Experts have declared the end of hepatitis C, thanks to a three-month course of tablets that could see the killer blood disease eradicated from Britain. The development of Sovaldi (sofosbuvir) has been hailed as a ‘game-changer’ in the treatment of the illness.
‘This new drug gives us the opportunity to clear hepatitis C from the UK,’ says Graham Foster, professor of hepatology at Queen Mary, University of London.
Hepatitis C is a blood-borne virus that was first identified in 1989. Many of those affected received contaminated blood from transfusions or medical procedures prior to 1989, or by sharing needles or having tattoos. Famous sufferers include Body Shop founder Dame Anita Roddick, who died of a brain haemorrhage in 2007, and former Baywatch star Pamela Anderson. The virus is estimated to affect 215,000 adults in the UK, of whom more than half remain undiagnosed.
Untreated, it rots the liver and, over a period of 30 to 40 years, leads to cirrhosis and liver cancer. Death rates have been rising rapidly. In 2011 there were 381 deaths from hepatitis C, but it now kills more people than diseases related to HIV. Until now, treatments, which can last up to a year, have been fairly effective, with a 60 to 70 per cent cure rate. But they have unpleasant side effects.
Sofosbuvir, when taken in combination with the current treatment options – injections of interferon and ribavirin tablets – cures up to 90 per cent of patients in just 12 weeks, and is tolerated by almost everyone. Prof Foster says: ‘If we treat 20,000 patients every year for the next ten years, nobody will transmit the virus and it will be gone.
Hepatitis C mutates every time it copies itself, making treating it like hitting a moving target. ‘Sofosbuvir hits at the enzyme at the very heart of the virus, stopping it from mutating or becoming resistant.’
The drug is now awaiting approval from watchdog NICE. At a cost of £35,000 for a 12-week course, it is not cheap, but experts are optimistic it will be seen as cost-effective. ‘It is estimated that hepatitis C currently costs the NHS £156 million per year,’ says William Rosenberg, professor of hepatology at University College London. Prof Foster adds: ‘Later this year we expect to see the availability of other new drugs, which we can combine with sofosbuvir. This will allow us to stop using interferon, which causes the worst side effects and can’t be tolerated by the sickest patients. ‘Studies show these new drugs administered with sofosbuvir have a 97 per cent success rate. It’s possible the treatment period will go down to a few weeks.’
There is just one shadow on the horizon: the low hepatitis C detection rate in the UK, which means many of those needing treatment will not be identified until they are seriously ill. The UK has no comprehensive screening programme, meaning we lag behind other European countries and the United States in identifying sufferers. ‘We need a proper screening programme if we are to gain full benefit from these drugs,’ says Prof Rosenberg. Charles Gore, chief executive of the Hepatitis C Trust, says: ‘This will be a huge step forward for patients towards the goal of short, easy-to-tolerate treatments that will cure hepatitis C in almost everyone who takes them. ‘We will be able to stop thinking of the virus as a chronic illness leading to cirrhosis and liver cancer and think of it instead as a nasty virus that is easily treatable. I hope this means that many more people will think about getting tested.’