Previously Unforeseen Risk Tarnishes Hep C Wonder Drugs

Previously Unforeseen Risk Tarnishes Hep C Wonder Drugs

Researchers share their unwelcome realization that liver cancer acceleration may be associated with Hepatitis C treatment.

The improvement in Hepatitis C treatment success marks a dramatic change in the prognosis for most Hepatitis C diagnoses.

New direct-acting antiviral drugs boast viral eradication rates in the high 90th percentile, rendering hope that the Hepatitis C virus can be eradicated. Until recently, the only major obstacle surrounding these Hepatitis C medications has been their outrageously high cost.

However, a large-scale prospective study has revealed a surprising caveat – revealing that the direct-acting antiviral drugs for Hepatitis C may not be the panacea the medical community had been hoping for.

Side Effects

Like all potent medications, the drugs used to eliminate Hepatitis C are likely to have side effects. Prior to 2014 when direct-acting antiviral drugs started getting approved by the U.S. Food and Drug Administration, the drugs used to treat chronic Hepatitis C had many severe side effects. Thankfully, the newer Hepatitis C treatments have fewer and milder side effects.

The most common adverse reactions to direct-acting antiviral medications for Hepatitis C include:

Fatigue

Diarrhea

Headache

Nausea

Insomnia

Skin Rash/Itching

Liver Cancer

Although none of the side effects listed above are pleasant, they are certainly minimal when evaluating their potential benefit of eradicating Hepatitis C. That was true until an Italian researcher presented results of his study at the American Association for the Study of Liver Diseases (AASLD) annual 2016 Liver Meeting in Boston, MA.

According to lead investigator Alfredo Alberti, MD, professor of gastroenterology at the University of Padova in Italy, direct-acting antiviral drugs could worsen liver cancer. If future investigations into this association support Alberti’s results, direct-acting antiviral drugs may present more hazard than benefit to our health.

Some details from Alberti’s study include:

Dr. Alberti and colleagues followed over 3,000 patients with Hepatitis C infection for an average of 300 days after beginning direct-acting antiviral therapy.

Direct-acting antiviral drugs appear to make previously undetected cancers worse and harder to treat.

50 percent of those studied who developed a tumor early during Hepatitis C treatment or just after stopping treatment developed a more aggressive type of tumor than what is typically seen

.

The severity of hepatocellular carcinoma (primary liver cancer) seemed to correlate with the antiviral therapy over a 540-day follow-up period.

The incidence rates of liver cancer were no different in those who received direct-acting antiviral therapy and those who did not receive the therapy.

Alberti and his colleagues hypothesized that when viral replication is halted, dramatic changes in the immunologic and molecular microenvironment occur in the liver, which impact tumor suppression mechanisms. This change allows or promotes the growth of previously undetected liver cancer cells.

Conclusion

In putting Alberti’s conclusion into a larger perspective, valuable information in the battle against Hepatitis C is gleaned. Just like the need for physical therapy to help someone recover from orthoscopic knee surgery, a rehab for liver health may be necessary following Hepatitis C viral eradication.

After the presentation of this large-scale study, more investigation into the risk of liver cancer growth acceleration from direct-acting antiviral medications for treating Hepatitis C is warranted. Until a definitive conclusion is drawn, Alberti’s work sends two clear signals.

One, patients with Hepatitis C who receive treatment with direct-acting antiviral medications must be monitored for hepatocellular carcinoma.

Two, even if the Hepatitis C virus has been eliminated, liver monitoring and care must persist.

Eliminating the virus has been the goal of Hepatitis C treatment since the infectious agent was first identified. However – Alberti’s study brings a larger picture into focus – the overall health of the liver. Viral eradication without severe side effects may only be step one of treating Hepatitis C. The second step may be finding ways to return the liver to a healthy microenvironment.

References

28 Replies

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  • Thank you very much for the information Jenny. On 8th March 2016 I had a liver transplant due to HCC on my liver and have been suffering from Hep C since the mid 70s. In the past I have had treatment twice for Hep C and both courses failed, leaving me with severe anemia. The only treatment then was Interferon and Ribavirin. Now with advice from my consultant I am waiting another new drug which is being assessed by NICE and with luck would be released next year. Now I'm a little worried

  • Just have fetaprotein test before treatment then in unlikely event of l.c.

    you can be treated before you go on the meds

    All good wishes for your health/recovery

  • What a shocker!

    This is the problem with pharmaceuticals - they don't work in a 'natural' way.

    Roll on 5 years assuming we get the necessary funding, we will have an affordable PDT treatment that produces nature's mechanism for killing disease.

    Thanks for sharing Jenny.

    I hope the degree of risk becomes better understood.

  • I have had great results with Healtone sound frequency therapy

    Available online from their site

    All good wishes

  • The more this type of treatment is made available, the better Jenny , it's much more natural.

    I know with PDT it is currently the last resort - not 100% sure why, but I do know there is a lack of trained technicians / surgeons in that field.

  • Difficult one this. I have just started treatment this week and had seen this unnerving research a couple of weeks ago. I think if I hadn't already had the pills in the cupboard I might have waited another year to see where this story is going. It does seem to be a bit of a gamble with the new DAA. I asked my liver nurse about it and she said it was related to having fibrosis, of which I have minimal and didn't apply to me. Hope it's true! I'm struggling quite badly with side effects already from Ribavarin plus Viekira Pak, tiredness, weakness, and pain in the liver area now...but often do have problems with medication...so no surprise there. did anyone else on here find the treatment got easier as time went on. I know Ribavarin takes about 4 weeks to do its worst, so not holding out much hope!

