1. New Treatment Options for Hepatitis C in 2014 | Columbia University Department of Surgery Blog 3/23/14, 8:54 AM
New Treatment Options for Hepatitis C in 2014
by Columbia Surgery on February 10, 2014
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Most people are aware of the implications of being diagnosed with HIV, but few have any notion
how to live with Hepatitis C. Both viruses are spread through some similar means, but for reasons
beyond this blog post, HIV is in our usual lexicon, and Hepatitis C (HCV) is not. This is about to change
thanks to new research that has and will lead to breakthrough treatments for this disease.
Between four and five million Americans currently have HCV—most were infected in the 1960s through the
1980s. Fifty percent of these HCV infections are caused by intravenous or other drug use (even casual
experimentation decades ago), the rest are from blood transfusions, body modifications such as tattoos and
piercings, and sexual transmission.
Hepatitis C
Those with HCV have up to a 37% risk of mortality due to liver failure. Hepatitis C starts insidiously as
inflammation and scarring (fibrosis) but then can progress to cirrhosis and liver cancer (hepatocellular
carcinoma). Because HCV is asymptomatic, up to 75% of cases aren’t diagnosed until it is too late.
Unfortunately our screening procedures don’t work well in targeting populations at risk, because the risks
occurred so long ago and may not even be remembered.
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2. New Treatment Options for Hepatitis C in 2014 | Columbia University Department of Surgery Blog 3/23/14, 8:54 AM
But, we are close to a tipping point. Due to the development of new drugs HCV will soon be curable in the
vast majority of patients. The decades old therapy of interferon and ribavirin work in some, but require
lengthy treatment and have hard-to-tolerate side effects.
To help make more sense of these new drugs, and to better understand the changes that will be coming in the
treatment of Hepatitis C, please join Dr. Robert S. Brown, Jr. of the Center of Liver Disease and
Transplantation for his webinar New Treatment Options for Hepatitis C in 2014 to be held on February 27th
at 1:00 PM/ET.
Topics discussed and questions to be answered include:
What is the timeline for DAA treatment therapies? What can HCV patients expect in the next few
years?
What are the survival rates and treatment costs for HCV?
What sub-populations of HCV patients require special attention?
What are the results and updates for the latest Hepatitis C clinical trials?
What factors should be considered when developing a personal treatment regime for someone affected
with HCV?
To register for this program and request a reminder please visits our New Treatment Options for Hepatitis C
in 2014 webinar page. To submit a question for Dr. Brown to answer live on our show, visit our question
submission form or send an @ reply to our @columbiasurgery Twitter account.
The common drugs used to treat HCV and the ways in which they are combined are:
Interferon
Interferon does not attack a cancer or virus directly,
but boosts the immune systems response to these
diseases.
There are different types (alpha, beta, lambda &
gamma) used to treat different diseases.
Many patients cannot tolerate interferon due to side
effects and co-morbidities.
Ribavirin
Ribavirin affects the reproductive capabilities of
the virus through its RNA and DNA.
It is a synthetic chemical not found in nature.
Ribavirin does not have as many side effects as
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3. New Treatment Options for Hepatitis C in 2014 | Columbia University Department of Surgery Blog 3/23/14, 8:54 AM
interferon but is a teratogen, which means it can
cause birth defects in a fetus or embryo.
Interferon & Ribavirin
Interferon and ribavirin have been used to treat
Hepatitis C for almost 20 years.
Interferon and ribavirin must be taken for at least 6
months usually up to a year.
This drug combination cures less than half of the
patients with HCV genotype 1 and 70% of the
patients with genotypes 2 & 3.
Boceprevir & Telprevir
Developed in May of 2011, boceprevir and
telprevir were the first drugs to act directly on the
HCV virus (DAA).
Boceprevir and teleprevir increased the cure rate
for HCV genotype 1 to 70%. (This is the same cure
rate for HCV genotypes 2 & 3 using interferon and
ribavirin.)
A treatment regime with boceprevir or telprevir,
with interferon and ribavirin lasts 24-48 weeks.
Sofosbuvir, Interferon & Ribavirin
Sofosbuvir was approved as first-in-class
nucleotide drug in December 2013.
When combined with interferon and ribavirin,
sofosbuvir can be used to treat HCV genotype 1 for
12 weeks with a cure rate of 90%.
When combined with interferon and ribavirin,
sofosbuvir for 12 weeks can also treat some
genotype 3 patients. (This is off-label.)
