In recent years, medicine has made a significant step forward in the treatment of hepatitis C. Modern methods of treating the disease have emerged, new drugs for hepatitis C are being synthesized and undergoing clinical trials. The proportion of patients who have been cured of this terrible disease has also increased.
Thanks to modern antiviral and immunomodulatory drugs, 50-80% of patients recover.
Every person who has been diagnosed with hepatitis C, begins to be interested in the question: How to treat and how much does treatment for hepatitis C cost?
I propose to consider in detail the treatment of hepatitis C, the cost of antiviral therapy and certain drugs.
How is hepatitis C treated?
Hepatitis C treatment is carried out in order to reduce viral load, relieve inflammation and prevent complications.
Drug therapy is not prescribed in all cases, because 5% of patients have a strong immune system that can cope with the virus on their own and forever.
Such patients require the observation of an infectious disease doctor and a hepatologist, as well as periodic laboratory monitoring of the viral load, the body, and the functional abilities of the liver.
The choice of treatment for hepatitis C depends on the age and sex of the patient, the form of the disease, the pathogen genotype, predisposition and propensity for fibrosis formation (the rate of development of liver cirrhosis).
The urgency of therapy depends on the rate of development of liver fibrosis:
- the degree of fibrosis – F0 – F1 – therapy can be postponed;
- the degree of fibrosis F2-F3 is the maximum term of delaying treatment for 2 years;
- the degree of F4 fibrosis requires immediate treatment.
The gold standard for treating hepatitis C
Standard double therapy of Ribavirin with Interferon equally affects all genotypes of the hepatitis C virus.
Ribavirin – is a tableted antiviral drug that is a synthetic analog of nucleosides.
Important! The main indication for the use of Ribavirin is chronic hepatitis C.
The drug is contraindicated during pregnancy, breastfeeding, hypersensitivity to the components of Ribavirin, in the late stages of cardiac and renal failure, decompensated liver cirrhosis, as well as to persons under 18 years of age.
Ribavirin has many adverse reactions, including the following:
- headaches, dizziness, general weakness, insomnia, depression, irritability, suicidal tendency, tremor, paresthesia, hyperesthesia, hypoesthesia, loss of consciousness;
- arterial hypertension, cardiac arrhythmia;
- hemolysis of erythrocytes, decrease in the number of leukocytes, neutrophils, granulocytes, platelets;
- violation of respiratory rhythm, cough, shortness of breath, inflammation of the middle ear, paranasal sinuses;
- dry mouth, decreased or no appetite, nausea, vomiting, diarrhea, abdominal pain, bloating, increased bilirubin in the blood;
- conjunctival inflammation, reduced visual acuity, hearing;
- pain in muscles and joints;
- hot flashes, decreased sexual desire, menstrual disorders;
- urticaria, skin rash, fever, angioedema, bronchospasm, Stevens-Johnson syndrome, toxic epidermal necrolysis;
- hair loss, dry skin, reduced secretion of thyroid hormones, thirst, reduced body resistance to viral, bacterial, and fungal infections, enlarged lymph nodes.
Ribavirin Average Cost
Interferon alfa has antiviral, immunomodulatory, antitumor and antiproliferative effects.
Interferon alpha is included in the treatment of leukemia, chronic myeloid leukemia, viral hepatitis B and C, thrombocytosis, myeloma, kidney cancer, as well as Kaposi’s sarcoma, fungal mycosis, reticulosarcoma.
The drug is widely used for the prevention and treatment of influenza and ARVI.
Interferon alpha is not prescribed for hypersensitivity to it, severe cardiovascular diseases, acute coronary syndrome, severe hepatic and renal failure, impaired blood clotting or a tendency to thrombosis, epilepsy, decompensated liver cirrhosis, during pregnancy and breastfeeding.
The drug is contraindicated in children.
During treatment with interferon alfa, adverse reactions occur, such as in ribavirin.
In the territory of the Russian Federation, such interferon alfa preparations are registered as Alferon, Altevir, Interferon leukocyte human liquid, dry and in candles, Inferon, Lokferon and others.
Russian doctors most often prescribed the following interferon drugs for patients with hepatitis C:
- IFN-5: 5 amp. 3 million IU each – 1,500 rubles, 5 amp. 5 million IU each – 2000 rubles;
- Roferon: 5 amp. 3 million IU – 800 rubles;
- Intron-A: 6 dose syringe pen – 7,200 rubles;
- Realdiron: 1 apm. 3 million IU – 400 rubles;
- Viferon-Feron: 10 rectal candles of 3 million IU each – 900 rubles.
Such a treatment regimen for hepatitis C, a combination of Ribavirin with Interferon with short and prolonged action, is considered more effective.
