Nearing a Cure for Hepatitis C


In the contest to get a creative name, few pathogens have done worse than hepatitis C. In the 1970s there were two known viruses that caused hepatitis – liver inflammation. You might have already guessed that these two viruses were called hepatitis A and hepatitis B. It was known at that time that people sometimes developed hepatitis after blood transfusions and that the majority of those patients tested negative for hepatitis A and B. A new pathogen was hypothesized and called non-A-non-B hepatitis. It wasn't until 1989 until the virus was isolated and named [drum-roll please] hepatitis C.

Hepatitis C is transmissible through contact with blood. Before the advent of routine testing of the blood supply it was transmitted through transfusions. It is still transmitted through the sharing of drug and tattoo needles and, in less developed countries, through the reuse of unsterilized medical equipment. Hepatitis C can cause liver failure and liver cancer. There are over 3 million people in the US who are infected with hepatitis C. It is the leading cause of liver transplantation and liver cancer in the US.

There are vaccines against hepatitis A and B, but none yet for hepatitis C.

For decades the standard therapy for hepatitis C has been a regimen including interferon and ribavirin. Interferon has to be given by injection and can have debilitating side effects. A course of treatment lasts 6 to 12 months, and many who begin a course are unable to tolerate it. Fewer than 50% of patients who are treated with this regimen have a meaningful benefit. Because of the length and difficulty of the treatment many hepatitis C patients are thought to be poor candidates and never are offered treatment.

Most of my posts are about a new interesting study, but this post is about a whole crop of studies published in the last two months in the New England Journal of Medicine (NEJM) about the safety and efficacy of novel treatments for hepatitis C. (For links to the individual studies, see the right sidebar of ” target=”_blank”>MERS and ” target=”_blank”>New Drug Combination Highly Effective For Hepatitis C (Forbes)
” target=”_blank”>A Costly Cure for Hepatitis C (The Medical Letter blog)
” target=”_blank”>Therapy of Hepatitis C — Back to the Future (NEJM editorial, free without subscription. The right sidebar has links to all the recent studies of drug trials for hepatitis C.)

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