What’s the Outlook and Life Expectancy for Hepatitis C?
Hepatitis C is a liver disease caused by infection with the hepatitis B virus (HBV). It affects more than 1 million Americans each year. Most people infected do not develop any symptoms or only mild ones. But some develop severe illness including jaundice, fatigue, nausea, vomiting, abdominal pain and fever. Untreated, it can lead to liver failure and death.
The average age at which people are diagnosed with hepatitis C is between 25 and 45 years old. About half of those infected never develop symptoms, while others experience them suddenly after they have been exposed to HBV. Those who develop symptoms usually recover completely within six months but a small percentage die from complications of their illness.
In 2015, there were approximately 2.5 million new cases of hepatitis C reported in the United States. Of these, almost 90% occurred among men who have sexual contact with other men (MSM) and black males aged 15–24 years. Among MSM, rates of infection are higher than among women; however, black females account for less than 10% of all female infections.
Recent reports have suggested that rates of new infections are falling steadily. The number of people infected is highest among those born between 1945 and 1965 and the virus can be spread through blood transfusions or from an infected mother to her baby.
It is a major cause of cirrhosis and liver cancer. Heavy alcohol use and certain diseases such as hemochromatosis and alpha-1 antitrypsin deficiency also increase the risk of getting or developing hepatitis C.
What is the latest news concerning hepatitis C?
The number of people in the United States who die from hepatitis C has dropped from 15,000 to 6,400 a year. This drop is due to a combination of factors, including more people getting tested, more people being treated successfully and the success of safer practices in hospitals.
Another factor is that people who get infected with both hepatitis A and B viruses have a lower risk of developing severe liver disease.
But the most startling new news is that a new and better treatment has been released that treats all types of hepatitis C. In February 2013, the Food and Drug Administration (FDA) approved another new drug for hepatitis C called sofosbuvir. It is a nucleotide analogue that prevents the hepatitis C virus from multiplying in your body and stops liver damage from occurring. It is sold under the brand name Sovaldi.
Sofosbuvir works in a very different way than older treatments and can be taken orally alone. It can lead to a better chance of cure in just eight to 24 weeks. It is very effective in various types of hepatitis C, including genotypes 1, 2 and 3, which cause the most damage to the liver.
Sofosbuvir was tested in combination with other drugs in 1,650 people with hepatitis C and preliminary results show it has a 95% cure rate.
Approved uses of sofosbuvir are for people with genotype 1 or 4 chronic hepatitis C who have had a liver transplant. It can also be used in people with genotype 2 or 3 who can’t take the DAA drugs for some reason.
It will be interesting to see how sofosbuvir will be used over the next few years. One possibility is for certain groups of people with genotypes 2 or 3 hepatitis C who can’t tolerate interferon and ribavirin. Another possibility is that people with genotype 2 or 3 may be treated initially with sofosbuvir alone and if it doesn’t work then interferon and ribavirin may be given.
What are the treatment options for hepatitis C?
Your doctor will determine how to treat your liver disease based on its stage (how much it has damaged your liver) and the type of virus that caused it. The five major types of hepatitis viruses are: A, B, C, D and E.
Hepatitis A is rarely fatal in developed countries and the infection usually clears up by itself. It can be spread through food or drink that has been handled by someone with the virus, through sexual contact, and in some parts of the world through contaminated sea food.
Hepatitis B is also rarely fatal and most people show no symptoms. It is spread in similar ways to hepatitis A. Most people become immune after a few months but it can lie dormant for many years and can return at a later date.
Hepatitis C was once rare in the United States but due to intravenous drug use and blood transfusions is now common. Most people don’t have any symptoms initially but the virus can still develop into a long-term (chronic) disease that can lead to liver failure or cancer.
Hepatitis D is similar to hepatitis B and only occurs in people already infected with hepatitis B.
Hepatitis E is also uncommon in the US and is spread through the environment and food, such as poorly washed vegetables.
