Curing your Patients from Hepatitis C: Addressing Complex Needs with Simplified Treatment Approaches - Episode 6

Treatment Options for HCV

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An overview of treatment regimens for HCV.


Anthony Martinez, MD: Mark, you mentioned a little bit about how the therapeutics have evolved. Jordan, can you kind of give us a high-level overview of what we have available for patients today?

Jordan Mayberry, MPAS, PA-C: Currently there are 2 different regimens in our treatment algorithm. I think it’s important to just reiterate that these medications are highly effective. For a majority of patients, they are going to be on treatment anywhere from 8 to 12 weeks. These medications are also incredibly tolerable. The most common [adverse] effects reported with these medications are headache and fatigue. I would say that a majority of our patients who take these medications feel great while on therapy; they’re able to continue their daily lives, which is very different from what we saw when we were treating patients with interferon. These patients continue to work, continue to exercise, and continue to be very healthy throughout this process. We do have to be concerned about a few drug-to-drug interactions. So it’s important that we are reviewing the other medications that these patients may be on, some common medications like statins, our PPIs [proton pump inhibitors], some seizure medications. So we need to get a good history about their current drugs and medications.

Anthony Martinez, MD: Excellent. And it’s important to point out that nearly every patient has some treatment option available to them. Mark, I can tell you in my area, we’ve seen an increase in the incidence of new cases of HIV. This is something that kind of got quiet for a while. Initially, when these new therapeutics came out, we treated all of our co-infected patients who had hepatitis C and HIV, and then things were quiet for a bit. We’ve seen an increase in prevalence of HIV in my area among people who inject drugs. I don’t know if some of you are seeing the same trend. If you have a co-infected patient, are you doing anything differently?

Mark Sulkowski, MD: Again, I have a simple short answer, no. We can certainly treat people with HIV co-infection in a very safe and effective manner with rates of hepatitis C cure identical to that of any patient. I do want to just pause to think about the amazing advantages we’ve had for HIV that made this possible, including HIV prevention. And, Tony, you talked about people with substance use disorder acquiring HIV. Two, I think, really important points. One is if you went to their community, went to their network, and looked at hepatitis C, it was on average months, if not years, before HIV entered that community or network. Really getting in…screening, treating hepatitis C, and then offering HIV prevention or PrEP [preexposure prophylaxis] are important strategies that, honestly, we’re not using enough. Those HIV infections are preventable. I think it’s important in this regard to note that HIV and hepatitis C are linked together. We used to have co-infection in 50% of our patients in my clinic at Baltimore [Maryland]. Active hepatitis C is now present in less than 3% of those patients. We can do great things when we apply evidence-based strategies in a manner that gives everyone access, equitable access.

Anthony Martinez, MD: I think the need for PrEP is that’s essential, especially in that specific cohort, and we’re definitely underutilizing it.

Transcript was AI-generated and edited for clarity.