New Medicine For Hepatitis C

What Are Genotypes And Do They Matter

Six different genotypes of hepatitis C have been identified. Genotypes 1 and 3 are the most common causes of hepatitis C in Australia and make up 90 per cent of all cases. They are important because they help determine the treatment you need. Unlike in the past, however, your genotype is not important in terms of the chance of cure. With the treatment drugs, all six genotypes have a very high chance of cure.

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Moving ahead, the Malaysian health authorities are also looking at hepatitis C self-testing.

Early diagnosis and treatment will prevent liver cirrhosis, liver failure and liver cancers, which means lives and treatment costs can be saved – a huge public health and economic impact, said Dr Noor Hisham.

Next is for us to scale up the detection of hepatitis C patients and eventually meet the goals of 2030 which is to eliminate hepatitis C in this country, he said in the press conference.

MALAYSIAS JOURNEY TOWARDS TREATMENT ACCESS

In 2017, the World Health Organization estimated that there were 71 million persons living with hepatitis C infection globally. A year earlier, Malaysia made a public declaration that hepatitis C was a public health concern affecting 400,000 people in the country.

Those at risk were intravenous drug users who shared needles, blood transfusion or organ transplant recipients before 1994, those undergoing dialysis, handling contaminated needles, sharing personal items such as razors, or did body piercing or tattooing.

The discovery of Ravidasvir brought back memories of searching for a cure for Isaac Tan, 62, who was diagnosed with hepatitis C in late 1990s. With no available treatment then, his liver condition deteriorated and an ultrasound in 2000 showed liver cirrhosis and scarring.

Despite completing six months of the treatment, he was not cleared of the virus.

What Will My Doctor Need To Know To Treat Me

If you want to be assessed for treatment, you need to make an appointment with a doctor. They will be mostly interested in the condition of your liver. Your doctor will organise, if possible, for you to have a Fibroscan examination. If Fibroscan is not available, your doctor will probably use an APRI test. This is an online calculator that estimates the health of your liver. It involves a blood test called a liver function test.

Dont forget, its very important to get a PCR test 12 weeks after finishing treatment this will mean the doctor can make sure you are cured.

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Why Cure Hep C

Curing your hep C clears the virus from your body. It reduces liver inflammation and can help reverse fibrosis and even cirrhosis.

Live free from the worry of hep C knowing that you no longer have hep C can help you feel better about yourself. For example, you may no longer feel worried about passing hep C to other people. There has been no better time to think about hep C treatment.

Find out more about the benefits of clearing hep C call the Hepatitis Infoline.

Pregnancy And Hepatitis C

The new hepatitis C medicines have not been tested in pregnancy.

You should not become pregnant while taking treatment as it could be harmful to unborn babies.

If you’re pregnant, you must delay treatment until after your baby is born.

Speak to your doctor before starting hepatitis C treatment if you’re planning to become pregnant in the near future.

You’ll need to wait several weeks after treatment has ended before trying to get pregnant.

Women taking ribavirin should use contraception during treatment and for another 4 months after the end of treatment.

Men taking ribavirin should use a condom during treatment and for another 7 months after the end of treatment. This is because semen can contain ribavirin.

If you become pregnant during treatment, speak to your doctor as soon as possible to discuss your treatment options.

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How Much Will It Cost Patients To Access The New Drugs

The Pharmaceutical Benefits Scheme listing means that hepatitis C patients will only pay the normal co-payment for the new drugs. The co-payment is currently worth $6.20 for patients with concessional healthcare cards and $38.30 for general patients without concessional healthcare cards, per drug, per month. For some patients needing three drugs, for example, the co-payment will therefore be $114.90 per month, or $18.60 per month concession.

More information on co-payment charges can be found on the Commonwealth Department of Healths website

Ombitasvir Paritaprevir And Ritonavir Tablets Co

This is a relatively new group of medicines that treat genotype 1 hepatitis.

Facts about the drug pack include:

• Treatment time is 12 or 24 weeks.
• Dosage is a pack of tablets containing 12.5 mg of ombitasvir, 75 mg of paritaprevir, and 50 mg ritonavir, taken once daily in the morning, and one 250 mg tablet of dasabuvir taken twice daily with a meal.
• Common side effects of this group of drugs include nausea, itching, and trouble sleeping. If the person also takes ribavirin, side effects include tiredness, nausea, fatigue, and skin reactions.

The following medications may be effective for genotype 2:

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New Drugs Cure Hepatitis C

Hepatitis C is a 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 a cure, 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 fasterwhich 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.

