Together with hepatitis A and B, hepatitis C is one of the alarming viral liver infections that can progress with serious outcomes such as liver inflammation, liver failure and ultimately cancer. For many years, the mainstay of treatment for adults with hepatitis C were months of painful interferon injections.

Then, two years back, the FDA approved a new series of oral anti-viral drugs to treat hepatitis C. Recently, the results of this new treatment have come to fruition with very promising results.

Hepatitis C

It is estimated that 3.5 million people in the United States suffer from the disease, with the figure continuing to grow. While there are several clinical signs of the infection such as fatigue, joint pain and jaundice, a majority of patients with the virus remains largely asymptomatic.

This can be a real problem as hepatitis C is known to cause severe long-term medical effects which only begin to manifest 20 to 50 years down the line. These problems start out as liver inflammation and fibrosis – before progressing on to liver failure or cancer.

The problem is further exacerbated as there are no known vaccines for hepatitis C and prior treatment modalities were very painful injections. Only under very rare cases does hepatitis C resolve on its own without any treatment.

Effectiveness of the new oral treatment

Two years ago the FDA approved several new oral anti-viral drugs aimed at treating hepatitis C – namely, sofosbuvir and ledipasvir. This new form of oral therapy was claimed to be able to cure hepatitis C within three months.

Nevertheless, solid statistical information for these claims were lacking until recently, where sufficient patients and trials have been completed to fully assess the viability of the new treatment.

The two major issues when it came to treating hepatitis C was that it remained a ‘silent’ disease in the majority of individuals, as well as the fact that the only existing treatment was very painful. Fortunately, a new plan of action has been formulated around the new treatment with the goal of overcoming the aforementioned issues.

In regards to hepatitis C being a silent disease, healthcare advisory boards have begun to advocate screening for hepatitis C in all patients born between 1945 and 1965, which make up three-quarters of the hepatitis C population.

Meanwhile, the pain in hepatitis C treatments has also been eradicated with the new anti-viral medication being taken orally. There is a 90-100% cure rate within 12 weeks with very little side effects exhibited thus far.

The new medication also shows good future applications in both the field of paediatric medicine and research. For one, the FDA has approved the new drug for use in children aged 12 and above as of April 2017. Meanwhile, researchers are working on finding a suitable cocktail for the remaining 10% that are unaffected by the treatment.

Roadblocks to success

Despite all of its success, there still remains one major roadblock for this new treatment – cost. Currently, the entire treatment regime can cost anywhere from USD55,000 to USD155,000; despite the great number of healthcare facilities offering the treatment.

Even in the United States, the treatment would be difficult to obtain without sufficient funds or health insurance. The situation is even worse for the lower income and developing nations.

At present, a cost-to-benefit ratio of the new treatment has yet to be assessed. But the harsh reality remains that the treatment would not be fully available worldwide unless the price decreases. Until then, this treatment remains reserved for the privileged few who are able to afford it.

Currently, the incidence of hepatitis C cases is at a 15-year high because of the ongoing opioid epidemic. The need for a viable and effective treatment for hepatitis C could not have appeared at a more opportune moment.

The only catch, as mentioned, is its cost. Without addressing this, hepatitis C may soon become out of control and even the creation of a cure can do little in slowing it down. MIMS

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