The symptoms of all these viruses are similar and they all can cause a liver transplant or lead to liver cancer or cirrhosis. There is no specific treatment except for people with severe liver damage who need a transplant. New drugs have been developed over recent years that have increased the chances of a successful liver transplant.
Hepatitis A and E usually clear up by themselves but all other types can be life-long conditions that require regular tests and treatment. All types can cause liver cancer and cirrhosis. The two most common types of hepatitis are hepatitis B and C.
What are the new drugs for treatment of hepatitis C?
There are several new drugs for hepatitis C that have been approved by the FDA. Sofosbuvir (Sovaldi) was approved in December 2013 for the treatment of hepatitis C genotypes 1,2,3,4. In January 2014 it was approved for genotypes 1-6. Several other drugs have been or are in the process of being approved by the FDA
Daklinza – (daclatasvir) is a combination drug used with sofosbuvir to treat genotypes 3,4 and 5.
Harvoni – (ledipasvir and sofosbuvir) is used for the treatment of genotypes 1 and 3.
Olysio – (simeprevir) is used in combination with sofosbuvir to treat genotypes 2,3,4 and 5.
Viekira Pak – contains ombitasvir, paritaprevir and ritonavir for the treatment of genotypes 1, 2 and 3.
In addition the drugs ribavirin and interferon are sometimes used to treat hepatitis C.
What is the treatment for hepatitis C?
Treating hepatitis C has become simpler over the last few years with newer drugs that have fewer side effects and fewer strains of the virus these drugs are not without controversy however. Since the “gold standard” for treating hepatitis C used to include the drug interferon and a ribavirin, many physicians believe treatment will be more effective if these two drugs are also used.
Most physicians also believe that the new drugs should not be used alone but in combination with each other.
Where can I find treatment centers for hepatitis C?
The CDC has a list of treatment centers
How much does treatment cost?
The cost of treating hepatitis C varies between $60,000 and $100,000 for a 12 week course of treatment.
Why are pharmaceutical companies selling the drugs so cheap?
The new drugs, or direct acting anti-virals as they are known to scientists, were developed over a 10-15 year period and cost pharmaceutical companies over $1 billion dollars to develop. They are very effective in treating hepatitis C and cause far fewer side effects than the older drugs like interferon and ribavirin that they have replaced.
Why are the drugs so cheap then?
The main reason is that pharmaceutical companies are not selling them at a profit – they are selling them at cost. They are simply trying to get the population of hepatitis C sufferers to quickly get diagnosed and then treated before rival drugs appear on the market that will provide a better cure. A similar situation occurred in the 90s when the “3TC” drug was replaced by a combination of other drugs that had fewer side effects. The cost of that drug nearly doubled when the patent expired.
Pharmaceutical companies are in fierce competition with each other and the introduction of new drugs is a very profitable exercise for them.
Will the price go up in the future?
Yes, the price of these drugs is certain to increase as competition increases and the market becomes more profitable.
The current drugs have a 90% cure rate and very few side effects, compared to interferon which has a 40% cure rate but leaves 60% of patients too sick to work or carry out their normal daily activities for a year or more.
The current drugs are a one time treatment and last for the rest of your life.
Newer drugs that have a higher cure rate with fewer side effects are in development and will probably be available over the next two years.
Who pays for treatment?
Insurance companies are now required to pay for these drugs and Medicaid in most states requires patients receive these drugs as part of their treatment.
Who is most likely to get the hepatitis C virus?
People who received blood transfusions before 1992 are at a high risk of having been exposed to the hepatitis C virus, as this is when reliable tests began to be used in the USA. Also people who received injected drugs and had multiple sexual partners before 1990 are also considered to be at high risk.
How can I find out if I have the virus?
In Australia all pregnant women are tested for the virus as a matter of course, and many doctors now routinely test their patients who may be at risk. In the USA it is advised that if you think you may have been exposed to the virus (eg.