How Well Epclusa Works
Clinical studies showed Epclusa to be effective at treating hepatitis C genotypes 1 to 6.
Researchers looked at adults as well as children who were at least age 6 years or weighed at least 37.5 pounds . Thats equal to 17 kilograms . The adults and children were given Epclusa every day for 12 weeks. The goal was to see how well the drug worked to help people achieve whats known as a sustained virologic response . An SVR means that blood tests show the hepatitis C virus is no longer detectable in your body.
Guidelines published by the American Association for the Study of Liver Disease and Infectious Diseases Society of America recommend Epclusa as a treatment option for people with hepatitis C genotypes 1 to 6.
Is There A Vaccine For Hepatitis C
There are no vaccinations that prevent the hepatitis C virus. Vaccinations for hepatitis A and B, however, are given to patients with HCV to prevent the possibility of acquiring another hepatitis virus. Getting hepatitis A or hepatitis B on top of hepatitis C can add liver damage or even cause severe hepatitis. People with hepatitis C should be screened for past infection with hepatitis A and B. If they have no evidence of antibodies, they should receive vaccines for hepatitis A and/or B.
Hepatitis A vaccine may be given alone or in combination with hepatitis B vaccine, depending on whether the patient needs one or both. Hepatitis A vaccine is inactivated hepatitis A virus that stimulates the immune system to develop antibodies against hepatitis A. These antibodies kill the virus before it can cause infection. It is given in 2 doses intramuscularly 6 months apart.
Hepatitis B vaccine is made with hepatitis B antigens that stimulate antibodies against the hepatitis B virus. There is no live virus in the vaccine. It is given in 3 doses intramuscularly the second dose is given 1-2 months after the first, and the last is given 6 months after the first dose. The A and B vaccine is a combination of the above and is dosed in the same way as the Hepatitis B vaccine. It is available under the brand name Twinrix.
Acytokines Alter Mental Processes And Behavior
There is striking evidence that cytokines administered in large doses as part of cancer treatment and hepatitis-C treatment can cause disturbances of mental function that resemble psychiatric disorders. Cytokines such as IFN- and IL-2 have been found, depending on dosage, to cause major mental status changes in as many as two-thirds of patients receiving the treatments. The changes observed include delirium , disorientation, irritability, delusions, agitation, fatigue, anorexia, malaise, and depression. Many of these changes are also seen in response to infection, thereby supporting the role of immune activity in behavioral disturbance and psychopathological conditions.
Studies in healthy humans using immune-activating substances such as endotoxin derived from Gram-negative bacterial membrane or vaccination with typhoid antigen have shown effects on mood and cognition. With respect to memory, the findings have been mixed with some studies showing decrements in memory function while others have found no effect. The effect on mood has tended to be more consistent and in the direction of increasing confusion, fatigue, and tension. Moreover, neuroimaging studies have shown that individuals injected with immune-activating substances show increased activity in limbic regions of the brain in response to pictures of faces expressing specific emotions. A finding suggesting immune modulation of emotional responses.
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Can Hepatitis C Be Cured
Considerable progress has been made by past clinical trials in the medical treatment of hepatitis C. The rate of cure has increased with the development of direct-acting, all-oral antiviral regimens, and the length of therapy is much shorter. Treatment recommendations continue to change as new medicines become available. Treatment helps to reduce progression of liver damage to cirrhosis, may prevent liver cancer, and may prevent spread of the infection to other people.
Tips And Remedies To Help With Side Effects
There are things you can do to ease many of the side effects from hepatitis C treatment.
Remember that these side effects will typically go away once you’re cured, so stick with your treatment. Work with your doctor on your treatment plan so that you can manage any problems and try to get the virus out of your body as soon as possible
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How Often To Use
You may be wondering how long you have to take Epclusa to treat hepatitis C. Youll likely use the drug once daily for 12 weeks. This is the amount of time it takes for Epclusa to clear the hepatitis C virus from your body.
Its extremely important to not miss or skip doses of Epclusa. Missed or skipped doses can lower the level of the drug in your blood, which may cause Epclusa to work less well than usual. As a result, the drug may not clear the hepatitis C virus from your system.
To avoid missing a dose, try setting a reminder on your phone. If you do miss a dose of Epclusa, its important that you call your doctor right away. Theyll advise you on the best action for you to take.
Hepatitis C is an infection caused by the hepatitis C virus. The virus is transmitted through blood or body fluids, which can occur in several ways, including:
- sharing needles with a person who has the virus
- getting pricked by a needle that has the virus, which can be common in a healthcare setting
- having sex with someone who has the virus without using a condom or other barrier method
Once inside your body, hepatitis C virus attacks cells in your liver, causing inflammation.
Ddi As Complication In Hcv Therapy
Table 3.
Induction and inhibition of enzymes or transporters by active substances for HCV therapy
However, theoretical potential for interactions does not always result in clinically relevant DDI. When predicting clinically relevant DDI, the following point needs to be kept in mind. DDI studies with reliable clinical end points or pharmacokinetic data are most eligible to determine clinical significance but still need an expert for interpretation, and in most cases such studies are not available . Table 4 shows commonly used concomitant medications in HCV, clinically relevant DDI with modern HCV regimens and the suggested management based on prescription information , www.hep-druginteractions.org and authors expertise .
