Treatment for hepatitis C

DAAs (direct acting-antivirals)

Since July 1, 2016, two DAAs (direct acting-antivirals) have been funded in New Zealand. Both have cure rates of 90+ per cent, fewer side effects and a shorter treatment duration compared to previous treatment. More than 50 per cent of people with hepatitis C can now access treatment (people with genotype 1 of the virus, or those with severe liver disease.)

The breakthrough medications are:

  • Viekira Pak, and Viekira Pak-RBV (which includes the drug Ribavirin), is funded for people who have hepatitis C genotype 1a or 1b.
  • Harvoni, made up of Ledipasvir (90mg) and Sofosbuvir (400mg), is funded for high-priority hepatitis C patients only, ie, patients with severe liver disease, regardless of genotype.

If you qualify for the above treatment, please visit your GP or specialist.

Accredited NZ pharmacies for delivery of Viekira Pak:

http://www.viekira.co.nz/locations/

If you do not qualify for the above treatment, the standard treatment of interferon and ribavirin is still available. Another option is personal importation, which allows people to legally self-import generic DAAs for a few thousand dollars. If you wish to personally import medication this can be done through The Fix Hep C Buyers’ Club. See below for more information about these options.
Medications which treat all genotypes of the hepatitis C virus are expected to be funded within the next few years. We will update this page as more treatments become available.

Other treatments

Interferon and ribavirin
These treatments have more evasive side-effects, longer treatment durations and are less effective than
  • Another treatment for hepatitis C in New Zealand is a self-administered weekly injection of pegylated interferon, and twice-daily ribavirin tablets. Treatment lengths vary between 24 and 48 weeks, depending on genotype and treatment type. Pegylated interferon (Pegasys) boosts the body’s immune system and changes the virus’ ability to multiply. It works to fight the virus more effectively in combination with ribavirin. It is a man-made version of a protein, called interferon, our bodies naturally produce to fight viral infections. The body does not always have enough naturally present interferon to fight the hepatitis C virus on its own. Pegylated interferon is injected once a week for the treatment duration.
  • Triple therapy is also available for those who meet the criteria. This involves a third drug, Victrelis (also known as boceprevir), which can be used in combination with pegylated interferon and ribavirin. Victrelis is only available for people who have chronic hepatitis C genotype 1 with IL28 gene CT or TT allele and who have never received treatment for hepatitis C. It will also be funded for those who have previously been treated with pegylated interferon with or without ribavirin who were partial responders, responders/relapsers, or who were treated prior to 2004.

Generic medications

If you do not qualify for new generation medications you may consider personal importation. If you are considering personal importation we advise you visit your GP.

  • In this article Professor Ed Gane provides instructions for personal importation.
  • Click here to read the rules and guidelines provided by Medsafe.

Side effects

Treatment for hepatitis C can be difficult to go through as side effects can impact your work, social relationships and self- esteem. The most common side effects are fatigue and flu-like symptoms such as fever, chills, sore muscles and joints, and headaches.

Other symptoms can ibb26e776b4db731703d9775aed0817c7_f898nclude:

  • Depression
  • Weight loss
  • Loss of appetite
  • Mood and behavioural problems
  • Shortness of breath
  • Hormone issues
  • Skin rash
  • Hair loss
  • Anaemia
  • Skin irritation at the injection site
  • Irregular sleep patterns
  • Irritability
  • Nausea
  • Vomiting.

Cure rates

For those on interferon and ribarivin treatment, two thirds of people can be cured. Your chances of clearing the virus and achieving a cure depend on a number of factors. The effectiveness of treatment usually depends on the genotype being treated. In general, genotype 1 is the most difficult to treat. However, there is a certain strain of genotype 1 that responds significantly better to treatment. This strain is known as the IL28B gene.

Cure rates for people taking pegylated interferon and ribavirin:

Genotype 1 2 3 4
Cure rate 45-50% 80-90% 60-70% 45-50%

If you are considering treatment you can read our information sheet about how to tell when the time is right.

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You can also read the article ‘Are you facing or finishing treatment? Tips from a psychiatrist‘ from issue 8 of Talking Hep C.

After treatment

Being ‘cured’ of the hepatitis C virus means having a sustained virological response (SVR), which is when the virus cannot be detected six months after treatment. This is a ‘cure’ from hepatitis C as being free of the virus six months after treatment means it is unlikely that the virus will ever return and the liver damage from hepatitis C will have been stopped. However, you are not immune from hepatitis C and you can become reinfected if exposed to the virus again.

If your treatment was successful and your liver is healthy, you can leave the Hepatitis Foundation’s Hepatitis C Programme. Your community nurse and/or hospital staff will talk to you about how you can stay healthy.

If your treatment was not successful you should stay in the Hepatitis C Programme to continue to be monitored and receive support.

Whether your treatment was successful or not, you should:

  • Maintain regular contact with health professionals to monitor your health. You will often need to have blood and/or liver function tests. If you do not clear the virus you should have regular visits to a health professional to monitor your health and find out if other treatments become available.
  • Maintain a good diet and healthy lifestyle. If you clear the virus this allows your liver time to recover. If you do not, maintaining a healthy lifestyle will help the health of your liver.

For more information about finishing treatment, read the article ‘So you’ve finished treatment… now what?‘ from issue 6 of Talking Hep C.

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© The Hepatitis Foundation of New Zealand 2016