of hepatitis C-related conditions.

But today, according to Director of Hepatology Zhiping Li, is a new day for patients with the virus.

“Within the very near future,” says Li, “we just might get rid of hepatitis C altogether.”

Taken in combination, two new medications—sofosbuvir and simeprevir—have shown enormous promise and are revolutionizing treatment. 

“We’re prescribing these together with good results,” says Li. “The patients tolerate them very well, and they clear the virus very quickly. Once hepatitis C clears, it clears forever.”

The virus first attacks the liver. Chronic infection leads to scarring and, later, cirrhosis. For decades, nearly all treatment options involved interferon, which controlled liver damage but often produced unpleasant, flu-like side effects. “Many patients experienced depression and low blood counts,” says Saleh Alqahtani, director of clinical liver research. “We also couldn’t use interferon in patients who already had liver damage and in patients who’d had kidney or liver transplants.” 

The sofosbuvir and simeprevir combination therapy is not yet FDA-approved, says Li, and the cost can be prohibitive. “Prescription is off-label right now. But it shouldn’t be long before the FDA approves this therapy. That will mean more insurance companies will pay for it.”

Patients taking the combination therapy can expect fast results, says Li. “They’ll experience very few side effects. They’ll take two kinds of pills a day for three months, and that should clear the virus.”

Li expects that the new therapy will change the way doctors treat hepatitis C, as well as what sort of provider treats it.

“Eventually, hepatitis C won’t be treated by hepatologists,” he says. “It’ll be treated by primary care doctors.”

“Think about it. Hepatitis C kills more Americans than any other liver disease,” says Li. “And yes, there are some patients who have already have cirhossis of the liver. But in five or 10 years, no one should die from hepatitis C.”

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