Hepatitis C Treatments Give Patients More Options

By Jane Farrell

Transformative advances in drug treatments approved by the U.S. Food and Drug Administration (FDA) are giving the 3.2 million Americans with chronic hepatitis C a chance for a longer, healthier life without the virus. That’s good news for baby boomers—who make up three of four adults with the hepatitis C virus—and millions of other Americans, many of whom don’t yet know they are infected and carriers.

Hepatitis C can be cured, and today’s drug therapies are very effective and easier for patients to take, says Jeffrey S. Murray, M.D., an internist at the FDA who specializes in infectious diseases.

Hepatitis (inflammation of the liver) refers to a group of viral infections that affect the liver. The most common types are hepatitis A, hepatitis B and hepatitis C. Each is caused by a different virus.

Hepatitis C is the most common chronic blood-borne infection in the United States. There is no vaccine for this disease, but new cases of hepatitis C can be prevented by avoiding behaviors that can spread the virus—including sharing needles, syringes or other equipment to inject drugs.

A diagnosis of hepatitis C no longer means months and months of painful drug injections, which for decades were the only option. Science is making strides in therapies, giving patients new alternatives.

“Interferon-based injections often make patients feel ill and give them flulike symptoms,” Murray says. The treatment by interferon also lasts six months to a year, and cures only 40% to 50% of hepatitis C patients.

“Patients with very advanced liver disease couldn’t take the traditional treatment because often those injections could make them worse,” he adds. “Now, patients can treat their hepatitis C with only pills—drug combinations that are faster and have a higher cure rate.”

Today’s pills have double the viral cure rates—90% to 100%—in just in 12 weeks’ time. Reducing the treatment from a year to three months is a huge advantage for people with hepatitis C, especially because it’s easier to swallow a pill than to get an injection, Murray says.

In recent years, FDA has approved multiple all-oral combination regimens, including drugs from multiple classes without the need to co-administer interferon. Patients should discuss the treatment options that would be appropriate for them with their health care provider.

For most people, hepatitis is a silent disease until it causes substantial damage to the liver. That process may take several years, and can lead to liver failure with the need for liver transplantation, and can also lead to liver cancer.

“Hepatitis C is a bit like smoking, the longer you’ve had it, the higher your risk of developing complications—in this case, liver cancer, cirrhosis (liver scarring) and end-stage liver disease. It’s a progressive disease that takes years, even decades, before the patient develops cirrhosis or cancer,” Murray says. “The good news is that when you cure hepatitis C, you also lower its risks, though you don’t completely erase the years of damage to your liver.”

Once infected with the hepatitis C virus, nearly 8 in 10 untreated people remain infected for life, according to the Centers for Disease Control and Prevention (CDC). Three in four patients with chronic hepatitis C are baby boomers (people born from 1945 to 1965), and many became infected before the virus was identified and the blood supply was tested for the disease. That’s why it’s important for baby boomers—there are about 75 million of them, according to the U.S. Census Bureau—to take a simple blood test for hepatitis C.

CDC recommends a blood test for hepatitis C as part of routine medical care for everyone born between 1945 and 1965 and those with other risk factors, including people who got a blood transfusion before 1992, have a history of injecting illegal drugs at any time, or are on hemodialysis (kidney dialysis).

“When it comes to hepatitis C, the outlook for the future is better, but the past is catching up with us—especially if you are a baby boomer,” Murray says. “Still, this is a fortuitous time because better hepatitis C treatments are available just as the patient population at risk of long-term complications is about to peak. There are treatments for chronic hepatitis and many reasons to get tested now more than ever because of the availability of safe and effective therapies.”

This article appears on the FDA’s Consumer Updates page, which features the latest on all FDA-regulated products.