Hepatitis C

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Like many urban centers in the Northeastern US, Philadelphia has a chronic shortage of donor livers. But the advent of new antivirals that eradicate hepatitis C infection is starting to change that picture. In a visit to Hahnemann University Hospital, MD Magazine spoke to specialists and patients who are seeing what a difference those drugs can make. Video interviews follow the article.

You see a 48-year-old white man for his annual examination. . The patient is overweight with a body mass index (BMI) of 32. A screening chemistry panel is normal except for an aspartate aminotransferase (AST, formerly SGOT) level of 85 U/L (normal 15-50 U/L) and an alanine aminotransferase (ALT, formerly SGPT) level of 98 U/L (normal 5-50 U/L). He says you are the first doctor he has seen in more than 10 years and does not recall the last time he had a blood test.

In a phase II trial, combination treatment with Gilead's simeprevir (Olysio) and Janssen's simeprevir (Sovaldi) yielded functional cure rates exceeding 90% in patients with hepatitis C virus (HCV) who received 12 weeks of therapy-even among difficult-to-treat patients.

An estimated 3.3% of people in the United States born between 1945 and 1965 have chronic hepatitis C infection. The increased risk of infection in this population has recently led the Centers for Disease Control and Prevention (CDC) to recommend one-time hepatitis C virus (HCV) testing for all persons in this age cohort.

An emerging epidemic of acute hepatitis C threatens the country's younger population, which experienced a significant hike in the number of cases during a recent 6-year period, according to a compound study that looked at trends of the disease among youth.

It's always hard to know how many new therapies will make it all the way through a drug development pipeline.There are 12 combination therapies in phase II trials, 19 individual agents in phase II, and five more in phase III.