Viral hepatitis has been called a "silent epidemic" by Dr. Howard Koh, the U.S. Health and Human Services Assistant Secretary for Health. People can live for decades with the disease without knowing they have it. When they are finally diagnosed, it often comes after they have developed severe complications, such as liver cancer. The end result is much more costly -- and ineffective -- care.
But new treatment options, including two drugs (sofosbuvir and simeprevir) recently approved by the Federal Drug Administration, offer hope to those living with hepatitis C, a serious disease that causes inflammation of the liver, which can lead to cirrhosis, liver failure, and liver cancer, and is the most common form of viral hepatitis. As of this writing, standard treatment for hepatitis C includes the drug interferon. Interferon does not come in pill form. It must be injected, and it often has acute side effects, including debilitating fatigue. The drug is so unpleasant that it isn't uncommon for some people who've been prescribed it to stop taking it before they've completed a full course of treatment.
The new drugs (sofosbuvir, approved earlier this month, and simeprevir, which was approved in November) could be game changers in the treatment of hepatitis C because they open up the possibility of combatting the disease without the use of interferon. And they can supplement other new drugs already in use -- the direct-acting antiviral medications telaprevir and boceprevir -- that have already been shown to dramatically improve hepatitis C cure rates, and shorten the length of hepatitis C treatment.
But none of this will matter if those living with hepatitis C remain unaware of their infection. Currently, there are an estimated 2.7-3.9 million people infected with heptatis C in the U.S., according to the CDC. (Though some say the number could be as high as 5.2 million people as the CDC may not be adequately counting those who are incarcerated, homeless, live in nursing homes, are hospitalized, or serve in the military.) Either way, researchers agree that the vast majority of those infected (approximately 75 percent) have no idea that they have hepatitis C.
To help get those infected with hepatitis C into care earlier, the U.S. Centers for Disease Control (CDC) in 2012 issued recommendations that Baby Boomers, those born between 1945 and 1965, get tested for hepatitis C. For reasons that aren't fully understood, rates of hepatitis C infection are five times higher among Baby Boomers than the general population.
In 2012, the CDC also launched the annual Hepatitis Testing Day on May 19 as a way to remind the general public and health care providers -- many of whom remain unaware of the CDC's testing recommendations -- of the need for everyone who is at high risk for hepatitis infection to get tested. Other high risk groups include injection drug users, people living with HIV, and men who have sex with men.
Getting those with hepatitis C into treatment before they develop serious complications such as liver cancer or cirrhosis could potentially save $8.6 billion in national health care costs related to advanced liver disease, according to a 2012 report published in Hepatology.
Early diagnosis and treatment of hepatitis C is critical to ending the epidemic. The addition of sofosbuvir and simeprevir to the treatment arsenal, combined with evidenced-based behavioral health interventions such as needle exchange and peer support, can -- and will -- save lives.