Tag: Harvoni

Why is Hepatitis C Spreading Across the US in Record Numbers?

Hepatitis C in America

hep c viral disease

What’s the worst disease you can think of?

Most people would probably say AIDS, cancer, or maybe the avian flu. Not many are going to say hepatitis C.

Guess what though? Hep C is currently spreading across the United States at far greater rates than any of the above.

It isn’t easy to admit, or pleasant to think about, but we’re in the midst of several wars. We’re fighting painkillers, heroin, synthetic drugs like spice and bath salts, and now – Hep C and liver disease.

Some sources are quick to point out that as IV heroin use has exploded, so have cases of Hep C. While the two have a close relationship, there still isn’t definitive proof one way of the other.

What we do know, and what affects people like you and me, is this – hepatitis C infection is up approximately 273% from 2009. Something very bad is going on here.

What is Hep C?

Although it’s often talked about, Hep C isn’t that well understood.

While explaining the ins and outs would take much more space than we have – not to mention, hepatitis C and various treatments are explored here – we’ll give you the basics.

Hep C, also known as HCV, is a viral infection that attacks the liver.

 

    • It can be symptomatic (showing signs) or asymptomatic (showing no signs)

 

    • It leads to fibrosis (scar tissue), cirrhosis (a build up of scar tissue on the liver causing major problems), and, in some cases, liver cancer

 

  • It can be acute (the first six months after becoming infected) or chronic (an HCV infection that last longer than six months. Most instances of HCV are chronic)

hep c liver
Hepatitis C is different from hepatitis A or B. Hep A is spread through contaminated food and water and has a vaccine. Hep B is spread through contact with infected body fluids and also has a vaccine.

HCV, on the other hand, is spread through blood-to-blood contact and has no vaccine. The primary route of infection is through IV drug users sharing needles.

Just How Quickly is Hep C Spreading?

That’s the real question, right? How bad is HCV in America? Find that information and more below:

    • Cases of acute Hep C grew 273% between 2009 and 2013

 

    • That breaks down to over 19,000 deaths due to HCV in 2013

 

    • This is up from 16,235 deaths in 2009

 

    • During early 2015, an average of 48,000 prescriptions were filled per month for Hep C fighting medications (Harvoni, Sovaldi, interferon, etc.)

 

  • Between 2007 and 2013, heroin use also exploded – rising close to 150%

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All statistics taken from the Star Tribune.

Since injection drug use is the primary transmission route of HCV and, during the same time period, both Hep C and heroin use increased dramatically – it’s safe to say the two are related.

Officials can’t say whether increased heroin use is the only cause, or even the primary cause, for the drastic increase in Hep C infections. Still, it’s clear the two are linked and having some impact on each other.

What States are Being Hit the Hardest?

Based on the above numbers, it isn’t hyperbole to say we’re in the grip of a hepatitis C outbreak…but what does that look like from the ground? What does it look like in individual states and counties?

Well, again according to the Star Tribune, it looks something like this:

    • The national rate of HCV infection is around .7 per 100,000 people. In Washington County, Maine, the rate is around 6 per 100,000 people.

 

    • Madison County, in Indiana, had 70 cases of Hep C in 2013. This number increased to 130 in 2014. All of which is to say nothing about Indiana’s HIV outbreak.

 

    • HCV infection in Massachusetts has grown from 10 new cases in 2009 to 174 in 2013.

 

    • Kentucky has 5.1 cases of acute Hep C infection per 100,000 people. Remember, the national average is .7 cases per 100,000 people.

iv drug use can cause hcv

  • Hepatitis C is on the rise in Springfield, Missouri. Although exact figures aren’t available, heroin is being seized at around five times the rate it was in 2013. This suggests cases of Hep C will be around five times higher than normal.

What Can We Do?

It’s easy to sit back and say that hepatitis C is on the rise in America. What isn’t so easy, though, is figuring out just what to do to slow it down.

Thankfully, there are a host of new medications that boast upwards of a 90% success rate in curing cases of Hep C. These, mentioned briefly above, are Harvoni, Sovaldi, and other direct protein inhibitors.

viral view of what hep c looks like

The downside to these new meds is their cost. They routinely cost upwards of $100,000 for a full course of therapy. This makes insurance companies wary of giving people the go ahead to take them.

The other major option we have is harm reduction. This is a form of substance abuse treatment aimed at helping addicts to, as the name suggests, reduce the potential harm of addiction.

It’s comprised of techniques like methadone maintenance, syringe exchanges, basic healthcare services, safe injection sites, and others.

Despite offering some major benefits – making sure addicts have access to clean syringes can almost entirely wipe out blood-borne disease like HCV – it’s also controversial and faces steep opposition from many politicians.

