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Hepatitis C Treatment

The treatment of hepatitis C revolves around medications that help the body get rid of the hepatitis C virus (HCV). There are many treatment options for hepatitis C, and the drug regimen is what doctors recommended as the first step of treatment. The medications vary depending on the type of virus you have and their genotype.

There have been rapid developments in the treatment and medications for hepatitis C, and new drugs today are helping people who did not experience success with therapy in the past. Medical experts are today also helping those people receive treatment who were unable to receive HCV treatment before due to other medical issues.

These new medications are also not only more effective, but they also have fewer side effects.

Antiviral Drugs Vs Protease Inhibitors: Overview

They are:

Antiviral Drugs

Traditionally, a combination of two antiviral drugs has been used for treating hepatitis C. Antiviral drugs are medications that work towards getting rid of the virus from the body.

The two drugs that are commonly used are known as pegylated interferon (PEG-INF) and ribavirin (RBV). PEG is administered as a weekly injection, while ribavirin pills are to be taken two times every day.

It generally takes anywhere between six months to a year to complete one round of this combination therapy, typically known as PEG/RBV.

PEG/RBV therapy is known to have worked for less than half of the people who have genotype 1 HCV infection, which is the most commonly occurring type of HCV in the US. (1) Nearly 75 percent of Americans who have hepatitis C suffer from genotype 1 of the infection.

The side effects of PEG/RBV therapy can be severe. These may include:

From 2011 onwards, the treatment options witnessed an improvement with the introduction of a new class of drugs known as direct-acting antivirals (DAAs). These medications work to directly destroy the virus by interfering with its ability to reproduce and multiply to remain inside the body.

DAAs are far more effective against most types of hepatitis C as compared to interferon and ribavirin. DAAs are also known to have fewer side effects.

Today, DAAs have become the standard treatment for people with chronic hepatitis C. PEG/RBV therapy is now usually no longer recommended for managing hepatitis C infections.

However, there are certain DAAs that can still lead to some adverse reactions with other drugs, for example, cholesterol-lowering statin drugs. Certain medications prescribed for erectile dysfunction can also cause an adverse reaction with DAAs.

Protease Inhibitors

Protease inhibitors are the new type of DAA medications that are today widely used for treating HCV infections. There are four protease inhibitors on the market for the treatment of hepatitis C. (2) These include:

  • Glecaprevir
  • Grazoprevir
  • Simeprevir (Olysio)
  • Paritaprevir

All of these protease inhibitors are used in combination with other medications, depending on what type of hepatitis C you have.

Protease inhibitors are also far more effective at treating all genotypes of hepatitis C as compared to the previously used therapies for hepatitis C. These drugs are also known to cause fewer and less severe side effects.

New Interferon-free Therapies

In late 2014, two advanced, interferon-free therapies have become available in the US for the treatment of genotype 1 hepatitis C. These medications, being sold as Viekira Pak and Harvoni, are the first all-oral and interferon-free therapies that have become available for people with genotype 1 hepatitis C.

  • Harvoni is available as a single tablet that is composed of a combination of two drugs. It is meant to be taken once a day for 12 to 24 weeks.
  • Patients who are using Viekira Pak, which is a combination of three medications, are meant to take four to six pills every day for at least 12 weeks.
  • Both these medications have shown to cure more than 90 percent of patients who have genotype 1 HCV infection. (3)

Conclusion

The new medications that have emerged for the treatment of hepatitis C are known to have fewer and less severe side effects. The side effects are generally mild and usually, only include minor headaches and fatigue.

Before you begin any treatment for hepatitis C, you must discuss all the available medication options with your doctor. This also includes over-the-counter medication, as well as prescription drugs.

References

  1. Chi.org. (2019). [online] Available at: http://www.chi.org/industry-intelligence-and-analysis/chi-reports/chi-report-innovation-in-hepatitis-c-treatment-page-3/ [Accessed 23 Oct. 2019].
  2. Casey, L.C. and Lee, W.M., 2013. Hepatitis C virus therapy update 2013. Current opinion in gastroenterology, 29(3), pp.243-249.
  3. HHS.gov. (2019). FDA Approves Viekira Pak To Treat Hepatitis C. [online] Available at: https://www.hhs.gov/hepatitis/blog/2014/12/19/fda-approves-viekira-pak-to-treat-hepatitis-c.html [Accessed 24 Oct. 2019].

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