Hepatitis C, When Diagnosed, Becoming Easier to Cure (Op-Ed)

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Hepatitis C, When Diagnosed, Becoming Easier to Cure (Op-Ed)
LiveScience.com
By Dr. David Bernstein, North Shore-LIJ Health System  5 hours ago



Dr. David Bernstein is chief of the Division of Hepatology / Center for Liver Disease at the North Shore-LIJ Health System, and a professor of medicine at Hofstra North Shore-LIJ School of Medicine. He contributed this article to LiveScience's Expert Voices: Op-Ed & Insights.

Hepatitis C is the most common cause of chronic viral disease in the United States, affecting an estimated 5 million to 7 million Americans. It is the most common indication for liver transplantation, as well as the leading predisposing factor for the development of liver cancer, in the United States.

In general, people with hepatitis C do not show obvious symptoms, and current strategies for hepatitis C screening are risk-factor based. This strategy has not been effective. More than three quarters of people infected with hepatitis C are unaware of their diagnosis.

Within the past year, the U.S. Centers for Disease Control and Prevention (CDC) and the United States Preventive Services Task Force have recommended a change in hepatitis C screening to include screening of all Americans born between the years 1945 and1965, in addition to risk-factor based screening. This new strategy should increase the hepatitis C detection rate.

Last week, New York Gov. Andrew Cuomo signed first-in-the-nation legislation mandating that hospitals and health-care providers screen all patients born between 1945 and 1965 for hepatitis C starting on Jan. 1, 2014. This campaign to increase hepatitis C diagnosis rate is in parallel to rapid advances in hepatitis C treatment.

The U.S. Food and Drug Administration (FDA) held hearings on Oct. 23 and 24 to discuss new therapies for hepatitis C, which are likely to be approved in early December 2013. Those new therapies, which are interferon based, have a cure rate approaching 90 percent, require a shorter therapy duration and are have fewer side effects than currently available treatments. In addition, researchers are testing several oral hepatitis C therapies comprised of new classes of medications that appear to have cure rates significantly greater than 90 percent. These therapies are likely to be approved for use in the United States in late 2014 or early 2015.

Physicians and staff of the Center for Liver Diseases at the North Shore-LIJ Health System are actively involved in the treatment of chronic hepatitis C. The center has the first Fibroscan machine on Long Island, an advanced technology that enables physicians at the center to non-invasively determine the extent of liver disease without having to perform a liver biopsy.

The center is actively involved in clinical research and has more than 30 clinical trials with new oral treatment agents available for our patients with hepatitis C.

These advances in hepatitis C should lead to cure in the vast majority of patients with hepatitis C and improve overall patient survival, lessen the complications of cirrhosis including liver cancer — and prevent the need for liver transplantation in the future.

Bernstein's disclosures are as follows:

Clinical-trial sponsors: Abbvie, BMS, Gilead, Janssen, Vertex, Merck, Genentech

Consultant/speaker bureau: Abbvie, Gilead, Janssen, Vertex, Merck


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