Explaining the ins and outs of treating HCV
By Andrea Arscott, Senior Columnist
Two new hepatitis C medications, sold under brand names Sovaldi and Harvoni, are now covered under BC PharmaCare to treat chronic hepatitis C (HCV or hep C). These antiviral therapies have a 90 per cent cure rate, whereas the older combination therapies haven’t had as high a success rate in curing HCV.
For those of you who don’t know, HCV is a virus that causes inflammation of the liver and can lead to cirrhosis and the need for a liver transplant. HCV can be a chronic terminal illness, but these days it’s more common to be cured with proper treatment.
Sovaldi (sofosbuvir) and Harvoni (ledipasvir and sofosbuvir) are both pills that are taken over a 12-week period, compared to a previous one-year period of injections and pills. There are different strains of HCV, so depending on which genotype a person has, a combination of the older medications may be prescribed with the newer ones.
Now in order to be eligible for coverage patients must be in the fibrosis stage F2 or greater. There are various tests to determine the severity of cirrhosis and fibrosis of the liver, including having a liver biopsy, transient elastography (FibroScan), or blood tests.
Since there is no vaccine for hep C (just hep A and B), and because some people don’t experience symptoms, it’s important to get tested. According to Catie.ca in 2011, “approximately 97,107 to 108,234 or 44 per cent of people [Canadians] living with chronic hepatitis C were unaware that they had this infection.”
People may not know they have HCV because they’ve never been tested and because symptoms can take up to 20 to 30 years to develop, if at all. By this time, they’d likely have severe liver damage.
Symptoms can include jaundice, fatigue, nausea, reduced appetite, and abdominal pain.
The Canadian Liver Foundation estimates there are roughly 250,000 people infected with HCV in Canada. If you’ve never asked your doctor to test you for HCV, now is the time. Or, get it done when you get tested annually for HIV and other sexually transmitted infections (STIs).
HCV is transmitted through blood-to-blood activities—sharing manicure equipment; toothbrushes; razors; unsterilized medical, dental, tattoo and piercing equipment; needles (acupuncture, diabetic, steroid, and injection drug use); blood transfusions prior to 1992; condomless sex during a woman’s menstrual period; rough, unprotected sex; and sharing other drug paraphernalia.
Basically, you don’t want to share anything that might have blood on it, as it could put you at risk, if the other person is HCV-positive. The virus is also a strong one and can live on surfaces, such as a bill or pipe, for up to six weeks.
If you’re considering Sovaldi or Harvoni talk to your doctor or specialist prior to starting these medications to determine if they interfere with other meds you may be on. The US Food and Drug Association warn that the new treatment for HCV can cause a deadly reaction when taken with the heart medication amiodarone. So be careful and be sure to weigh the pros and cons before subscribing to any treatment regimen.
The easiest way to prevent the spread of HCV is to know your status, so get tested! For any other questions you can contact the Purpose Society, or book an appointment with your doctor.