Ken mitchell never really felt sick.
Sure, he got tired easily, but perhaps that could be chalked up to getting older. He had lived with the hepatitis C virus for more than 10 years, but his liver tested fine. He didn’t have any other symptoms.
Then he was cured. And his energy level shot up.
“It’s incredible,” says the 56-year-old Chesapeake, Va., resident. “Now that I’m cured of it, I feel better.”
Mitchell’s cure of hepatitis C comes during what’s being called a new era in the treatment of liver disease. Thanks to a new class of drugs that recently became available, cure rates are reaching more than 90 percent for a virus that causes more deaths a year than HIV/AIDS.
Dr. Mitchell L. Shiffman, a liver specialist and the medical director of Bon Secours Liver Institute of Virginia, calls the new treatments “an enormous public health achievement.”
Hepatitis C is a slow-moving but deadly virus that has become a major public health issue for millions of baby boomers, according to the Centers for Disease Control and Prevention. More than 3 million Americans are infected with the virus, which over time can cause liver damage and liver cancer, and is the leading cause of liver transplants.
People born between 1945 and 1965 are five times more likely to have the virus than other age groups—they’re the ones who grew up during the decades when more blood transfusions were being done. It was also a time when experimenting with recreational drugs was in its heyday.
That’s what got Mitchell in trouble. He believes his hepatitis C can be traced back to high school, when he had a little too much to drink and experimented with shooting up cocaine. He didn’t find out he was infected until 1999, when he tried to donate blood. A blood screen found that Mitchell was positive for type 1 of the virus—the most common, accounting for some 70 percent of infections, and the most difficult to treat.
At the time, Mitchell was told he could go through a year of fairly unpleasant treatment that had less than a 50 percent chance of curing him. So he decided against it, instead making lifestyle changes that included healthy eating, refraining from alcohol and avoiding painkillers, such as Tylenol, that could hurt his liver.
Then last year, he met Shiffman, who invited him to take part in a groundbreaking clinical trial through the Bon Secours Liver Institute, which treats patients at Mary Immaculate Hospital in Newport News, Va., and at St. Mary’s Hospital in Richmond, Va.
The trial focused on a new drug called sofosbuvir—a medication found to interfere with the hepatitis C virus’ replication in the body.
Taken in combination with another drug, ribavirin, sofosbuvir was found to clear the virus in adults with types 2 and 3 hepatitis C after just 12 weeks of treatment with once-daily pills. It was a far cry from the previous treatment protocol, which involved injections several times a week of a medication called interferon, an immune stimulant that caused severe, flu-like side effects.
Sofosbuvir cleared approval by the U.S. Food and Drug Administration in December 2013. The FDA is also expected to approve sofosbuvir taken in combination with ribavirin and interferon for patients with types 1 and 4 hepatitis C.
Shiffman calls sofosbuvir “one of the most promising drugs in the pipeline today” putting the medical community on the verge of being able to eradicate the hepatitis C virus.
Four different pharmaceutical companies are currently developing hepatitis C-fighting drugs, with the goal of being able to treat patients without interferon at all, Shiffman says.
Shiffman, who’s been treating and researching liver disease since 1990, when the cure rate was barely 10 percent, says it’s an exciting, rewarding time for in the field of hematology.
The challenge now, Shiffman says, is to identify patients (routine blood screening is now recommended by the CDC for all baby boomers), because three in four people infected with hepatitis C don’t even know they have it.
“The future is very, very bright for patients with hepatitis C,” he says. “When we see patients, we can really tell them we can cure their disease. We have people who are cured every day.”
Image courtesy of Gilead