Galveston County Daily News February 25, 2014
Medical Discovery News
By Drs. David Niesel and Norbert Herzog
Good news awaits hepatitis C patients. In the next few years, new drugs that specifically target the Hepatitis C virus, curing a person more quickly without the severe side effects, will become available. Some physicians and patients are even opting to wait for these new drugs rather than endure the current therapy.
Today, this viral infection is most often acquired by drug users sharing needles. The hepatitis C virus can cause a mild illness lasting a few weeks but in some people it can cause a serious lifelong illness. One major problem is that many people are unaware that they are infected until they have symptoms of liver damage. It is the leading cause of cirrhosis and liver cancer and the most common reason for liver transplantation in the United States.
An estimated three to four million Americans are infected, and deaths from hepatitis C are expected to rise in the future as those unaware of their infections begin to have symptoms. There is no vaccine and the current drug regimens can cure about 70 percent of infected people but the serious side effects include anemia, insomnia, depression, fever and severe rashes.
Hepatitis C is most commonly treated with a combination of interferon and ribavirin for 24 to 48 weeks. However, because of their side effects and the fact that the drugs do not work for everyone, drug companies have been working hard to develop new treatments.
These new drugs are predicted to wipe out hepatitis C infections with one pill per day for as little as eight weeks, without severe side effects. The only downside is their predicted costs range from $60,000 to more than $100,000 for a course of treatment. The new drugs, much like those that are used to treat HIV infection, target enzymes the hepatitis C virus requires to reproduce. However, the hepatitis C virus does not make its genetic information a permanent part of a cell’s genome like HIV does, so it can be eliminated, therefore curing the person. If the virus is eliminated, the liver can heal itself to some extent, but people cured of hepatitis C may still be at higher risk for liver cancer.
One of these new drugs, called sofosbuvir by Gilead Sciences Inc., inhibits the enzyme that copies the virus’s genetic information, therefore blocking virus reproduction. The effectiveness of the drug depends on the type of hepatitis virus. The majority of hepatitis C patients in the United States would require the addition of interferon for 12 weeks. Gilead has a second drug nearly ready called ledipasvir, which in combination with ribavirin could eliminate the need for interferon, the source of the worst of the side effects of current treatments.
Several other companies are racing to introduce additional medications to treat hepatitis C. Having tolerable therapies available will encourage people to get tested and treated earlier for hepatitis C, before liver damage begins. This is a huge benefit to public health that will substantially reduce the need for liver transplants and the number of deaths from liver failure and liver cancer.
Medical Discovery News is a weekly radio and print broadcast highlighting medical and scientific breakthroughs hosted by professor emeritus Norbert Herzog and professor David Niesel, biomedical scientists at the University of Texas Medical Branch at Galveston. Learn more at www.medicaldiscoverynews.com.