Four years ago, the first curative pills for hepatitis C virus (HCV) were handed to patients. These drugs were a breakthrough for people infected with this pathogen. Lacking in serious side effects and eradicating the virus from the body in just 12 weeks, these so-called direct-acting antivirals (DAAs) offered a clean escape from this potentially fatal liver illness.
But with numerous DAAs now available—along with their long trail of clinical trial data—primary care physicians are left to navigate a crowded and confusing landscape for treating HCV. Controversy surrounding the cost of these drugs has also become a concern.
As a result, doctors may be hesitant to treat patients directly, preferring instead to refer them to liver specialists or delay treatment until symptoms arise, which could be several years after the infection is diagnosed. “Many primary care physicians are still too unfamiliar with the regimens to speak with confidence about them,” says hepatologist Ira Jacobson, who leads the department of medicine at Mount Sinai Beth Israel Hospital in New York.
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