“The Price of Progress”

The treatment of Hepatitis C infection is undergoing a revolution at present.

Traditional treatments using pegylated Interferon injections and ribavirin are poorly tolerated, often requiring almost a year of treatment and with only a 40-50% success rate overall in eradicating the virus.

In a few years time, treatments using Direct Acting Antivirals(DAAs) will be available that will be taken orally for three months, and with greater than 90% success rate. Interferon treatment for Hepatitis C will almost certainly be a thing of the past. The first of these DAA drugs (Telepravir and Bocepravir) are already on the market in some places but are likely to be superseded by newer and better tolerated DAA drugs in the not too distant future.

However these new treatments will not come cheaply. A treatment course for one patient will run into tens of thousands of dollars. Added to this is the fact that the real benefits of treatment are often not seen for decades. By eradicating Hepatitis C infection from a patient, the risk of subsequent liver cirrhosis and carcinoma is reduced in the future.

It will be interesting to see how keen governments and health institutions are to fund the new treatments, given the long term vison that is required.

A good proportion of patients with Hepatitis C have a history of injecting drug use. It is hoped that this will not further compromise their chances of being treated with the new drugs.

Potentially an active case finding and treatment programme using the new treatments could virtually eradicate Hepatitis C within 20 years. I cannot see that happening though….


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