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What is hepatitis C?

Hepatitis C is a liver disease that results from infection with the Hepatitis C virus (HCV). It can range in severity from a mild illness lasting a few weeks to a serious, lifelong illness. Hepatitis C is usually spread when blood from a person infected with the hepatitis C virus enters the body of someone who is not infected. Today, most people become infected with the Hepatitis C virus by coming in contact with infected blood. Common risk factors are tattoos and drug use (especially IV drug users),or exposure to contaminated medical instruments. There is an increased risk of becoming infected with hepatitis C if you have multiple sex partners. There have been rare, documented cases of people with chronic hepatitis C transmitting the virus to their only, long-term sexual partner. In this case, the risk of sexual transmission appears to be low. Before 1992, when widespread screening of the blood supply began in the United States, hepatitis C was also commonly spread through blood transfusions and organ transplants.

The vast majority of people with hepatitis C develop chronic liver disease that, without treatment can progress to cirrhosis or liver cancer. HCV is the most common indication for liver transplants.

There are six major genotypes or genetic variations of HCV. Genotype 1 is the most common, accounting for about 70% of the infections in the U.S. This is important in determining treatment.

Treatments

Until recently the standard treatment for hepatitis C infection for all genotypes was pegylated interferon shots plus oral ribavirin for 24 for genotypes 2 and 3, or 48 weeks for genotype 1. The SVR rates (sustained viral response), patients whose virus remains undetected after treatment, for this treatment was approximately 50% for genotype 1 and 75% for genotype 2 and 3. In addition, interferon and ribavirin caused many serious side effects.

In mid-2011 two new drugs, telaprevir and boceprevir, were approved by the FDA that had a significant change in the treatment of hepatitis C for people with genotype 1.  Adding these new drugs to the standard treatment increased SVR rates to 65-75% in genotype 1 patients but did not decrease side effects. These new drugs are not useful in treating genotypes 2 and 3.

There are now a number of novel oral DAAs (direct acting anti-virals) in development for all genotypes of hepatitis C. Researchers are actively seeking treatments with higher virologic response rates, shorter treatment durations, and fewer side effects. Many of these new treatments in development are all oral, interferon-free combinations.  Some of these new treatments have been submitted to the FDA for final review and approval – late 2013 or early 2014.  Please check our news section for the latest developments.

MARG and Hepatitis C

We have been working on hepatitis C trials for more than a decade. MARG participated in the clinical trials that led to the approval of both telaprevir and boceprevir. Currently we are working with all of the pharmaceutical companies that are developing new medications and have been part of many recently published articles about these breakthrough treatments.  People with hepatitis C who are interested in receiving treatment with new drugs in development can contact us and find out about our currently enrolling trials.