New Treatment For Hepatitis C

‘New’ drug is already FDA approved for lowering cholesterol

University of Oklahoma

image: Ted Bader, M.D., the principal investigator on the project and director of liver diseases at the University of Oklahoma Health Sciences Center.view more

OKLAHOMA CITY Researchers at the University of Oklahoma Health Sciences Center have found a new use for an old drug. Their findings appear online in the American Journal of Gastroenterology.

The drug, Fluvastatin, has been approved since 1993 by the U.S. Food and Drug Administration for the treatment of elevated cholesterol in adults. Millions of patients have taken Fluvastatin for cholesterol without difficulty.

In a study of 31 veterans at the Veterans Administration Medical Center in Oklahoma City, researchers found that Fluvastatin significantly lowered the viral load, or levels of hepatitis C virus, for up to six weeks when used alone. Hepatitis C is the disease that claimed the life of Oklahoma and Yankee baseball great Mickey Mantle.

This research is the first to demonstrate the antiviral activity of Fluvastatin in human beings infected with hepatitis C, most of whom were non-responders to the standard of care treatment, said Ted Bader, M.D., the principle investigator on the project and the director of liver diseases at the OU Health Sciences Center.

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How Is Hepatitis C Treated

Hepatitis C is treated using antiviral drugs.

Treatment in the first 6 months focuses on:

• treating symptoms
• preventing the spread of the disease
• preventing complications, such as liver damage

For someone who has the disease beyond 6 months, treatment includes a combination of medications. However, not everyone with this form of hepatitis C will need treatment.

Whether or not you are getting treatment, you can help lower the risk of damage to your liver by:

• avoiding alcohol

Can Hepatitis C Be Treated

Yes, since 2010 enormous progress has been made in the treatment of chronic hepatitis C. New therapies called direct-acting antivirals are pills that act on the virus itself to eradicate it from the body, unlike older medicines like interferon injections which work by stimulating an immune response. These new treatments are very effective and can achieve cure rates of over 90%. In most situations now, there is no need for interferon, which was responsible for many of the side effects previously associated with HCV treatment. The new treatment combinations require shorter treatment durations , have reduced side effects and appear to be effective at all stages of the disease.

Because these new therapies are very new, they remain very expensive. As such, drug coverage from both government and private companies may require that your liver disease has progressed to a certain stage before they are willing to cover the cost of these drugs.

Your primary care physician may refer you to a specialist to determine whether you are eligible for treatment. A specialist will help you decide which drug therapy is best for you based on the severity of your liver disease, your virus genotype and whether or not you have been treated in the past.

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What Does It Mean To Have A Successful Treatment What Is A Sustained Virologic Response

In an untreated state, the hepatitis C virus infects the cells of the liver and then continuously lives there, making copies of itself that circulate in the bloodstream. Antiviral medications can destroy the ability of the virus to reproduce, so the amount of virus in the bloodstream then decreases. The amount of virus in the blood is measured by aviral load.

Treatment is successful when the viral load drops toundetectablelevels, which means the virus cannot be detected in the bloodstream at all. The viral load becomes undetectable during treatment and remains undetected after treatment has ended. If there is still no detectable virus in the blood 12 weeks after the end of the treatment, the treatment was successful. This is called a Sustained Virologic Response .

A patient who has achieved an SVR is considered to be cured of the hepatitis C virus.

From Us$84000 To Us$: Malaysia A Step Closer To Eliminating Hepatitis C With New Affordable Drug

World Hepatitis Day is observed on Jul 28 every year and this years theme is Hepatitis Cant Wait. Hepatitis C elimination in Malaysia may be possible after it made diagnosis and treatment more affordable and accessible.

A general skyline view of Malaysias capital Kuala Lumpur on Oct 25, 2020.

KUALA LUMPUR: When Nurul Huda Abd Halim discovered in 2015 that she had hepatitis C virus shortly after donating blood, she was worried about getting another cancer.

The 26-year-old kitchen helper in Kuala Lumpur had recovered from lymphoma then. She was well aware that hepatitis C virus, which is transmitted through blood, could cause liver cirrhosis, scarring and cancer if untreated.

A silent killer, it could take 20 to 30 years before symptoms appear.

The first highly effective direct-acting antiviral drug Sofosbuvir had been approved in the United States since 2013, but Ms Nurul Huda could not get the cure because Sofosbuvir was too costly for the government to bring in.

The US$84,000 12-week treatment was the price of a medium-cost apartment in Kuala Lumpur.

