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Hepatitis C

For more information on Hepatitis C treatment, please contact the GP Liaison Department on:

T: 020 7234 2009

or visit

www.londonbridgehospital.london

Hepatitis C

TWENTY

TWO

In the UK, there are around 216,000 people chronically infected

with Hepatitis C – with over 180 million people infected worldwide.

The aim of HCV treatment is to clear

the virus from the blood to prevent

progression of liver disease and to

inhibit transmission. There has now been

a revolution in the treatment of the

Hepatitis C virus, with the arrival of new

medications signifying a breakthrough for

this chronic illness. Healthcare body, NICE

(National Institute for Health and Care

Excellence), has confirmed final guidance

on ledipasvir-sofosbuvir (Harvoni) as the

recommended treatment option. We

are delighted to announce that London

Bridge Hospital is now offering a package

treatment service to patients and the

results have proved to be very promising.

The all-oral combination therapy of

ledipasvir-sofosbuvir (and also ribavirin

for some cases of genotype 1-6 chronic

Hepatitis C), boasts cure rates of over

95% in patient groups among most

people infected with Hepatitis C. Previous

interferon-based treatment has been

recorded to clear the virus in only half

of all cases. The new recommendation

has a number of ideal properties that

make it preferable to previous treatments,

including once-daily dosing, no meal

restrictions, minimal side effects, minimal

interactions with other drugs, as well

as high levels of safety and efficiency

in patients with advanced liver disease.

Unlike all previous recommended

treatments, little monitoring and no

injections are required.

Professor Graham Foster, Consultant

Hepatologist at London Bridge Hospital,

who has helped develop the treatment

along with colleagues at the hospital,

comments, “This is a breakthrough for

the disease and a revolution in healthcare,

one that could potentially cure Hepatitis

C and eradicate the virus entirely. It is a

wonderful new, almost side-effect-free

treatment, and is available at London

Bridge Hospital immediately. For over 20

years, the standard treatment for Hepatitis

C has been interferon-based therapy –

a treatment prescribed as an injection

for up to 48 weeks. This treatment is

associated with severe and common side

effects, with three out of four people

experiencing one or more side effects

such as depression, anxiety, dizziness and

hair loss. It is therefore unsurprising that

it is has been an unpopular choice of

treatment, and many have put themselves

at risk of cirrhosis and liver damage as a

result of discontinuing their treatment or

opting out.”

New guidance for the treatment of

HCV is currently available at London

Bridge Hospital after the Committee

acknowledged ledipasvir-sofosbuvir as a

valuable new therapy for treating chronic

Hepatitis C. NICE has not yet issued final

guidance to the NHS and it is not yet

clear when this treatment will be available

to NHS patients. This is not covered by

insurance companies and will be available

on request, as part of our self-pay package.

Professor Foster concludes,

“The key with the new recommended

treatment is to find the individuals who

are transmitting the virus and prioritise

their treatment, in order to initially

limit the spread of the disease. We’ve

been working on improving the options

available to Hepatitis C patients with

the aim of improving cure rates and

preventing transmission.”

For more information on key trials refer

to ‘Therapy of Hepatitis C – Back to the

Future’ T. Jake Liang, M.D., and Marc G.

Ghany, M.D., M.H.Sc. N Engl J Med 2014;

370:2043-2047 May 22, 2014

DOI: 10.1056/NEJMe1403619

Hepatitis C

• For uncomplicated Genotype 1 HCV

infection focosbuvir and ledipasvir

(combined in a single tablet) led to viral

clearance in 94% of patients in a phased

3 clinical trial (Kowdley K.V. et al. NEJM

2014; 370:1879)

• Alternative regimes for patients

with Genotype 1 infection involve

combining a number of different drugs

(parataprevir, ombitasvir and dasabuvir).

This led to sustained virological

response rates in 96% of patients in a

phase 3 clinical trial (Feld JJ, et al NEJM

2014:370:1594)

• For patients with chronic Hepatitis C

of other genotypes a number of new

regimes are emerging that offer the

prospect of a sustained virological

response for the majority of patients

– in theValence study in patients with

Genotype 3 HCV 85% of patients

cleared the virus with 24 weeks

treatment with all oral medication.

• The new regimes for chronic Hepatitis

C are extremely well tolerated with

minimal side effects seen in large

cohorts of treated patients.

Revolution in

the treatment

for Hepatitis C