Understanding hepatitis C

Hepatitis C is a potentially life-threatening disease of the liver. Over time, it can lead to cirrhosis, liver cancer, and liver failure. Hepatitis C is caused by the hepatitis C virus (HCV), which is spread through contact with infected blood.

More than 130 million people are infected with HCV worldwide. Most people with HCV don’t experience any symptoms for years. Some people don’t have symptoms.

If early symptoms are present, they can include:

  • mild fatigue
  • joint pain
  • muscle pain
  • low energy
  • nausea
  • a lack of appetite

As the disease advances, symptoms can include:

  • severe fatigue
  • persistent nausea
  • vomiting
  • a loss of appetite
  • yellowing of the skin and whites of the eyes, which is called jaundice
  • low-grade fever

What is Harvoni?

For many years, there were only a few medications available to treat HCV. These medications were expensive and often came with serious side effects. They weren’t always effective, either.

In the early 2000s, researchers began to develop more effective ways to cure HCV. That’s where Harvoni came in. During clinical trials, this drug cured 94 percent of the people who took it for 12 weeks. Harvoni is a combination pill made up of ledipasvir and sofosbuvir.

Sofosbuvir is a polymerase inhibitor. It interferes with the action of a protein needed for the growth of the virus. This prevents HCV from multiplying. In 2013, the U.S. Food and Drug Administration (FDA) approved sofosbuvir as a stand-alone treatment (Sovaldi) for HCV.

The FDA approved Harvoni in 2014. During this time, the FDA approved ledipasvir only as part of the combination medication Harvoni.

Harvoni is a direct-acting antiviral medication. This means that the medication can directly attack the virus and prevent the virus from replicating. Harvoni was designed to treat people with HCV genotype 1.

A genotype is the particular strain of the virus. Developing drugs that could effectively target the particular genotype was a major step in the ongoing effort to find effective cures. HCV strains include genotypes 1, 2, 3, and 4.

Learn more: Harvoni vs. Sovaldi: A side-by-side comparison »

What to expect during treatment

Harvoni is an oral tablet that’s taken once per day, with or without food. It was the first combination pill that allowed people with genotype 1 to adhere to an all-oral medication regimen. Previously, HCV treatment included the use of an injection drug called interferon.

A typical course of Harvoni treatment takes 12 weeks. For people with cirrhosis of the liver, treatment may last 24 weeks. You may have the best results if you take the drug at the same time every day. Follow your doctor’s advice about dosage. Taking a smaller or larger dose than the one prescribed may render the drug less effective.

You may still pass the virus to another person while you’re taking Harvoni. It’s important that you follow your doctor’s orders about safety and preventing the spread of HCV. Frequent blood tests may be ordered throughout your treatment to determine whether the virus has been eliminated.


Risk factors to consider

Harvoni is generally well-tolerated. The most common side effects are headache and fatigue.

There are some drug interactions that can occur in people taking Harvoni. For example, you shouldn’t take an antacid within four hours of taking a Harvoni pill. You should also avoid the herbal supplement St. John’s wort and the antibiotic rifampin, which is usually prescribed to treat tuberculosis.

How to afford Harvoni

Harvoni, like all HCV treatments, is expensive. The wholesale cost of a 12-week treatment is more than $90,000. That price doubles for a 24-week treatment.

Medicare, Medicaid, and some private insurers cover Harvoni, at least in part. You should discuss your coverage of Harvoni with your insurer before starting therapy.

The medication’s manufacturer, Gilead Sciences, also has an assistance program to help those who can’t afford the drug. Your doctor or pharmacist may also know of other programs to help cover the cost of therapy.

Speaking with your doctor

Harvoni is proving to be an expensive but effective drug. If it’s taken correctly, this medication can clear the virus from your system in as little as 12 weeks.

If you’ve been diagnosed with HCV, you should discuss your treatment options with your doctor as soon as possible. Together you can decide which course of treatment is best for you. The earlier you begin treatment, the less time there is for liver damage to occur.

Keep reading: The effects of Harvoni on the body »