New drugs hailed as a new dawn for people with hepatitis C
Liver Health New drugs becoming available now could cure hepatitis C with few side effects, but many patients may have to wait for them, says a leading hepatologist.
"New drugs now becoming available in England could eliminate deaths from hepatitis C," says Professor Graham Foster, consultant hepatologist at Barts Health NHS Trust.
Hepatitis C, a viral infection spread through bodily fluids, affects over 200,000 people in the UK. Many are undiagnosed as it can lie dormant for up to 30 years. Of those infected, 75 per cent develop the chronic form of the disease, which can lead to permanent liver scarring (cirrhosis) and liver cancer. Public Health England reported in July 2014 that UK deaths from hepatitis C had quadrupled in 16 years to around 400 in 2012.
However, only 3 per cent people who develop chronic hepatitis C annually get treatment to help clear the virus and without better treatment an extra 2,700 people could face hepatitis-C-related liver cancer or cirrhosis in England before July 2015. Given access to new drugs, however, 8,000 people could avoid the often-fatal complications by 2025.
"Without better treatment we will see more end-stage liver disease, liver cancer and demand for transplants leading to a huge rise in costs," says Professor Foster.
Previously the treatment has been combination therapy: a 6 to 18 month course of interferon and an antiviral drug, which eliminated the virus in about 70 per cent of cases. However, debilitating side effects led many patients to reject treatment or drop out.
The new drugs, however, that include a variety of direct-acting antiviral agents, have been shown in clinical trials to eliminate the hepatitis C virus in 95 per cent of previously untreated patients within eight to 24 weeks - with many fewer side-effects. The new drugs treat all of the six genotypes of hepatitis C but in genotype 3 response rates are slightly lower. They work with genotype 1 which is harder to treat with interferon-containing combination therapy.
However, many people with Hepatitis C will have to wait for access to the new drugs. Though approved for use in the UK before Christmas 2014 the NHS has so far restricted their use to people with decompensated (severe) cirrhosis. However, says Professor Foster: "NHS England has indicated that it will consider treating people with less severe disease from April 2015. That is not guaranteed, but I hope it will be the start of a rolling programme to treat everyone with hepatitis C."
People with severe hepatitis C-related cirrhosis should ask for treatment now, he says. Those with a milder condition must wait for the NHS to make the drugs available to them or pay £30,000-£40,000 for a course.