When’s the best time to treat hepatitis C? As soon as possible. Some insurance companies recommend delaying treatment until a patient reaches advanced liver disease. However, the research simply doesn’t support that choice.
At this year’s European Association for the Study of the Liver (EASL) 50th International Liver Congress in Vienna, research was presented showing that waiting on hepatitis C treatment comes with significant downsides. Specifically, waiting until advanced liver disease occurs tends to reduce the effectiveness of treatment and brings a higher chance of adverse outcomes.
Perhaps readers are wondering why anyone would ever have advocated waiting at all? It goes back to when treatment options were different from today. It used to be that the interferon-based hepatitis C treatments took a long time (almost a year), came with low rates of success, and triggered nearly unbearable side effects. In that scenario, waiting until the disease clearly progressed was not a bad idea.
The treatment landscape today – with the introduction of interferon-free and short duration all-oral treatment – is radically changed. It no longer makes sense to wait to cure this disease. In the International Liver Congress presentation, researchers shared data comparing treatment outcomes for patients’ treatment that started either before or after they developed advanced liver disease.
The data, from 187,869 veterans with chronic hepatitis C infections, showed that treatment effectiveness went down in patients waiting to start therapy after liver disease progressed. On the other hand, earlier treatment brought a 41% lower chance of adverse clinical events and a 36% reduction in mortality.
The benefits of treatment are not as plentiful the longer one waits to start. In fact, delays can end up costing more money while risking poor health outcomes.
McCombs J, Tonnu-Mihara I, Matsuda T, et al. Can hepatitis C treatment be safely delayed?: Evidence from the Veterans Administration Healthcare System. EASL 50th International Liver Congress, Vienna, Abstract O005, 2015.
Highleyman, L. Another study confirms detrimental effects of delaying hepatitis C treatment. HIVandHepatitis.com April 30, 2015.