Regardless of where you stand on harm reduction, the fact that is can help to reduce the current spread of Hep C is pretty impressive. That’s something we can all agree on.

What do you think about the recent rise in Hep C infections? Let us know on social media.

Why is the New “Hep C Cure” So Expensive?

The “Hep C Cure” is Essential & Expensive!

The breakthrough in treating Hepatitis C over the past three years has been nothing short of amazing. Two new drugs, Harvoni and Sovaldi, have largely replaced the standard treatment of Interferon and its host of negative side effects.

hep c drugs too expensive
via Wikimedia Commons

What’s even more impressive are how effective these drugs are. Rather than “curing” approximately 50% of those treated, Harvoni and Sovaldi have success rates over 90%. They also have mild to nonexistent side effects.

So, it came as no surprise when the World Health Organization added both Harvoni and Sovaldi to their Essential Medicines List. With between 130 and 150 million people infected with Hepatitis C worldwide, these drugs are certainly essential!

 

In a statement to the press, WHO Director-General Dr. Margaret Chan said the following,

“When new effective medicine that could treat serious and widespread diseases appears on the market, it is necessary to ensure that everyone who needs the treatment can acquire it…Placing them on WHO Essential Medicines List is a first step in that direction” (The Standard Daily).

What is surprising, however, is the price tag of these blockbuster drugs. Find out more about the WHO’s Essential Medicines list below and, more importantly, why the much needed Harvoni and Sovaldi are so expensive.

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What’s This List All About?

The World Health Organization’s Essential Medicines List is a sort of international standard used by governments to guide their national-level medical policy. In other words, it’s how various nations decide which medications and treatments should be used and at what scale.

The list is updated every two years. In addition to Harvoni and Sovaldi, this year’s update contained a handful of cancer drugs and some aimed at drug resistant tuberculosis.

Traditionally, the Essential Medicines List is divided into two sections, the core and complimentary lists. The core list is made up of the medications necessary for a basic health care system to function. The complimentary list is made up of medications that treat specific diseases.

Another standard of the WHO’s list is their focus on making sure all medicines included are inexpensive. They disregarded that qualification this year, in favor of adding drugs that have been proven to be remarkably effective.

This point brings us nicely to the ongoing dialogue around Harvoni and Sovaldi’s cost. Why do these literally essential medications cost so much?

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The “Hep C Cure” is Too Expensive!

Before we go any further, it’s probably time to lay out how much Harvoni and Sovaldi cost. Harvoni clocks in at between $80,000 and $100,000 for a full course of treatment (approximately twelve-weeks). Sovaldi is slightly more reasonable at between $63,000 and $90,000 for a full course of treatment.

Both medications usually come with insurance and manufacturer discounts, which drop the average cost a few thousand dollars. Still, with a price tag ranging from the high five to low six digits, most people can’t afford these drugs.

It’s easier to obtain them in developed countries where heath insurance will cover most of the cost. It isn’t guaranteed however. There’s been anecdotal evidence of insurance companies refusing patients’ treatment because it’s simply too expensive.

In the developing world, well, it’s a whole different story. The World Health Organization Assistant Director-General, Dr. Marie-Paule Kieny, said, “While some efforts have been made to reduce their price for low-income countries, without uniform strategies to make these medicines more affordable globally the potential for public health gains will be reduced considerably” (NDTV).

How can Harvoni and Sovaldi be made less expensive and more available to those who need them most? How can these drugs be put into the hands of low-income peoples the world over? Well, Dr. Kieny believes adding both these drugs to the Essential Medicines List is a good first step. I can’t help but wonder what the next step is though.

Still confused about Hep C treatment? Learn everything you need to know in this handy guide!

A Simple Guide to Understanding HCV Treatment

What is HCV?

hcv treatment

What is HCV? I’ll give you a hint, you probably already know, though you may not have heard of it by this particular name.

HCV is an acronym for the Hepatitis C virus. To put it another way, HCV is the virus that causes Hep C. In turn, Hep C is a liver disease that leads cirrhosis, or a hardening, of the liver.

There are seven different types of HCV. These are labeled genotypes 1 to 7. Genotype 1 is the most common form of Hep C, accounting for approximately 70% of all infections. Genotype 2 accounts for around 20%, with the remaining genotypes accounting for around 1% each.

How is HCV Spread?

HCV is spread through blood-to-blood contact. This frequently occurs from unsafe IV drug use. Think things like sharing needles, not properly disposing of used syringes, or unsafe syringe sterilization.

what is hcv

HCV can also be spread through blood transfusions, sex, unsterile tattooing, and anything which requires blood to blood contact.

Find out how needle exchange programs cut down on the transmission of HCV

What is HCV? A Nightmare

HCV affects approximately 150 million people worldwide. Of those millions, HCV related liver disease kills between 350,000 and 500,000 people each year.

