DAAs (direct acting-antivirals)
Since July 1, 2016, two DAAs (direct acting-antivirals) have been funded in New Zealand. Viekira Pak and Harvoni have cure rates of 95+% and very few side effects. Treatment duration for most people is only 12 weeks.
- Viekira Pak and Viekira Pak-RBV (Ribavirin) is funded for people with genotype 1a or 1b. General practitioners as well as hospital specialists can prescribe this treatment.
- Harvoni is only available from hospital specialists for people in liver failure. It can be used to treat all genotypes of the virus.
More medicines to treat hepatitis C are expected to be funded by the government soon. Let your GP know you have hepatitis C so that you can be contacted when new treatments are available. While waiting for the government to fund more medicines some people have been buying medicines from overseas. Please see here for further information on self-importation of medicine.
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 people who have liver failure caused by the hepatitis C virus.
If you qualify for the above treatment, please visit your GP or specialist.
Accredited NZ pharmacies for delivery of Viekira Pak:
More than half of people with hepatitis C in New Zealand are eligible for the new treatments: Those with genotype 1 virus and those with severe liver disease. To see if you qualify for these treatments please see your GP or specialist.
If you do not qualify for the above treatment it is still a good idea to let your GP know you have hepatitis C as we expect more DAA medications to be funded by the government in the near future. 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.
Liver assessment before treatment
Everyone should have a Fibroscan before having treatment for hepatitis C. It is important to know how much scar tissue or damage is present.
If there is mild or moderate scarring in the liver:
- Then your treatment can be supervised in the community.
- After successful treatment, no further follow-up is needed.
- After successful treatment, the scar tissue in the liver will reduce over time.
However, if severe scar tissue (cirrhosis) is present in the liver:
- You should be cared for in a specialist clinic.
- The specialist will supervise your treatment.
- After treatment, you should stay under specialist follow-up. This is because there is a risk of developing liver cancer (hepatocellular carcinoma) even many years after the virus has been cured.
If the Fibroscan test was unsuccessful then you should be referred to a specialist to assess your liver prior to treatment.
If you do not qualify for the new DAAs you may consider personal importation. If you are considering personal importation we advise you visit your GP who may refer you to a specialist to provide detailed advice on this.
- In this article Professor Ed Gane provides instructions for personal importation.
- Click here to read the rules and guidelines provided by Medsafe
Interferon and ribavirin
These treatments have more side-effects, longer treatment durations and are less effective than newer medications. The interferon is a weekly injection and the ribavirin is a tablet that is taken twice a day. 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.
Being ‘cured’ of the hepatitis C virus means having a sustained virological response (SVR), which is when the virus cannot be detected 3 months after treatment. This is a complete 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 (no cirrhosis), you will not need any further follow-up for your liver. It is important to maintain a good diet and a healthy lifestyle. If you clear the virus this allows your liver time to recover. Your community nurse and/or hospital staff will talk to you about how you can stay healthy.
For more information about finishing treatment, read the article ‘So you’ve finished treatment… now what?‘ from issue 6 of Talking Hep C.