New Face of Cure for Hepatitis C

New Face of Cure for Hepatitis C
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New Face of Cure for Hepatitis C
TABLE OF CONTENTS
1 Executive Summary ……………………………....……………………………..3
2 Chapter 1: Definition of the Problem/Hypothesis ……………….………………5
3 Chapter 2: Literature Review ……………………………………………………8
4 Chapter 3: Methodology ………………………………………………………..10
5 Chapter 4: Data Analysis ………………………………………………………..11
6 Chapter 5: Summary, Conclusions, and Recommendations …………………….14
7 List of References ……………………………………………………………….15
8 Appendix ………………………………………………………………………...16
EXECUTIVE SUMMARY
Hepatitis C (hep C) is a viral infection that is brought about by the Hepatitis C virus (HCV). The virus is spread by blood and mostly in health care facilities. If left untreated, hep C can cause irreversible damage to the liver and even end up in death. Experts point out that Hep C is the primary cause of liver cancer and accounts for nearly 82% of all the liver transplants. Apart from this, the virus is also linked to numerous other conditions including but not limited to diabetes and depression. According to the US Centers for Disease Control and Prevention (CDC), there are over 3 million people infected with the virus but only half of this number is aware that they are infected. Although statistics show that there are about 16,000 hep C deaths each year, other statistics show that the true hep C-connected deaths is over 50,000.
From the moment that HCV was identified as the major cause of hep C, finding the ideal cure for the disease has been a concentrated field of research by academicians and drug companies. Immediately after the discovery of the virus, the introduction of interferon, and shortly after that, pegylated interferon and ribavirin presented for the very first time the possibility of finding a cure for people suffering from hepatitis C. There were, however, challenges with these efforts as majority of the individuals with the virus were ineligible for treatment using interferon while those eligible for treatment the rate of success was no more than 50%. In addition to this, only a small fraction of those who commenced treatment ended up completing due to the harsh side effects of interferon. The good thing is that in recent years a better treatment for the disease has been invented. The main objective in offering cure for any disease is a harmless, uncomplicated, and highly efficient cure that is attained quickly with low eligibility restraints. All scientific evidence shows that the world is at a point where a cure that has a success rate of more than 95% is about to be attained. Given time, these new medications have the capability of changing the face of hep C in America by radically bringing down the sickness and death linked with the disease.
CHAPTER 1: DEFINITION OF THE PROBLEM/HYPOTHESIS
Hep C is a viral infection that attacks the liver. Since the virus spreads rapidly in the body, it is linked with numerous disorders that are outside the liver. The disease is spread through coming into contact with infected blood and is usually contracted in hospital settings although in rare occasions some infections are contracted through having sex with an infected person or through the use of needles. A large number of Americans that have the disease got it from infected blood in the 1970s and 1980s before blood screening tests became routine in the 1990s. Estimates show that a large percentage of the individuals with the disease were born between 1946 and 1964 and most of them also have the genotype 1 type that is the most difficult to cure (Singal et al, 2010).


Source: Arase et al, 2012.
The CDS projects that at the present about 4.1 million have been exposed to HCV while over 3 million people are chronically infected meaning that they will not be able to get rid of the virus from their bodies without getting proper medical attention. Some other research shows that 5.2 million Americans are directly exposed to the virus. This high number included those without homes and prisoners. Today, the rate of new contagion has been reduced significantly but the number is still high. Estimates show that there were over 17,000 new infections in 2011 although most people think that this is a low estimate. The first reason for this opinion is that majority of the new infections do not come to light immediately and the second is that the CDC epidemiology does not incorporate the high risk populations from their analysis. Actually, there have been rising cases of new infections among young drug users and what is worrying is that most of these patients do not have any link to the health care system (Arase et al, 2012).
While hep C spreads at a slow rate, the end result can be fatal. According to CDC, 75% of all the patients infected with HCV develop liver cirrhosis which 10% end up dying from the effects of the disease. Some scholarly studies have pointed to mortality rates of up to 30%. The CDC notes that there were 16,622 HCV related deaths in 2010. This number is, however, projected to be high since some of the HCV cases go undiagnosed. Apart from the relatively high mortality rate, hep C causes major morbidity. Liver disease that has progressed for a long time, as well as liver cirrhosis can give rise to other complications such as jaundice, anemia, diabetes, and in some case liver cancer. Most important, there is always a high chance that the symptoms will persist even if the HCV is cleared in the event that treatment is postponed for a long time since at this stage the liver has undergone a permanent damage. Today, hep C is the leading cause of lung cancer among all age groups. Once cirrhosis gets at the advanced stage, the only available option for treatment is liver transplant and at the present this does not seem to be working since there is a shortage of liver donors in the country with statistics showing that there are over 16,000 people in the liver transplant waiting list (Arase et al, 2012).
Over the years, the treatment for HCV has been hampered by several interlinked factors. The first of these factors has been the use of medications that have a low propensity for cure, as well as a poor diagnosis rate that leaves over 2 million people unaware of their status. The other factor has been low treatment rates even among people who are fully aware of their status. The last factor is the low socio-economic forces that bar most populations from prone areas having access to health care. In the last few years, the use of DAA in combination with pegIFN plus ribavirin (PR) has been found to give a high sustained virologic response (SVR) thus giving the impression that a new face in the cure for HCV is in the offing.
Definition of Key Terms
Incidence: The rate at which a certain disease takes place
Prevalence: The rate at which a certain disease is concentrated in a certain area
Chronic HCV Infection: A long standing infection that has spread to other vital organs
Genotype: The genetic makeup of the body
Sustained viral response (SVR): Aviremia 24 weeks after completion of antiviral therapy for chronic hepatitis C virus (HCV) infection
CHAPTER 2: LITERATURE REVIEW
There are various studies done in the last 10 years which show that using DAA together with pegIFN plus ribavirin (PR to attain a high SVR has the ability of changing patient outcomes in the treatment of HCV. A 2010 study by Singal et al (2010) established that patients who had a SVR after treatment with IFN had a 95% recovery rate. These results were collaborated by another study done by Kimer et al (2012), which also reported a recovery rate of 95%. The only difference between the two studies was that the one by Singal et al included only studies with cirrhosis while the one by Kimer et al included two studies done among non-cirrhotic patients.
Studies investigating the effect of SVR on risk for hepatocellular carcinoma in Japan are of special interest due to the high comparative occurrence of HCV genotype 1b (which is linked to a higher incidence of HCV genotype 1a) and high rate of HCV-affiliated hepatocellular carcinoma in this setting. For HCV patients that develop cirrhosis, the yearly likelihood of HCC is 1-4%, although this goes up to 5-8% if the patient has HCV genotype 1B. Studies done...