Northland Patients Part of Worldwide Hepatitis C Cure
12 April 2017
Northland Patients Part of Worldwide Hepatitis C Cure
Northland is among the locations worldwide where a drug to treat Hepatitis C is achieving a near-100 percent success rate. Curing the disease in individuals is hoped to contribute to the worldwide eradication of the debilitating liver disease as an epidemic.
Viekira Pak is a combination of four antiviral medicines which PHARMAC began publicly funding from July 2016. In Northland – where there are up to 500 people diagnosed with Hepatitis C, and many more undiagnosed – 73 patients have been successfully cured of Hep C as of the end February, with only one known unsuccessful treatment.
Viekira and other antiviral drugs, combined with prevention programmes, are expected to eradicate the virus as a public health problem by the year 2030, the World Health Organization says. Currently 50,000 New Zealanders are estimated to carry the blood-borne virus, although only half that number of people are currently diagnosed. Globally, WHO estimates up to 150 million people live with the disease.
Northland DHB physician Dr Kaye Logan and Hepatitis clinical nurse specialist Sandra Meyst said the release of Viekira was “exciting” for patients of Genotype 1, a genotype representing around 60 percent of patients.
Because of the origins of Hep C infection, including blood exchange from intravenous drug needles or tattooing equipment, many patients have experienced, guilt, shame or stigma around their condition, intensified by the low success rate of the Interferon and Ribavirin antiviral treatment options which were the norm until Viekira. These antivirals were expensive and would sicken people with many side effects. “For so many years it’s been depressing to treat, very intensive, often disappointing, with patients unwell and miserable,” Kaye said.
The cure rate brings great news to the patients born between 1945 and 1965 most likely to suffer from Hepatitis C. “In my job often you don’t always cure people,” Kaye said. “It’s nice to be able to cure something.” Those who have successfully taken the course of Viekira “have had a big emotional burden lifted,” Sandra added.
The next step in eliminating Hepatitis C as a public health problem will be ensuring Viekira is safely prescribed and dispensed and that GPs - who are able to treat patients without cirrhosis- understand safety around Viekira interacting with other drugs.
Other factors in the patient’s health will also affect the success of Viekira. GPs are being educated about the funding available to get Hep C sufferers engaging with their clinic. “When the dust settles we will go out and reach people who don’t see their GP and aren’t treating their disease,” Kaye said. “We want to seek them out and give them treatment – in future we want to eradicate the disease, like with smallpox.”
Dr Kaye Logan said the main issue at this time preventing all estimated 400-500 Hep C positive patients in Northland being treated is that Viekira is suitable only for genotype 1 patients (60 percent of patients, or up to 300 out of those 500.)
Provided their genotype is suitable for treatment, all patients should eventually be receiving treatment once GPs are confident in prescribing Viekira and supporting patients through their 12 week course of treatment. General Practice needs nurses to be capable of monitoring blood results during the treatment. It’s also essential patients are free of alcohol, cannabis and medications which may interfere with Viekira.
“This can be complex, especially for psychiatric or respiratory patients,” Kaye said.
A new lease of life: Martin’s story
A Whangarei patient who asked to be known as Martin wept as he shared the story of Viekira curing him of a 20-year illness “equal to cancer.” Martin says he has a “new lease of life” after Hep C gave him years of shame, discomfort, depression, and made him feel he was a burden on the healthcare system.
Martin, now 62, contracted the virus while a university student four decades ago, but like many people he was only diagnosed in his 40s, after which cirrhosis began to set in.
“When I heard Viekira was coming I rang Nurse Sandra and got on the Viekira list. I’m so thankful. I feel like it’s given me another thirty years of life.” Martin thanked Sandra and Kaye for their caring approach and said the work of award-winning Auckland City Hospital hepatologist Professor Ed Gane and his team of specialists also helped Martin's recovery.
Part of Martin's journey involved giving an emotional speech to GPs and pharmacists as they learned about the impact Viekira can make. “The speech was a pretty emotional time. I was so thankful, and other patients were, to be given that chance. It felt good to share my story, it was an eye-opener to them. I had felt like a burden on society. You couldn’t talk about it, it was not cool that I got my illness through perceived irresponsibility. No one wanted to know about it.”
“It was a debilitating disease, equal to cancer. You live with depression; you wake up feeling like you’ve got the flu and don’t know why. You just put up with it. It’s not something you share. People don’t appreciate what it does to you - it’s like running on half your cylinders. On top of my shitty liver I had unexplainable grumpiness and moodiness and when I was stressed the effects of Hep C hit me tenfold.”
“I have lost a couple of mates to liver cancer. In the last 2-3 years I was getting pretty desperate; mild cirrhosis was kicking in. In the back of my mind was finality.”
It was the New Year when Martin received the good news: after 12 weeks on Viekira Pak, blood tests proved he was now clear of Hepatitis C. “I’m not ashamed of what I did, how I got it, I was just fortunate to live through it.”