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With over 200 million people currently infected, around 11 million new cases and almost 700,000 deaths every year, hepatitis C is undoubtedly one of the most serious diseases that mankind has ever had to fight with. It is caused by hepatitis C virus – an RNA virus belonging to Flaviviridae family that mainly affects the liver and can eventually cause conditions as serious as cirrhosis, liver failure, liver cancer and the like.
The signs of hep C are not that easy to notice after the initial infection – only 15% of the patients report very vague symptoms, the most common of which include fatigue, abdominal pain, decreased appetite and consequent weight loss, nausea and mild pain in muscles and joints. Therefore, it’s absolutely no surprise that the majority of hep C cases are only diagnosed long after the end of the acute stage and in most patients the doctors have to deal with long-term chronic infection. Unfortunately, by that time the harm done by the virus makes the therapy increasingly more challenging.
Most patients get hepatitis C after being exposed to infected blood. This may happen as the result of sharing drug paraphernalia for intravenous use, blood transfusion, during childbirth when the virus is transferred from mother to child. There are also recorded cases of infection resulting from sharing personal care items such as razors or toothbrushes, penetrative anal sex and body modifications involving the use of shared needles or tattoo equipment. However, it’s worth saying that such cases are extremely rare nowadays.
Fortunately, hepatitis C is no longer the incurable disease that it used to be literally a few years ago. Today’s article will be dedicated to a relatively new medication that shows truly outstanding efficiency in treating hepatitis C: sofosbuvir (currently manufactured and sold in most countries under the brand name of Sovaldi). According to recent clinical studies, combination therapy with sofosbuvir, ribavirin and, occasionally, pegylated interferon proves to be effective in up to 90% of the cases. Before the invention of sofosbuvir that was discovered and hit the market in 2013, the main means of treating hep C was therapy with ribavirin and peginterferon alone. Not only was it likely to cause more serious side effects but also was considerably less reliable – only around 50% of all patients showed no signs of hep C infection 3 months after the end of therapy.
So, how exactly does sofosbuvir work, how does one take it and what side effects and health risks should a person considering therapy with this medication be aware of? All of these questions, along with a few more, will be answered in the following paragraphs of this article. Please, keep reading.
If you or someone you know have hep C and consider therapy with sofosbuvir, there are a few things that you should be aware of. First of all, it’s important to understand that this medication is available by prescription in most of the countries, so Sovaldi hep C therapy certainly can’t be self-prescribed and administered. Even though this medication is fairly simple to take, you should definitely consult your doctor prior to starting the treatment and undergo all necessary tests in order to make sure sofosbuvir is right for you.
Before we switch on to basic therapy instructions that patients using sofosbuvir should follow, let us give you a brief description of this drug’s mechanism of action, which should help you understand why sofosbuvir is not effective when taken alone and why it should always be prescribed as part of combination therapy.
Being a nucleotide analogue HCV polymerase inhibitor, sofosbuvir doesn’t actually kill hep C virus – it only prevents its replication by affecting it on RNA level. Once the virus has stopped spreading and affecting more cells in the patient’s system, it’s easier for other drugs to kill it off. In most cases of hep C genotype 2 and 3 infection, sofosbuvir is taken together with ribavirin, which also alters the RNA of hep C, causing mutations that are lethal to the virus. In patients with hep C genotype 1 and 4, combined therapy with oral drugs like sofosbuvir and ribavirin also includes peginterferon (pegylated interferon) injections, which also help to decrease the amount of hep C virus in the system of the person suffering from this disease.
There aren’t too many specific recommendations regarding the use of sofosbuvir. Basically, all a patient undergoing combination hep C therapy will have to do is take 1 pill of sofosbuvir and 2 pills of ribavirin at around the same time every day for 12 to 24 weeks depending on the genotype of hep C virus they are infected with. As we have already said above, patients with hep C genotype 1 or 4 will also need peginterferon injections but the good news is that they only need to be made once weekly.
