HepC treatment success, testing debate

Doctors have new tools to treat the liver disease hepatitis C.

Right now, a two-drug therapy is the standard treatment.

This month, the Food and Drug Administration approved add-on medicines that can be used to create a new three-drug cocktail.

The new drugs are protease inhibitors, a drug type also used in HIV treatment.

“It attacks the virus itself and it prohibits it from replicating,” said Lisa Pedicone, who leads scientific affairs for the Hepatitis division at Merck.

She says the two older hep C drugs nudge the body’s immune system to clear out infection; the protease inhibitor works directly on the virus.

Hep C therapy is often described as a grueling regimen of weekly shots and daily pills. Treatment lasts 48 weeks, and after nearly a year, the therapy only works in about 40 percent of patients. The success rate is even lower among some hard-to-treat people.

Reading resident KellyAnn Mann-Hester tried the standard treatment seven times.

“So I would be virus free so long as I was on treatment, but within six weeks, I would relapse,” Mann-Hester said. “You do get to where you pray it works but you don’t get your hopes up anymore.”

In 2009, Mann-Hester joined the drug trial for Incivek. Doctors say she’s virus free today.

The 51-year-old says she’s also shed the symptoms she lived with for nearly two decades.

“Low grade fever and the fatigue from having the hepatitis. I don’t have the fullness in my stomach, from my liver being swollen, all of those things that were day-to-day living,” she said.

For some patient groups–people new to therapy–the three drug cocktail doubles the chances for success–and can slash months from the time it takes to complete treatment.

Dr. Vishal Patel is a liver care specialist at Temple University Hospital. He says standard treatment for hep C can cost from $30,000 to $50,000. Adding one of the new medications may add another $15,000 to $30,000, he said.

“Final numbers haven’t been released but talking to some specialty pharmacies, it’s going to be up to two times as costly, however, it’s going to become standard treatment and most of insurance will pay for the treatment,” Patel said.

There are two approved protease inhibitors for hep C. Incivek is from Massachusetts drugmaker Vertex Pharmaceuticals. Victrelis is from pharma giant Merck.

Some health experts want to step up efforts to get more people tested for the hepatitis C virus. Dr. Kenneth Rothstein is chief of the hepatology division at Drexel University College of Medicine. He says current recommendations suggest screening just for high risk people.

“The main risk factors in the U.S. are anyone who had a blood transfusion before 1992 and anyone who’s ever used intravenous drugs. There are other risk factors that are considered somewhat controversial, these would include anyone who’s ever snorted cocaine; anyone who’s ever had tattoos,” he said.

U.S. experts are gathering in coming weeks to discuss more routine testing for Baby Boomers. Supporters say the change could reduce the number of people with advanced liver disease.

The hepatitis C virus can go undetected in the body for decades, and today, many newly diagnosed people are between age 50 and 70.