In recent years, the outlook for people with chronic hepatitis C virus (HCV) has changed dramatically for the better. New anti-viral drugs have made HCV curable for many people. These drugs can be used alone or in combination with other medications.
Why Is Hepatitis C a Big Deal?
HCV causes an infection that attacks the liver. If the disease becomes chronic, it can lead to liver disease. This can include cirrhosis of the liver, liver cancer, and even liver failure.
HCV is transmitted through blood and other bodily fluids. At one time, the disease frequently was spread through blood transfusions. Today, current or former intravenous drug users and people who received blood transfusions before 1992 are at the greatest risk. Often, people don’t experience symptoms until the disease progresses. The virus disappears without treatment in about 15 to 20 percent of people who are infected.
Hepatitis C and Its Treatment: A Timeline
Hippocrates described a condition he called “epidemic jaundice.” In the 8th century A.D., Pope Zacharias quarantined men and horses with jaundice. This was meant to control the spread of the disease.
Jaundice was reported throughout many centuries. More than 40,000 cases were recorded in the Union Army during the Civil War. It was so prevalent among armies that the condition is sometimes referred to as “campaign jaundice.” Scientists today believe many of these cases of jaundice were forms of hepatitis.
Hepatitis and World War II
Approximately 182,383 service members were hospitalized for HCV during World War II. The disease was contracted in two different ways. The two different types that are recognized are serum and acute.
An epidemic of hepatitis broke out among many service members who were vaccinated against yellow fever. The source of the infection was traced to the serum, or clear fluid in the blood, that was used in the vaccine. This form of the disease became known as serum hepatitis.
A different form of hepatitis, acute hepatitis, was found among soldiers who had received blood transfusions.
Hepatitis B Is Accidentally Discovered
Baruch Blumberg was researching genetic links to disease susceptibility. During this time, he accidentally discovered the hepatitis B (HBV) virus in the blood sample of an Australian Aborigine. This discovery led to the development of a test to screen people for HBV. This also led to an effective vaccine for the disease. In 1976, Blumberg was awarded the Nobel Prize for his work.
Hepatitis A Is Discovered
Led by Steven Feinstone, scientists at the National Institutes of Health identified the virus responsible for hepatitis A (HAV). The virus was discovered in fecal samples from prisoner volunteers. Noted microbiologist Maurice Hilleman developed the first effective vaccine for HAV in 1981.
A Previously Unrecognized Hepatitis Is Found
American and British researchers identified a type of hepatitis that didn’t test positive for the proteins found with HAV or HBV. Both teams conclude that a previously unrecognized human hepatitis virus is the likely cause.
Hepatitis C Virus Is Identified
The Centers for Disease Control and Prevention and Chiron came together to identify the hepatitis C (HCV) virus. There isn’t a vaccine for HCV at this time.
A New Drug to Treat HCV Is Approved
The Food and Drug Administration (FDA) approved interferon alfa-2B (Intron A), the first of the interferon drugs for the treatment of HCV in 1991. Interferons are proteins found in the human body. They were given their name because they interfere with virus’ ability to replicate.
Testing of the Blood Supply Begins
Screening the United States’ blood supply for HCV began in 1990. But in 1992, a more sensitive test became available. Today, the risk from known genotypes of HCV is virtually nonexistent.
FDA Approves Combination of Interferon and Ribavirin
The anti-viral drug ribavirin is used to treat some viral infections. When used alone, this drug proved ineffective in treating HCV. When used in combination with interferon and other drugs, it became an important element of HCV therapy. This drug is most effective in preventing HCV relapse rather than as an anti-viral agent.
Pegylated Interferon Boosts Effectiveness of Interferon
Peginterferon alfa-2b (PegIntron) is a mix of interferon and polyethylene glycol. This combination helps the drug stay in your bloodstream longer. The FDA approved both pegylated interferon and the combination of pegylated interferon with ribavirin.
Rapid Antibody Test Improves HCV Detection
The detection of HCV was transformed when the FDA approved a rapid antibody test called OraQuick. This test gives you results in just 20 minutes.
New Direct-Acting Anti-Virals Are Approved
The FDA approved these new medications for HCV in 2013:
- Sofosbuvir (Sovaldi) is a new drug that can be used in therapies without the addition of pegylated interferon. The cost of this breakthrough drug is extremely high. This places it out of reach for many people throughout the world. There’s a compassion program called SupportPath, which can partially or fully subsidize the drug for qualified individuals.
- Sofosbuvir (Sovaldi) combined with ribavirin provides similarly effective treatment without pegylated interferon.
- Simeprevir (Olysio) is an effective new drug that’s also used without pegylated interferon. It offers many of the same benefits as sofosbuvir.
These drugs vary in effectiveness depending on the drugs used and the genotype of the HCV. For example, one study found that sofosbuvir (Sovaldi) combined with ribavirin cured 95 percent of people with genotype 2.
In addition to higher cure rates, all three drugs offer a far shorter length of treatment and fewer side effects. They’re available in pill form.
The Future of HCV Treatment
Approximately 2.7 million Americans have chronic HCV infection. However, the future has never looked brighter for those with the virus. The new drugs that are being developed and tested bring the promise of a cure within reach for many people affected by HCV.