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Hepatitis C Treatment: Moving Past Ribavirin and Peginterferon

If you have chronic hepatitis C and you are treated and cured, it is likely you will receive some benefits from this. These benefits include improved quality of life as well as a longer life. Over the years, there have been many studies supporting this, and in this post, I focus on the latest research.

Hepatitis C work productivity

Patients whose hep C was cured with Harvoni had increased work production

Zobair M. Younossi and colleagues published “Improvement of Health-Related Quality Of Life (HRQL) and Work Productivity in Chronic Hepatitis C Patients with Early and Advanced Fibrosis Treated with Ledipasvir and Sofosbuvir” in the Journal of Hepatology (August 2015). The title speaks volumes. These researchers reported that viral eradication with Harvoni (ledipasvir/sofosbuvir aka LDV/SOF) leads to HRQL improvement and increased work productivity regardless of fibrosis stage.

Let me repeat and expand on what I just said, just in case insurance companies and state Medicaid programs don’t understand this: Patients with early fibrosis experience similar improvement as those with advanced fibrosis. Even more importantly, these outcomes were better in patients who received interferon-free/ribavirin (RBV)-free treatments. In other words, patients who were cured with Sovaldi (sofosbuvir) plus peginterferon and/or ribavirin did not have as much improvement as patients who were cured with Harvoni. (Yes, I know I am shouting. At least I didn’t use ALL CAPS.)

“We believe that it is the side effects of RBV, rather than the stage of liver disease, that primarily determines on-treatment impact on quality of life in LDV/SOF-based treatment,” the authors wrote. Translated to patient-speak, “Ribavirin sucks.” Granted, if you have to take it, then it can be a lifesaver. I took it and survived, but that doesn’t make me a ribavirin fan. However, if you don’t have to take it, then it is time for insurance companies to step up and pay for gentler, more effective hepatitis C treatments.

By the way, this was not a small study. Younossi et al. looked at 1000 hepatitis C patients who were treated with Harvoni. Currently, the entire study is available at the Journal of Hepatology website.

If you are insured through your employer, and you are denied treatment, take this study to your Human Resources department. Tell them that your insurance company denied access to treatment, and possibly the opportunity to become an even more productive employee. Also, mention that the HCV Guidelines recommend treating all hepatitis C patients, regardless of fibrosis stage. Better yet, write this in a letter, and copy your insurance company on the communication. For other tips on how to get treatment, read my blog at HepMag.com for suggestions about what to do.

If your doctor refuses to treat you, ask him or her if she has seen this study. If you are feeling brave or surly, ask if they routinely deny treatment to diabetic patients who are in the early stages of their disease or if they wait until they are blind or have lost a few toes. (Warning, this might not go over too well, unless you can say it sincerely and directly rather than threateningly.) If still no luck, get a new doctor.

Lucinda K. Porter, RN is the author of two books, Free from Hepatitis C and Hepatitis C Treatment One Step at a Time. She also blogs at HepMag.com  



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