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The Beginning of the End for HCV?

Hepatitis C (also known as hep C) is a viral infection that can cause serious and permanent liver damage. The goal of treatment is to clear the virus from the body and stop, slow and prevent liver problems. Until recently, doing that involved inconvenient and painful injections of interferon and a pill called ribavirin. That therapy is known for its toxic side effects and has been compared to "low-grade chemo." Worse, it doesn't always work that well. These traditional drugs offer a 50% cure rate at best.

But today, we're witnessing a revolution in hepatitis C treatment, as more and more medications that directly target the virus gain approval. These medications offer better cure rate, instead of a partial clearing of the virus. And, as a bonus, most come in the form of a pill. They have fewer side effects and work much faster—which means you don't have to stay on treatment as long as compared to interferon and other drugs.

The rapidly-evolving Hep C medication list is giving new hope for the 3.2 million Americans living with the chronic form of the disease. Antiviral therapy for hep C continues to rapidly evolve with the introduction of new drugs and treatment regimens that vary based on hep C genotype, previous treatments, and the presence of cirrhosis. Here's a closer look at some of the currently prescribed interferon-free medicines for hepatitis C.

HARVONI (Ledipasvir and Sofosbuvir)

This drug — a once-a-day pill — ushered in a new era of hep C medications. The FDA approved Harvoni in October 2014, making it the first interferon-free treatment for people with the most common form of the disease, called genotype 1 (type 1). The pill is also the first to combine two medicines that effectively eliminate the hepatitis C virus (HCV). Such medicines are called direct-acting antivirals. They get in the way of proteins in the body that the virus relies on to grow and multiply.

In studies, the drug cured the infection in 94% of patients in just 12 weeks. Common side effects are fatigue, headache, upset stomach, diarrhea, and sleeping difficulty. Harvoni is approved for use in children ages 12-17. One tablet Ledipasvir 90mg & Sofosbuvir 400mg taken orally with or without food.

Available Generic Substitutes of HARVONI 90MG/400MG : Hepcinat LP, Ledifos, HepCvir L, Ledviclear, MyHep LVIR, Sofokem L......VIEW MORE

SOVALDI (Sofosbuvir)

Solvaldi, a once-daily pill, was approved to treat HCV genotypes 1, 2, 3 and 4. This was the first drug that allowed genotype 2 and 3 patients to be treated with pills only, offering an interferon-free regimen with ribavirin. The first line therapy for genotype 1 and 4 patients became a 12-week combination regimen with peginterferon and ribavirin. Patients ineligible for interferon could be offered a 24-week regimen of sofosbuvir and ribavirin.

The FDA approved it as a "breakthrough therapy" in December 2013. According to the FDA, such designation means "preliminary clinical evidence indicates the drug may demonstrate a substantial improvement over available therapies for patients with serious or life-threatening diseases." (Other new hepatitis C drugs have also received this designation.)

The most common side effects are fatigue, headache, sleeping difficulty, nausea, insomnia, anemia and upset stomach. One tablet Sofosbuvir 400 mg taken orally with or without food.

Available Generic Substitutes of SOVALDI 400 MG : MyHep, Sofocure, Sofovir, Virso, Hepcinat, Sovihep, Resof......VIEW MORE

EPCLUSA (Sofosbuvir and Velpatasvir)

Epclusa is a once-daily, fixed-dose combination tablet approved for the treatment of adults with chronic HCV genotype 1-6. Epclusa for 12 weeks was approved in patients without cirrhosis or with compensated cirrhosis, and in combination with ribavirin for patients with decompensated (advanced) cirrhosis.

International clinical trials involving 1,035 patients with genotype HCV 1-6 without cirrhosis or compensated cirrhosis, received 12 weeks of Epclusa. Twelve weeks after treatment, their blood was tested to see if the hepatitis C virus was no longer detectable, indicating they achieved a sustained virologic response (SVR 12), or cure; 1,015 trial participants (98%) achieved SVR12 and were considered cured.

In another study, 267 patients with HCV genotype 1-6 with decompensated cirrhosis received 12 weeks of Epclusa with or without ribavirin, or 24 weeks of Epclusa. Patients that received 12 weeks of Epclusa with ribavirin had the highest cure rate (94%), compared with those who received Epclusa for 12 weeks (83% cured) or 24 weeks (86% cured).

The most common side effects of Epclusa were headache and fatigue. When Epclusa was given with ribavirin, common side effects included fatigue, headache, anemia, nausea, insomnia and diarrhea. Serious slowing of the heart rate (bradycardia) may occur when amiodarone (brand names Cordarone, Pacerone, Nexterone), a medicine used to treat heart problems, is taken with Epclusa.

One tablet Sofosbuvir 400 mg and Velpatasvir 100 mg taken orally once daily with or without food.

Available Generic Substitutes of EPCLUSA 90MG/400MG : Velpanat, Myhep All, Sovihep V, Hepcvel, Velasof, Sofocure V......VIEW MORE

DAKLINZA (Daclatasvir)

Daklinza is the first drug that demonstrated safety and efficacy in treating HCV genotype 3 without the need for co-administration of interferon or ribavirin. (This type of hepatitis C affects about 1 in 10 people infected with the virus.) The once-a-day pill is taken with Sofosbuvir (Solvaldi). The treatment boasts cure rates similar to the other, landmark hepatitis C medicines. In studies, 98% of patients without cirrhosis had no traces of the virus in their blood after 12 weeks.

The most common side effects are fatigue and headache. The FDA warns it can sometimes cause a serious slowing of the heart rate, which may require a pacemaker. The recommended dose of Daclatasvir is 60 mg once daily, to be taken orally with or without food.

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It’s a very exciting and hopeful time for people with Hepatitis C as treatment is rapidly changing for the better. We now have higher cure rates, shorter treatment times, and oral treatment regimens for all people with HCV infection.

Remember, there is no one-size-fits all treatment for chronic hepatitis C. Which medication is best for you depends on many things, including:

  • The amount of liver damage
  • Your previous treatments
  • The specific type of hepatitis C

Always talk with your doctor about all of your treatment options.

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