There were older medicines but they were not as effective and I didnt take them because the side effects were severe and I was afraid it might affect my studies, said Ms Nurul Huda, who was preparing for her Malaysia Higher School Certificate examinations then.

After taking the tablets for 12 weeks at home, she was cured.

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What Are The Side Effects Of Treatment

Some people stop therapy because of side effects. Since hepatitis C can lead to liver damage, cirrhosis, and liver cancer if not treated, its vital to stick with a treatment plan.

Newer drugs have fewer severe side effects than pegylated interferon and ribavirin. Nevertheless, you may feel some effects while taking hepatitis C medication. Side effects can include:

• nausea, vomiting, or diarrhea
• appetite loss or weight loss

Serious side effects can occur with pegylated interferon and ribavirin treatment. If youre taking these medications, you should be monitored for these serious side effects:

• anemia
• thrombocytopenia
• light sensitivity in the eyes
• trouble breathing because of lung tissue inflammation
• suicidal thoughts, depression, or irritability
• thyroid disease
• elevated liver enzymes
• autoimmune disease flares

Some medications arent recommended if theres evidence of liver damage, like cirrhosis . A co-infection with HIV also affects medication options.

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• Recent advances in antiviral treatment have led to the development of new highly effective drugs for the treatment of all types of hepatitis C.
• The new hepatitis C treatments are sofosbuvir with ledipasvir sofosbuvir daclatasvir and ribavirin .
• These new treatments are now available on the Pharmaceuticals Benefits Scheme.

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Nonstructural 5a Complex Inhibitors

The NS5A complex plays a role in HCV RNA replication regulation as well as viral assembly and packaging, and directly interacts with the RNA-dependent RNA polymerase . The exact antiviral action of NS5A inhibitors is unknown they are theorized to inhibit hyperphosphorylation of the NS5A protein and alter the proteins location from the endoplasmic reticulum, likely causing faulty HCV assembly. Ledipasvir, ombitasvir, daclatasvir , elbasvir, velpatasvir, odalasvir, samatasvir, ravidasvir, ruzasvir, and pibrentasvir currently make up the class of NS5A inhibitors . Ledipasvir is one of the most potent inhibitors of the NS5A complex, but may have lower activity in HCV genotypes 2 and 3 infections.,, Ombitasvir is approved in combination with paritaprevir, ritonavir, and dasabuvir as part of the 3D regimen for the treatment of HCV genotypes 1 and 4 infections, but also has a higher pill burden, which could affect compliance. Velpatasvir has antiviral activity against HCV replicons in genotypes 1 through 6. NS5A complex inhibitors have high potency, multigenotypic coverage, and generally a low barrier to resistance. Newer agents in this class have the promise to increase the resistance threshold.

What Are The New Hepatitis C Treatments And When Will They Be Available

Recent advances in antiviral treatment have led to the development of new highly effective drugs for the treatment of all types of hepatitis C.

The new hepatitis C treatments are sofosbuvir with ledipasvir sofosbuvir daclatasvir and ribavirin .

These new treatments will be available on the Pharmaceuticals Benefits Scheme from 1 March 2016.

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Who Can Prescribe The New Drugs

A section 85 listing on the Pharmaceutical Benefits Scheme will allow general practitioners, as well as specialists, to prescribe the new treatments. This means that people with hepatitis C will be able to be treated by a general practitioner in the community. However, people with more advanced care needs, such as cirrhosis, may still need to see a specialist.

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 Are The New Hepatitis C Treatments Better

The new treatments are highly effective with a cure rate of 95-97 per cent. Treatment time is reduced to 12 weeks, drugs are tablets and there are very few side effects.

This is a major change from just a few years ago, when hepatitis C treatment time was from six to twelve months, with toxic side effects, and only a 50 percent chance of being cured.

This means that people newly diagnosed with hepatitis C, as well as those who have been living with chronic hepatitis C for many years, will now have access to a fast, effective and well-tolerated cure.

Sofosbuvir Velpatasvir And Voxilapresvir

This drug combination is similar to Epclusa but also includes a drug called voxilapresvir.

Facts about Vosevi include:

• Treatment time is 12 weeks for people without cirrhosis or compensated cirrhosis .
• Dosage is fixed at 400 mg of sofosbuvir, 100 mg of velpatasvir, and 100 mg of voxilapresvir once per day with food.
• Common side effects include tiredness, a headache, diarrhea, and nausea.

Doctors often recommend Vosevi for people who have had previous treatment for hepatitis C that did not work.

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