Sofosbuvir (looks a little like a Twinkie) - Photo: Andrew Karpenko, University of Washington
Sofosbuvir (looks a little like a Twinkie) - Photo: Andrew Karpenko, University of Washington

Another day, another story about rising hepatitis C rates, most likely related to the similarly rising rates of heroin use. Recently, I wrote about rising rates in Minnesota. Today the problem seems to be among young people (15 to 25 years old) on Cape Cod, Massachusetts.

Approximately 15 to 20 of the Cape Cod Healthcare patients have been prescribed the new (soon to be blockbuster) drug Sovaldi (Sofosbuvir) which was released by Gilead (I am still kicking myself for not buying shares at $60) and received US Food and Drug Administration (FDA) approval in 2013. Sofosbuvir is used to treat infection of hepatitis C virus (HCV) and has a very high cure rate. It acts to inhibit the viral RNA polymerase, which is a viral protein that replicates the viral genome. Without an active viral RNA polymerase, the virus cannot replicate. Sofosbuvir was a major step forward in the treatment of HCV, not only due to its fantastic cure rate, but also due to its relative lack of side effects compared to earlier methods of treatment. Before Sofosbuvir, a combination of pegylated interferon alpha and ribavirin were used, and while effective, had side effects of fatigue, flu-like symptoms, anxiety, depression, and suicidal tendencies.

One problem with Sofosbuvir is that it is prohibitively expensive. Stupidly expensive. Insanely expensive.

There has been some discussion about trying to get the cost of Sovaldi down. Hopefully, some funding for public health programs geared toward younger adults and heroin use/HCV infection happen soon. To have an uptick in heroin use and HCV infection after years of a downward trend would erase years of progress.

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  • Lance D. Presser has a PhD in microbiology and immunology and is a public health laboratorian.
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This entry was originally published on Lance’s Science Macrocosm May 20. It is reprinted with permission.