Oral drugs in health basket can wipe out hepatitis C in a decade

Hepatitis C, a potentially fatal liver disease that affects some 2.5% of the population, is likely to be wiped out in a decade, thanks to highly effective drugs that are included in the basket of medical technologies covered by the health funds.

That’s the prediction of Dr. Tova Goldberg Klein, a hepatologist in the liver unit of Hadassah-University Medical Center in Jerusalem’s Ein Kerem, speaking at the Eighth Jerusalem Conference for Family and Community Physicians at the David Citadel Hotel on Wednesday.

The all-day event, co-chaired by family medicine specialist Prof. Amnon Lahad and attended by some 100 family doctors from around the city, addressed a wide variety of problems dealt with by primary physicians including asthma, reluctance by parents to take children for vaccinations, smoking, contraception, diabetes and new cardiac drugs.

Klein said that various new drugs for hepatitis C, which if untreated can lead to cirrhosis and liver cancer, were introduced in 2011, but they were injected and caused a wide variety of side effects. They did not constitute a cure.

However, since 2014, there have been protein and polymerase inhibitors called sofosbuvir, daclatasvir and the sofosbuvir/ledipasvir combination – pills taken once a day for about 12 weeks. At the end of treatment, which rarely involves side effects, the hepatitis C patient is almost always cured. The regimen costs $100,000 apiece, but the cost is going down because of competition among drug companies, she said.

Those who have been infected are being gradually invited by their doctors to undergo the treatment, with the aim of eradicating the disease, for which there is no preventive vaccination (unlike hepatitis B).

The most common of the four hepatitis C genotypes in Israel is genotype 1, which is well handled by the new drugs, said Klein. Prevention of hepatitis C infection depends upon reducing the risk of exposure to the virus in healthcare settings and in higher-risk populations, including emigrants from Eastern Europe, people who inject drugs, people with tattoos and through sexual contact. Most people have no idea they were infected as they were asymptomatic. In a fifth, the virus was naturally eradicated by the immune system, but in the rest, the virus was not. “So we have to treat all those with hepatitis C antibodies,” the doctor said.