Hepatitis C treatment has come a long way over the past decades. Treatment with direct-acting antivirals can be done in as little as 8 to 12 weeks with fewer side effects and high cure rates over 90%.
Treatment is now available for all genotypes (virus strains) and liver conditions.
Hep C Treatment History
1989: Non-A, non-B hepatitis is identified and named hepatitis C.
1991: FDA approved the first alfa interferon (Scherings’s Intron A) to treat hepatitis C.
1998: FDA approved Rebetron (Scherings Intron A plus ribavirin).
1991 to mid-2011: Advances in interferon and ribavirin treatment for hepatitis C were made but continued to be the only treatment available.
2011: FDA approved the first two protease inhibitors used in combination therapy with Interferon and ribavirin, boceprevir (Victrelis) and telaprevir (Incivek) for genotype 1. For the first time, a cure rate between 66% to 79% was available.
2012: Clinical trial studies of DAAs (direct-acting antiviral medications).
2013: FDA approved Janssen’s Olysio (simprevir) plus peg-interferon and ribavirin for genotype 1. Cure rate up to 80% with 24 weeks treatment.
FDA also approved Gilead’s Sovaldi (sofosbuvir) plus peg-interferon and ribavirin for genotype 1 and 4. Cure rates up to 90% for genotype 1, and 96% for genotype 4. Treatment duration for 12 weeks.
FDA also approved Gilead’s Sovaldi (sofosbuvir) plus ribavirin without interferon to treat genotype 2 and 3. Cure rates 93% for genotype 2 for 12 weeks treatment and cure rate of 84% for genotype 3 for 24 weeks treatment.
2014: FDA approved: Gilead’s Harvoni (sofosbuvir/ledipasvir) interferon- and ribavirin-free treatment. The first single dose per day treatment for genotype 1a, 1b, with treatment range from 8 to 24 weeks.
FDA also approved AbbVie’s Viekira Pak, interferon-free. 3D combination treatment with and without ribavirin for genotype 1a, 1b for 12 to 24 weeks.
2015: FDA approved two new drugs.
AbbVie’s Technivie for genotype 4, an interferon-free treatment, used with ribavirin for 12 weeks, in clinical trials cured 100% of patients without cirrhosis.
Bristol-Myers Squibb, Daklinza for genotype 3. An interferon- and ribavirin-free treatment for 12 weeks with cure rate averaging from 58% to 98% depending on the patient’s liver condition with or without cirrhosis.
2016: FDA approved Gilead’s Harvoni to expand treatment to include genotype 4 along with genotype 1 for liver transplant patients and patients with and without cirrhosis.
Merck’s Zepatier (elbasvir/grazoprevir) for genotypes 1 & 4 to be used with or without ribavirin for 12 weeks, with a cure rate of 94% to 97% for genotype 1 and for genotype 4 cure rates of 97% to 100%.
Epclusa (sofosbuvir/velpatasvir) by Gilead Sciences was approved in June 2016. The first treatment is effective for all genotypes.
2017: On July 18 the U.S. Food and Drug Administration approved the new hepatitis C treatment Vosevi to treat adults for all genotypes 1-6. Vosevi is for patients without cirrhosis or with mild cirrhosis.
In August, the FDA approved hepatitis C treatment Mavyret, for all genotypes, for patients without cirrhosis and those with compensated cirrhosis as well as patients with genotype 1 who have been previously treated with an HCV NS5A inhibitor or NS3/4A protease inhibitor but not both and for patients with severe kidney disease, including those on dialysis.
2018: Olysio by Janssen was discontinued due to more effective treatment available on the market with pan-genotypic treatments.
Discontinued: Viekira Pak and Daklinza
No longer commonly used but still available: Solvadi and Ribavirin.
2018: AbbVie announced Technivie used for Genotype 4 will only be available until 1/1/2019 due to more effective treatment available on the market with pan-genotypic treatments.
2019: Gilead released the first generics for hepatitis C in the U.S. The generics are for Epclusa and Harvoni by Asegua Therapeutics (a Gilead Science subsidiary).
AbbVie discontinued Technivie.
2020: Improvements for hepatitis C treatment continue in ongoing clinical trials.
Clinical trials continue for medications to help those with cirrhosis.
Clinical trials continue for a hepatitis C vaccine.
This entry was originally published in Life Beyond Hep C, and is reprinted with permission.