  • You'll most likely be fine

    At least you know now and can have regular check ups for reassurance

    All good wishes for your cure and continued health.

    Jenny

  • My messaging buddy on this site had l.c. with no fibrosis at all

    So important to have regular post treatment checks

    Hope all goes well :-)

  • Hi there.. I'm 5 weeks into viekerax but without ribavirin. I was really weary prior to treatment but actually felt better within days. no side effects to write of.. it's ribavirin, nasty stuff. had it with interferon treatment. Do hope it levels out for you, if it's really bad they may reduce ur dose.

  • Hi there, thanks for reply. Good to know it's only the Ribavarin causing these nasty episodes. I could always ditch that if I really can't stick it. I am genotype 1a and presumably you are 1b as at our hospital also you have Viekira Pak on it's own if you are 1b. I'm sticking with it so far. Yesterday was horrendous. Today ok. Funny the difference of days. Good luck with your treatment.

  • I'm 1a too

    I can't take Riba and only Viekiera/Riba on offer

    Will continue to self treat

    All good wishes for your cure/recovery

  • I was really reluctant going on this clinical study as there was a chance I'd be given ribavirin as well.. Eee nasty stuff. The viekerax already has an anti viral booster within it, ritonavir. ribavirin bit of overkill if u ask me like n studies other than pharma don't show much difference. Current studies show having a test for NS5A RAVs indicates if ribavirin is needed as they cut effectiveness of the protein inhibitors. Not sure if we're allowed links but have a look at 1a in this hcvguidelines.org/full-repo...

    Maybe ask for this test Jenny 🙂

  • Cheers for reply.. I'm same as you 1a. I'm on a study 8 wk treatment. although I'm 25 yrs hep c I don't have bad physical damage 8kpa and a vital load of 860,000. had bloods at 0, 3, 7 and 14 days. clear by about 10 th day 😊

  • Thanks Jenny, I think will ask for the liver cancer marker test next time I get my bloods taken. At least then I have got some base line to go from.

  • Hi I had the new treatment last December for hep c for 3 months after finishing it came back the it had dropped but not worked then last week I went to see my consultant for the 3 moth checks he does on me and he said it had shown clear in my last blood test which would of been 3 months earlier so a weird one but good news until this cancer brief so now worrying because of the fibrosis and cirrotic liver he has been doing checks for liver cancer for quite a while on me I just hope this doesn't now speed it all up it does make you wish one hadn't bothered as I've had it since 86 bri

  • It won't speed up what isn't there

    If tests have shown clear of lc you should be fine

    I'm not a Dr or medical researcher

    I've had Hep C 35 years and done quite a lot of online

    investigation as i don't want to go the Big Pharma route

    Best I've found is Healtone sound frequency healing.

    All good wishes..Jenny

  • But what about nodes on liver will this now make them cancerous got to have endoscopy next week and ultrasound in two weeks just can't really beleave they didn't do longer trials or are we the guinea pigs for long term trials I heard a couple of people last year post that they had developed cancer and I just thought it was the usual way with having cirrociss but they had finished the new treatment about 6 months before hand and had got really ill and we're warning then just a bit scary now wishing I hadn't gone down that route now sorry to be pessimistic about it all peace and love and good karma to you and every one out there bri

  • I really like ur thinking.. I've avoided interferon over the years and have changed the way I live and used various meditations with visuals and love.. ive also used reiki. May sound strange to some but if ur that way inclined the spiritual route can help sustain our health to a point. In my opinion ☺

  • oh thats just dandy, speaking as someone with fibrosis who's got her post treatment 3 month check coming up next week :/

  • Good to have regular check ups

    Send all good wishes for your health and wellbeing

  • A MRI just Six months After the ribavirin and Sovaldi treatment showed that I had tumors that didn't show up before the treatment. So in reading this article that helps explain something. The treatment worked as far as hep c is concerned,The tumor on my spleen is fast growing the others on my liver and kidneys not as much at the latest MRI. My one year post treatment blood work is due in February 2017. So what is next again it's dam if you do and dam if you don't.

  • Hope all goes well for you in every way

  • Thanks for posting.

    I have my appointment in two weeks to discuss starting treatment so will ask what their take is on the risks.

    Have just had 5 year all clear from neck and thyroid cancer and as taking azathioprene for RA and Lupus which I was told increases the chance of cancer? it really feels like a huge thundering rock or very hard place to have the news that the " new brilliant Hep C drug with few side effects" could cause its own scary hidden problems.

    So grateful you folks are all here as feel very much walking in deep sand dunes at the moment.

  • From one perspective good to know so you can have regular checkups

    A comparatively small percentage from the article

    Hope all goes well

  • heres a link to the full article, a comforting quote from it *Direct-acting antiviral drugs do not appear to increase liver cancer risk for people with Hepatitis C and cirrhosis.* hepatitiscentral.com/news/p...

  • and another article worth a read for those considering taking the new treatments, I still feel that getting treated was the better choice...however I'll let you know if i change my opinion after my post treatment check up this week :o

    Liver cancer risk reduced after hepatitis C treatment, but vigilance needed for aggressive cancers in months after treatment

    infohep.org/Liver-cancer-ri...

  • Hope all goes well

    Best wishes for your continued good health

  • Thanks for posting this Tess. The article puts all the facts into perspective very well. While curing hepc does not reduce the odds of getting of liver cancer in susceptible people in the short term, as an overall strategy, curing hepc does lower the risk significantly long term. It makes me feel better about doing the treatment.

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