Sofosbuvir & Ribavirin
Sofosbuvir & ribavirin for 12-24 weeks cured HCV
and allowed the elimination of interferon for the
treatment for ~90% of HCV genotype 2 and for
many HCV genotype 3 patients.
The combination of these drug classes together has
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4. New Treatment Options for Hepatitis C in 2014 | Columbia University Department of Surgery Blog 3/23/14, 8:54 AM
Sofosbuvir with Simeprevir or NS5A
inhibitors
not been approved for use by the FDA, but will be
important since interferon and, likely, ribavirin will
no longer be needed.
Tagged as: Brown, Hepatitis C
{ 12 comments… read them below or add one }
Jacqueline F. February 12, 2014 at 1:11 am
Thank you for the information HCV. I am scheduled to see a liver specialist here in Georgia. I have a
neighbor who started on this new treatment/medicine and she is loosing her teeth. She says this is one
of the side effects. I am concerned about side effects because I am a Light Weight where medications
are concerned but I want to be cured and this may be the opportunity. I contact HCV in 1982 after a
blood transusion during a complicated pregnancy.
Much Appreciation
Jacquie
Jennie February 14, 2014 at 2:44 pm
hello my brother is suffering from hep C, and now it is starting to effect his liver, he doesn’t own a
computer but I’m interested in ways of prolonging his life. could you help me?
Best Regards
Jennie
Columbia Surgery February 15, 2014 at 8:55 am
Jacqueline:
Thank you for your question. I’ll send it to Dr. Brown for the show.
If you have the chance, please tune in on the 27th at 1:00 PM. After that, we’ll have a recorded version
on our Columbia Surgery YouTube channel at http:www.youtube.com/columbiasurgery
Columbia Surgery February 15, 2014 at 8:56 am
Jennie:
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5. New Treatment Options for Hepatitis C in 2014 | Columbia University Department of Surgery Blog 3/23/14, 8:54 AM
Thank you for your question. I’ll send it to Dr. Brown.
If you have the chance, please tune in for our show. After that, we’ll have a recorded version on our
Columbia Surgery YouTube channel at http:www.youtube.com/columbiasurgery as well as an
embedded copy here on this page.
Ngangbam L February 15, 2014 at 4:39 pm
I have been treated with peginterferon and rivabirin for 24weeks in 2013 .Am I cured from hep c???
Columbia Surgery February 18, 2014 at 2:53 pm
Ngangbam:
Thanks for your question. I’ll send this to Dr. Brown to be answered during his show on the 27th at
1:00 PM ET. If for some reason you cannot make that time, please bookmark this article or go to our
YouTube channel at http://www.youtube.com/columbiasurgery. We’ll have a recorded version available
for you to access on-demand.
Claudia February 20, 2014 at 9:43 pm
My brother could not tolerate ribavirin even though it was working. It was destroying his skin. Is there
a treatment that doesn’t involve ribavirin? Thank you -
Columbia Surgery February 26, 2014 at 10:41 am
Claudia
Thank you for your question. I’ll be sure to forward it to Dr. Brown to answer during the webinar.
If you have the chance, please tune in tomorrow at 1:00 PM/ET. After that, we’ll have a recorded
version on our Columbia Surgery YouTube channel at http://www.youtube.com/columbiasurgery
Claudia March 9, 2014 at 11:58 pm
Hi, I couldn’t download the software to join the webinar live, so I’ve been checking youtube for the
recording but can’t locate it. Will it be available soon?
Columbia Surgery March 10, 2014 at 10:49 am
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6. New Treatment Options for Hepatitis C in 2014 | Columbia University Department of Surgery Blog 3/23/14, 8:54 AM
Hi Claudia,
Thank you for your interest in the webinar. I apologize for the delay, but we expect to have the webinar
available by week’s end. I will reach out again once it is live. Thank you for your patience. All the best.
Judith March 10, 2014 at 3:12 pm
My husband is in week 22 of triple therapy, Peg, Riba and Victrelis. Can he change to new drug Sofo
mid-treatment?
Columbia Surgery March 12, 2014 at 11:15 am
Hi Judith,
Thank you for your question. Unfortunately, this webinar has already occurred. You can watch an
archived version of the webinar on our YouTube Channel. We hope this helps provide you and your
husband with additional information about the new treatment.
For more information about Hepatitis C or to arrange a consultation with Dr. Brown, call the Center for
Liver Disease and Transplantation at 877-LIVERMD (877-548-3763) or visit http://www.livermd.org.
Thank you.
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