WASHINGTON – There's new hope for an overlooked epidemic: Two powerful drugs are nearing the market that promise to help cure many more people of liver-attacking hepatitis C – even though most who have the simmering infection don't know it yet.
Surprisingly, two-thirds of hepatitis C sufferers are thought to be baby boomers who’ve harbored since their younger, perhaps wilder, years a virus that can take two or three decades to do its damage.
What could be a treatment revolution is spurring the government to consider if it’s time to start screening aging baby boomers for hepatitis C, just like they get various cancer checks.
“We’re entering a whole new era of therapy,” said Dr. John Ward, hepatitis chief at the Centers for Disease Control and Prevention. “We really want to begin that clarion call for action for this population who’s at risk.”
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Today’s two-drug treatment for hepatitis C cures only about 40 percent of people with the most common variety of the virus, and causes some grueling side effects. Now major studies show that adding a new drug – either Vertex Pharmaceuticals’ telaprevir or Merck & Co.’s boceprevir – can boost those cure rates as high as 75 percent. And they allow some people to cut treatment time in half, to six months, thus lessening how long they must deal with those side effects.
If the Food and Drug Administration approves the drugs – a decision widely expected this summer – they would be the first that work by directly targeting the hepatitis C virus. Specialists draw comparisons to the early 1990s when potent combination therapies emerged to treat AIDS. Many recently diagnosed patients are postponing therapy to await these new drug cocktails in hopes of a better chance at a faster cure, says Dr. Paul Pockros, hepatology chief at the Scripps Clinic in La Jolla, Calif., who helped test telaprevir.
However, the bigger impact could come if more people get tested for hepatitis C, a blood-borne virus. It’s often stigmatized as a risk only to people who inject illegal drugs. But the virus could have begun festering from a blood transfusion before 1992, when testing of the blood supply began.
Lapses in infection control in health facilities still occasionally expose people today. So could even a one-time experiment with drugs way back in college, something doctors are reluctant to ask a middle-aged, button-downed patient to reveal, says Ward.
About 3.2 million Americans, and 170 million people worldwide, have chronic hepatitis C. In the U.S., new infections have dropped dramatically – although the disease’s toll is rising as people infected decades earlier reach ages where their livers start showing damage. Hepatitis C already is a leading cause of liver transplants, and it kills about 12,000 U.S. patients a year, a number expected to triple within 20 years.
Most people find out they’re infected like Brian Graham of Briarcliff Manor, N.Y., during a routine checkup that spotted elevated liver enzymes. So over the last decade he tried three rounds of traditional treatments, with increasingly tough side effects, to no avail.
“I didn’t want to die of liver disease or cancer or suffer the prospect of having to tee up for a liver transplant. Scary stuff,” says Graham, now 56.
Enter the new drugs. They work by blocking an enzyme that’s key for the virus to reproduce. But they must be taken together with standard medications – ribavirin pills plus injections of interferonalpha – that are thought to boost the immune system.
According to studies presented at a recent medical meeting, 67 percent to 75 percent of patients given treatment including either boceprevir or telaprevir, respectively, had what doctors call a cure. That’s defined as no sign of the hepatitis C virus six months after their last dose. Importantly, only about onequarter of black patients are helped by standard therapy but adding one of the new drugs more than doubled their cure rates.