So, what is HCV? It’s a nightmare for addicts and their loved ones. In years past, there have been various HCV treatments of moderate success. However, as science progresses, HCV treatments are becoming increasingly sophisticated.

Now that we’ve thoroughly answered the question “what is HCV?”, let’s examine some common HCV symptoms.

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HCV Symptoms

Hepatitis C is an unusual disease in that it doesn’t immediately present symptoms. In fact, according to the World Health Organization, approximately 80% of those infected with HCV are asymptomatic or don’t exhibit symptoms.

HCV has a six-month incubation period. Following this period, symptoms can include:

  • Fatigue
  • Nausea
  • Fever like Symptoms
  • Joint Pain
  • Jaundice

Now that we’ve looked at various HCV symptoms, let’s turn our attention to different treatment options.

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HCV Treatment

This is where things can get a bit confusing. There are a ton of HCV treatment options available. These range from homeopathic remedies to cutting edge medical care.

The goal of HCV treatments is to produce a Sustained Virologic Response or SVR. This is when the Hepatitis C virus isn’t present in blood six months after completing a course of treatment.

Harvoni: New Hope for HCV Treatment

Harvoni is a once daily pill that was approved for treating HCV genotype 1 in late 2014. It’s a combination of the drugs ledipasvir and sofosbuvir (which we’ll touch on below).

hcv symptoms

Harvoni works by attacking the Hep C virus itself, rather than boosting your immune system’s ability to fight off infection (how Interferon and Ribavirin works).

Harvoni treatment is usually a twelve-week course of therapy. During this time, patients take the pill once a day. Its side effects are said to be mild and consist of headache and nausea.

Clinical trials have shown Harvoni to be upwards of 95% effective in eliciting a SVR.

The only drawback to using Harvoni as a HCV treatment is its cost. A twelve-week course of therapy is approximately $95,000. For this reason, insurance companies are often wary of approving patients.

Sofosbuvir: Polymerase Inhibitors as HCV Treatment

In late 2013, sofosbuvir was approved to treat HCV genotypes 1, 2, 3, and 4. It’s a polymerase inhibitor, which means it belongs to a family of drugs that actively block HCV proteins from replicating.

Sofosbuvir can be used with and without Interferon and Ribavirin. The specific combination depends on which HCV genotype a patient has.

For example, those suffering from genotypes 1 and 4 must take sofosbuvir, Interferon, and Ribavirin. However, those with HCV genotypes 2 and 3 can take only sofosbuvir and Ribavirin.

The latter combination cuts down on many of the unpleasant symptoms associated with HCV treatment.

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Simeprevir: Protease Inhibitors as HCV Treatment

Also in late 2013, simeprevir was approved for treating HCV genotype 1. Since its introduction to the pharmaceutical market, it’s been used as an off-label treatment for HCV genotype 4.

Simeprevir belongs to a family of drugs known as protease inhibitors. These are similar to polymerase inhibitors and block proteins in HCV from replicating. This means that the Hep C virus can’t create new versions of itself.

Simeprevir, unlike Harvoni and sofosbuvir, must be used in combination with Interferon treatment. It’s used as a sort of boost for Interferon, shortening the duration of treatment and increasing SVR rates.

This is accomplished through keeping the virus from replicating, while Interferon and Ribavirin “beat it up.” Think of one person attempting to fight three. That’s what happens to HCV while taking simeprevir, Interferon, and Ribavirin.

Interferon & Ribavirin: The Old HCV Treatment

Interferon and Ribavirin are the most well known forms of HCV treatment. They’ve been around since the 1980’s and are approved to treat all genotypes of Hepatitis C. In fact, until 2011, they were the only medical form of HCV treatment available.

interferon hcv treatment

Interferon is a protein that works by increasing the body’s immune system. This better equips the body to fight HCV.

Ribavirin keeps HCV from replicating. This makes Interferon’s job easier, as it doesn’t have new viral bodies to fight. While sofosbuvir and simeprevir block key Hep C proteins from replicating, thus slowing the spread of the virus, it’s not known how Ribavirin keeps Hep C from replicating.

The combination of Interferon and Ribavirin is approximately 50% effective at producing a SVR. The downside to this course of therapy are the side effects. In fact, many patients report the side effects to be worse than HCV itself.

Common Interferon side effects include: headache, extreme fatigue, nausea, vomiting, pain, diarrhea, loss of appetite, dizziness, fever, chills, muscle aches, and hair loss.

Homeopathic Remedies for HCV

There are many homoeopathic options available for HCV treatment. It’s worth noting that none of the following are shown to produce a SVR. Rather, they help the body naturally fight and cope with Hepatitis C.

  • Vitamin D
  • Milk Thistle
  • Licorice Root
  • Lactoferrin
  • Schisandra
  • Thymus Extract

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