New Drug Continues The Winning War Against Hepatitis C

With the FDA approval of Epclusa ten days ago, the medical community now has a strong armamentarium of side effect free oral medications to eradicate hepatitis C. These medications which include Harvoni, Vykiera, Zepatier and now Epclusa have 95 to 100% chance of permanently curing chronic hepatitis C infections, with eight to twelve weeks of treatment consisting of one or two pills a day. Several hundred thousand people have already been cured of their hepatitis C, but an estimated two million or more are still out there carrying the disease. Many of these people may not even know they have it as the disease may be quiescent for decades before the liver-destroying effects begin.

For complicated epidemiologic reasons a large reservoir of chronic hepatitis C infection resides in the population born between 1945 and 1965. Therefore, the CDC recommends that all patients born in that period get tested to see if they may be infected (even though they have no symptoms at all, and may have no specific risk factors like exposure to transfusions). In addition anyone who has needle exposure or transfusion exposure in their lifetime should be tested. The test is a simple blood test that can be performed by or ordered by any physician.

Hepatitis C also appears to have an increased incidence in persons born in Eastern Europe and Egypt as a result of exposure to contaminated needles and blood products during infancy. Following some wrangling with the medical profession and the government, almost all health insurance companies are now approving these new treatments for hepatitis C in totally asymptomatic patients without overt signs or symptoms of liver disease. The liver team at Vanguard Gastroenterology, under the direction of Hillel Tobias, MD PhD, Clinical Professor of Medicine in the New York University Langone Medical Center Division of Gastroenterology, has been very active for many years in the diagnosis and treatment of hepatitis C as well as the management of patients with symptomatic, early or advanced liver disease. We can be reached at call us.

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