Guidelines Update Priority Treatment of Hepatitis C

Recent updates of guidelines for the treatment of Hepatitis C recommends priority to the sickest patients with advanced fibrosis, compensated cirrhosis or those in need of a liver transplant.

The updates have been posted on HCVguidelines.org, which is backed by the American Association for the Study of Liver Diseases, the Infectious Diseases Society of America and the International Antiviral Society-USA. The organizations announced earlier this year that the new website had been created to offer a mechanism for updating treatment guidance in a more timely fashion.

Chronic infection of hepatitis C affects an estimated 3 million people in the US and 130 million to 150 million people worldwide. There is currently no vaccine for the virus, which is transmitted through exposure to hepatitis C-infected blood and can remain symptom-free in the body for years before liver damage is detected.

The guidelines support treatment of all hepatitis C infected patients with the exception of those with life expectancy less than 12 months due to non-liver related comorbidities. They assign highest treatment priority and recommend immediate treatment to patients with advance fibrosis, compensated cirrhosis, liver transplant recipients and patients with extrahepatic hepatitis C, according to new text added under a section that identifies when to initiate treatment and for whom.

“Based on available resources, immediate treatment should be prioritized as necessary so that patients at high risk for liver-related complications and severe extrahepatic hepatitis C complications are given high priority,” state the guidelines.

Another update adds women of child-bearing potential who are infected with the virus and want to become pregnant to the list of groups considered at elevated risk and whose treatment could reduce the risk of transmitting the disease. Treatment of the disease while a woman is pregnant to prevent transmission to the fetus has not been proved safe and is not recommended.

The rapid advancement in drug development of direct-acting antivirals for treatment of hepatitis C is one of the reasons cited earlier this year for adopting timely updates to guidelines. In the past, revisions to the guidelines could take two or more years to complete.

The website aims to keep current about diagnostic tools and new drug treatments approved by the US Food and Drug Administration. Leading the way in the accelerated battle against hepatitis C are drugs like the blockbuster Sovaldi by Gilead Sciences that can treat the virus faster and with fewer side effects and higher cure rates.

The cost of the new hepatitis C drugs continues to stir controversy and debate about affordability of the drug, who should get it and when, and whether health insurance companies can and will foot the bill. In the United States for example, Sovaldi is priced at roughly $1000 a pill, which amounts to at least $84,000 for a typical treatment period.