Hepatitis C treatments formerly involved months of strenuous injections of s with serious side effects and up to only 50% cure rates. The new medications are now oral combination therapies with a duration of several weeks. The side effects are mild and have a success rate of removing the virus from the blood 90% of the time.
The ultimate goal in treating HCV is to hopefully reduce the risk of liver disease, end-stage liver disease, and risk of death. Sustained virology response means complete disappearance of the hepatitis C virus for at least twelve weeks, after which a patient may stop treatment.
Medications
Direct-Acting Agents (DAAs): Direct-acting agents include the options of protease inhibitors, nucleotide polymerase inhibitors, and NS5A inhibitors.
HCV treatment combinations containing protease inhibitors and nucleaotide polymerase inhibitors:
- Mavyret (Glecaprevir and pirbrentasavir)
- Daklinza (daclatasvir)
- Sovaldi ()
- Pak (ombitasvir/paritaprevir/ and )
- simeprevir (Olysio)
- telaprevir (Incivek)
- Epclusa ( and velpatasavir)
- ( and ledipasvir)
- Zepatier (grazoprevir and elbasvir)
- Technivie (ombitasvir/paritaprevir/)
- boceprevir (Victrelis)
Protease Inhibitors
Protease inhibitors are direct-acting antiviral agents.
How do nucleotide polymerase inhibitors work?
Nucleotide analog polymerase inhibitors are a different type of direct-acting antiviral agents which work by hindering the action of proteins.
What are the side effects of DAAs?
The most common side effects of DAAs include diarrhea, fatigue, and headaches. The less prevalent side effects experienced include insomnia, hair loss, muscle pain, joint pain, nausea, and dysgeusia.
Other side effects of the medication include:
- vomiting
- anemia
- rash
- itching
- increased photosensitivity
- reduced white blood cell count
- shortness of breath
The addition of protease inhibitors to PegIFN/RBV is shown to result in a decrease in red and white blood cells compared to just PegIFN/RBV alone.
Daklinza causes diarrhea, insomnia, fever, fatigue, flu-like symptoms, and elevated liver enzymes. Certain medications used to treat heart rhythm, like amiodarone, can potentially cause a slower heartbeat.
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