Table 4.
For additional information:
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Treatment Of Patients With Impaired Renal Function/dialysis
Renal excretion is the main elimination pathway of the NS5B polymerase inhibitor sofosbuvir and its metabolites. For patients with mild to moderate renal impairment administration of sofosbuvir is safe. Since patients with severe renal dysfunction or hemodialysis have not been included during the initial phase III study trials, drug safety of sofosbuvir in these patients has not been studied in detail, and therefore sofosbuvir treatment is not recommended by the FDA and EMA label. Nevertheless, some real-world studies and preliminary data of a prospective multicenter trial show high efficacy and safety during full dose sofosbuvir treatment for patients with severe kidney dysfunc nt-related discontinuations or treatment-related serious adverse events . However, in some studies these patients also experience higher rates of anemia and worsening of kidney dysfunction . Therefore, sofosbuvir-free treatment options should be preferred if possible. Since the introduction of the pangenotypic combination of glecaprevir/pibrentasvir, a highly effective treatment of GT 2 and 3 is available, and safety and efficacy for patients with renal impairment and hemodialysis have been shown successfully . Alternatively, grazoprevir/elbasvir can be safely administered in patients with GT 1 or 4 infection and severe renal dysfunction .
What Are The Names Of The Medications For Treating Hepatitis C
Since 2014, multiple different antiviral treatments for hepatitis C have been developed. With the many options now available, often there is more than one good choice for a patient. Some of the treatments are recommended as first-line options, some are second-line options, and others are used less commonly in light of all the available choices.
- Elbasvir/Grazoprevir
Second line hepatitis C medications:
- Sofosbuvir/Velpatasvir/Voxelaprevir
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Today’s Daas Are More Effective
DAAs achieve sustained virologic response , a.k.a. a cure, in nearly all HCV patients, according to K.V. Narayanan Menon, M.D., a gastroenterologist, hepatologist, and medical director of liver transplantation at Cleveland Clinic.
That’s a world of difference from when he started practicing medicine 20 years when response rates were about 10%, says Dr. Menon. Slowly it went up to about 20-25% , then in the late 2000s, it rose to about 50% ,” he says. “Now, we are at a 99% cure rate with the most recent DAAs.
Will Hepatitis C Pass On To The Fetus
Although it is possible for the virus to pass from the pregnant person to the fetus, it does not occur in most cases.
However, vertical transmission to the fetus during pregnancy is the most common way for children to acquire HCV. The baby can contract HCV in the womb or during labor or the postpartum period through contact with the blood.
In about 5% of cases, the virus transmits from the pregnant person to their baby in this way. The risk increases if the person has a high viral load or also has HIV.
There are no recorded cases of HCV transmission taking place during breastfeeding or chestfeeding. However, if a persons nipples become cracked or bleed, there may be a risk. The recommend temporarily stopping nursing until the nipples heal, if this occurs.
Doctors can test for HCV once the baby reaches 18 months of age . Testing cannot take place before this point, as the baby will still have maternal antibodies in their blood, which can lead to a false positive. Once doctors determine that a baby has HCV, they can begin regular monitoring and make a plan for treatment.
The timing of HCV treatment can depend on a persons age, the severity of the infection, and whether treatment will be safe for them.
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Hepatitis C: A Nasty Little Virus
The side effects of the Hepatitis C Virus Cause More Damage than you would guess
Today I received the email below from one of the people I recently assisted to buy generic Harvoni from India to cure their Hepatitis C genotype 1. As you will see when you read it after only four weeks of treatment using generic Harvoni this person has experienced some quite profound health improvements.This made me realise that I should write a little about what the side effects of Hepatitis C really are because many people, including doctors, often think that the damage that Hepatitis C does is restricted to the liver, this is not true.The side effects of the Hep C virus can cause profound health problems in seemingly unrelated areas of the body. I will discuss this in detail after the email below:
Subject: Health Improvements
So just how extensive is the damage that the side effects of HCV can cause?
The side effects of Hepatitis C are much more extensive than you would imagine and it is why postponing treatment can lead to many seemingly unrelated health issues.
HCV and the Central Nervous System
When your liver doesnt filter toxins from the blood, it can damage the central nervous system. This can lead to a variety of symptoms peripheral neuropathy, impairment of motor skills, and sleep disruption. A buildup of toxins in the brain can also cause what is commonly known as Brain Fog. Brain fog typically includes, confusion, forgetfulness and poor concentration.
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Geoffrey Dusheiko Md Frcp
Interferon alphas have been widely used to treat chronic hepatitis C virus infection. These include recombinant interferons, or purified natural leucocyte or Lymphoblastoid interferon. Interferon alpha is usually administered by subcutaneous or intramuscular injection. The terminal half-life of interferon alpha is 4-5 hours. Renal excretion is the predominant route of elimination.