Ribavirin and Interferon of mild action is taken every day for 6-12 months, and prolonged Interferon once a week or every three days.
The effectiveness of this scheme is 60-90%.
Contraindications to combination therapy of hepatitis C:
- children up to three years;
- persons with a history of organ transplantation;
- hypersensitivity to ribavirin and interferon alfa;
- insulin-dependent diabetes mellitus;
- chronic obstructive bronchitis;
- decompensated pathology of the cardiovascular system.
Patients who are contraindicated in combination with ribavirin and interferon, have to prescribe a short-acting interferon monotherapy. Accordingly, the duration of such treatment increases to 12-18 months.
Until 2014, there was a program in Russia that provided free treatment for patients with hepatitis C. But, unfortunately, it was canceled.
Interesting! Today, only patients with a combination of hepatitis C and AIDS can be treated for free. The lack of these drugs is not only in their high cost, but also in a large number of adverse reactions and poor patient tolerance.
Patients often violate the recommended regimens or stop taking medications. This contributes to the formation of resistance to this combination.
Triple therapy for hepatitis C
Since 2013, European countries and the Russian Federation have begun to apply a triple regimen for treating patients with hepatitis C affected by the first genotype of the virus. Recovery occurs in 70-80% of patients.
The triple regimen includes Ribavirin, Long-acting Interferon and Boseprevir / Telaprevir. The duration of the course depends on the activity, the prevalence of the process and the presence of complications and averages 6-18 months.
Boseprevir is an antiviral drug of a new generation that inhibits proteases (CYP3A4 / 5) of a viral cell, thus preventing the reproduction of the hepatitis C virus in hepatocytes.
Boceprevir is used in combination with Interferon for the treatment of chronic hepatitis C, which is caused by the first genotype of the virus, in persons over 18 years of age without decompensated liver function.
Combination therapy with boceprevir is contraindicated in patients with hypersensitivity to the components of the drug, with autoimmune hepatitis, during pregnancy, under the age of 18 years, and also in the presence of contraindications to Ribavirin and Interferon. The main side effects of the drug can be listed as follows:
- on the part of the hematopoietic system: a decrease in the amount of hemoglobin, erythrocytes, neutrophils, platelets, leukocytes;
- on the part of the digestive tract: loss of appetite, dry mouth, thirst, nausea, vomiting, diarrhea, abdominal pain;
- nervous system: insomnia, irritability, depression, apathy, headaches, dizziness, tremor;
- skin: dry and itchy skin, dermatitis, urticaria, angioedema;
- on the part of the respiratory system: cough, shortness of breath;
- on the part of the thyroid gland: hypothyroidism;
- on the part of the reproductive system: a violation of erectile function, aspermia, amenorrhea, menstrual disorders, decreased libido and many others.
The cost of a month course of treatment with boceprevir is 4 tis. y e.
Telaprevir is a protease inhibitor (NS3-4A) of a hepatitis C viral cell, without which the pathogen cannot multiply.
Teleprevir is used in the combined treatment of the chronic form of hepatitis C of the first genotype without uncompensated liver conditions.
Important! Monotherapy with Teleprevir is ineffective, so it is used only in combination with prolonged Interferon and / or Ribavirin.
The drug is not used in patients with hypersensitivity to its components, as well as in patients under 18 years and over 65 years. Also, the drug is contraindicated during pregnancy and lactation.
Side effects of the drug, such as in Boceprevir.
The cost of a month of treatment with Telaprevir is 15 tis.
New Hepatitis C Cure
Since 2013, countries in the Americas and Europe have begun to conduct clinical trials of new hepatitis C virus protease inhibitors, Sofosbuvir and Simeprevir.
The advantages of these drugs:
- no adverse reactions;
- excellent tolerability of therapy by patients;
- high efficiency of hepatitis C virus rectification;
- short course of treatment (only 12 weeks);
- efficacy of monotherapy;
- tablet release form;
Disadvantages of Sofosbuvir and Simeprevir:
- no license in the territory of the Russian Federation;
- very expensive treatment – Sofosbuvir will cost 84 tis. y e., and Simeprevir – 70 tis. y e.
Pathogenetic and symptomatic drugs for hepatitis C
In addition to etiotropic therapy, you need to spend money on the pathogenetic and symptomatic treatment of hepatitis C:
- During an exacerbation of the disease, bed rest or half bed therapy is prescribed. In remission, physical and mental stress should be limited.
- Drinking mode should be sufficient –
Hepatitis C treatment is a time consuming and lengthy process that requires large financial expenditures. Maybe soon patients will be able to be treated at the expense of the state budget. So far, drugs for the treatment of hepatitis C need to buy yourself. Doctors, of course, enter into the position of each patient, and try to select drugs with the best price and quality.