Curing Hepatitis C Will Take More Than New Treatments.

November 1, 2010, 10:23 AM ET

By Jonathan D. Rockoff

At the annual meeting of the American Association for the Study of Liver Diseases that wraps up tomorrow, there’s been lots of talk about the potential for some experimental treatments for hepatitis C.

Pivotal trials have shown that the two therapies farthest along in development — telaprevir from Johnson & Johnson and Vertex Pharmaceuticals, and boceprevir from Merck — are more likely to cure hepatitis C than currently available treatment. There’s widespread anticipation the pills will win FDA approval next year. And they could be followed by the introduction of even more new therapies, the WSJ reports.

Yet the rollout of new medicines won’t be sufficient to wipe out the infectious disease, companies acknowledge. “Just adding a new drug that doubles the cure rate of hepatitis C will not solve the problem,” Camilla Graham, a medical affairs official at Vertex, tells the Health Blog.

One big obstacle: most of those carrying the virus don’t know it. Most estimates say just a quarter of the 4 million infected Americans have been diagnosed. Screening for hepatitis C via a blood test isn’t routine. And the blood-borne disease, which is popularly associated with drug use since it can be spread through sharing of contaminated needles, carries a stigma that can deter people from seeking help.

Another hurdle, doctors say, will be giving the new treatment correctly. The FDA hasn’t signed off on how the new pills would be administered if approved, but doctors expect it’ll be complicated. They anticipate they’ll have to stay on top of the progress of treatment in order to determine its course and duration.

The new pills are “going to increase the cure rate, but at the same time, they are going to add to the chance of side effects, so patients must be vigilant,” says Zobair Younossi, who heads the Inova Health System’s Center for Liver Diseases in Falls Church, Va.

This probably won’t be easy, at least in the beginning, according to doctors. Telaprevir and boceprevir will be used in addition to the antiviral injection and pill currently being given to patients, not in their stead. And those older regimens can produce side effects such as flu-like symptoms and depression.

Addition of a third medicine “makes management slightly more intensive for doctors, and I think the learning curve is going to be steep,” says David Bernstein, chief of gastroenterology and hepatology at North Shore University Hospital and Long Island Jewish Medical Center. He’s been trying to counsel doctors on using the new therapies.

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