A wide array of side effects have been encountered in several large trials of treatment of hepatitis C. Side effects are common they are usually minor but are problematic for a significant proportion of patients. Major adverse events can occur, but life-threatening adverse events have been rare in large surveys. Tolerance in elderly patients and children is usually similar.
Early flu-like side effects are predictable and are encountered in the majority of patients. These tend to occur within 6-8 hours after starting treatment and are worst with the first injections. These side effects include fever, malaise, tachycardia, chills, headache, arthralgias, and myalgias. However, they are usually acceptable at doses of 3-6 million units of interferon alpha, and tachyphylaxis generally develops after the first few injections. These side effects are ameliorated by paracetamol .
Neuropsychiatric Side Effects
table 1. Most Common Adverse Events in a Recent Large Trial of Patients Treated With Consensus Interferon or Interferon Alfa 2b
Immune Disorders
Cardiovascular Side Effects
Renal Side Effects
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What About Patients With Hepatitis C Who Also Have Hepatitis B
Hepatitis B virus can flare in patients who are co-infected with hepatitis B and hepatitis C and are taking medication for hepatitis C. This has been reported as a potential risk for patients who are taking hepatitis C treatment and have underlying hepatitis B as well. The flare usually occurs within a few weeks after the patient starts taking medication for hepatitis C. Therefore, patients who have both hepatitis B and hepatitis C should be seen by a hepatitis expertbeforestarting treatment of the hepatitis C they may need to start taking hepatitis B treatment to avoid a hepatitis B flare.
Are There Ways To Cure Hepatitis C Other Than With Medications
Patients sometimes ask whether there are ways to treat hepatitis C other than taking medicines. Currently, there are no vaccines to prevent hepatitis C. Once a person is infected, the only way to treat it is with prescribed antiviral medications.
Some patients worry that having hepatitis C means they will need a liver transplant. Only a very small fraction of people with hepatitis C require a liver transplant. By far, most people with hepatitis C never need a liver transplant. A transplant is performedonlywhen damage to the liver is extremely advanced and the liver is unable to perform its basic functions. A transplant provides a new working liver, but a transplant does not get rid of the hepatitis C virus in the patient. Patients with a liver transplant still need antiviral medication to cure their virus.
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Why Does It Matter That I Have Genotype 2
Knowing that you have genotype 2 offers important information about your treatment options and how likely they are to be effective.
Based on the genotype, doctors can narrow down which treatments are most likely to be effective and how long you should take them. This can prevent you from wasting time on the wrong therapy or taking medications longer than you have to.
Some genotypes respond differently to treatment than others. And how long you need to take medicine can differ based on your genotype.
However, the genotype cant tell doctors how quickly the condition will progress, how severe your symptoms might get, or if an acute infection will become chronic.
15 to 25 percent of people clear the hepatitis C infection without any treatment. Since there isnt a way of knowing who falls into this category, in an acute infection, your doctor will recommend waiting for 6 months to treat the virus, since it may clear spontaneously.
Hepatitis C is treated with antiviral drugs that clear your body of the virus and prevent or lessen damage to your liver. Often, youll take a combination of two antiviral drugs for 8 weeks or longer.
Theres a good chance youll have a sustained virologic response to oral drug therapy. In other words, its highly curable. The SVR rate for many of the new hepatitis C drug combinations is as high as 99 percent.
When choosing drugs and deciding how long you should take them, your doctor will usually consider the following factors:
What Is The Dosage For Daas
Victrelis
- 800 mg is taken three times a day, and simeprevir 150 mg is taken once daily with food, combined with ribavirin.
Technivie
- Technivie is given with ribavirin for 12 weeks for genotype 4 chronic hepatitis C virus infection without cirrhosis.
- Each tablet contains 12.5 mg ombitasvir, 75 mg paritaprevir and 50 mg ritonavir.
- Two tablets are taken every morning, with ribavirin dosed by weight: 1000 mg per day for patients weighing less than 75 kg, and 1200 mg per day for those 75 kgs and over this is divided into a twice-daily dose with food.
Viekira Pak
- Viekira is used for genotype 1a or 1b chronic hepatitis C, including people with or without cirrhosis and no liver failure symptoms.
- Viekira Pak is ombitasvir 12.5 mg, paritaprevir 75mg, ritonavir 50 mg in each tablet, packaged with dasabuvir 250mg tablets.
- It is dosed as two ombitasvir, paritaprevir, ritonavir tablets once daily and one dasabuvir tablet twice daily , along with a meal.
- It is given with or without ribavirin .
- Genotype 1a is most resistant to treatment, so Viekira is given with ribavirin for 12 weeks if there is no cirrhosis, or 24 weeks if there is cirrhosis.
- Genotype 1b is usually treated with Viekira alone for 12 weeks if no cirrhosis with cirrhosis it must be given with ribavirin for 12 weeks.
- Viekira may also be used in liver transplant recipients.
Zepatier
Sovaldi
Harvoni
Daklinza
Mavyret
Epclusa
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