Note that a person taking Sovaldi as treatment for hep C can potentially overdose on this medication, which is why it is extremely important to follow your doctor’s prescriptions at all times and never increase the dosage even in case you missed a day or two from your therapy. If you missed a dose, take it as soon as remembered on the same day and then continue treatment in accordance with your regular schedule. If, however, you only remember about the missed dose the next day, don’t double the dose but discuss possible risks and solutions with your healthcare provider instead.
The day sofosbuvir was first introduced to the market in 2013 was indeed a big day in the history of hep C treatment. Before that there wasn’t even a single drug or combination thereof that would show a cure rate of above 50%. With Sovaldi, hepatitis C treatment effectiveness is much much higher – between 83% and 96% for different genotypes of the virus, to be precise. Why is this medication so effective and what should one do to avoid falling under the unlucky 17%? Let’s get these questions along with a few more answered in this part of our article.
First of all, let’s define what ‘being cured’ with sofosbuvir actually means. Since this medication is less than 3 years old, the data concerning its use and effect can still be considered insufficient. Therefore, when we’re saying that someone has been cured of hepatitis C with sofosbuvir, we mean that there was no hep C virus found in their blood 3 months after the end of therapy. It’s still unclear whether there’s risk of the virus returning after long periods of time or not but so far there’s no evidence of the effect of sofosbuvir being unstable or temporary. Looks like this medication works exactly like its manufacturers and consumers say it does.
It’s also very important to remember that hep C therapy with sofosbuvir, ribavirin and peginterferon shows different cure rates with different genotypes of the virus. The best cure rates are currently observed with genotypes 2 and 4 – 93% and 96% respectively. With hep C genotypes 1 and 3 the effectiveness of the abovementioned medications is lower but still remains unrivaled with 90% and 83% respectively. To be completely honest, however, we should mention that these results were obtained during clinical studies of somewhat limited focus groups – the numbers of patients with hep C genotypes 2 and 4 who took part in the test were 72 and 28 respectively. When talking about hep C GT 1 and 3, however, we can say that the size of the focus groups was considerably more representative – 292 and 250 respectively.
In order to make sure their hep C therapy with sofosbuvir works as expected, a patient suffering from this disease should always follow their doctor’s prescription down to the tiniest detail. Dosage, schedule, other recommendations – all these matter. Additionally, just like any other disease, hep C is treated best when diagnosed at an earlier stage, so if you know you belong with the risk group for this virus (e.g. have recently undergone blood transfusion, shared syringes or other drug paraphernalia for intravenous use, engaged in unprotected anal sex or got any body modifications in an unprofessional environment), make sure you undergo regular screening.
Even though hepatitis C pill sofosbuvir (Sovaldi) is known to produce a very limited number of side effects, most of which are really mild and barely cause any discomfort to the ones taking the drug, we definitely can’t call treatment with this medication 100% safe. The most dangerous adverse effect is actually not even due to sofosbuvir but to ribavirin, which the medication we review today is usually taken with. Ribavirin is not allowed for use by pregnant women as it may cause serious fetal birth defects and even miscarriage. Therefore, there are a number of very strict limitations concerning the use of sofosbuvir+ribavirin combination in therapy of hep C. First of all, all fertile women taking these medications should use at least 1 form of non-hormonal birth control and take pregnancy tests monthly. Furthermore, male patients on sofosbuvir+ribavirin should also avoid unprotected sex in all circumstances as conceiving a child during therapy significantly increases the chances of birth defects or death in fetus as well.
Other adverse effects of sofosbuvir and ribavirin can probably be called negligible as they include such conditions as nausea, headaches, fatigue, rashes, irritability and mild to moderate muscle and joint pains. Not that high a price to pay for getting rid of hep C, isn’t it? Recent clinical studies show that all of these adverse effects are most likely to be observed in patients taking sofosbuvir and ribavirin in combination with interferon while interferon-free therapy of hep C genotypes 2 and 3 produces hardly any side effects at all.
So, summing up everything stated in this article, we can conclude that sofosbuvir clearly is the most effective hep C medication available today. Its outstanding cure rate and relative safety make it #1 choice for all patients suffering from hepatitis C. Moreover, it’s very easy to take, which only adds to its success in the pharmaceutical market of today.