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New NICE draft guidance for hepatitis C

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Cancer drugsNICE has published draft guidance recommending three different treatment options for some people with hepatitis C. These are daclatasvir, ledipasvir-sofosbuvir and ombitasvir-paritaprevir-ritonavir with or without dasabuvir.

 Hepatitis C is a virus that infects the liver. It is spread by contact with infected blood, for instance by using contaminated needles for injecting drugs or sharing razors or toothbrushes. The virus can cause inflammation of, and damage to the liver, preventing it from working properly.

About a third of people infected with the hepatitis C virus will eventually develop liver cirrhosis, where normal liver tissue is replaced by scar tissue. A small number of people with chronic hepatitis C and cirrhosis also go on to develop liver cancer.

Professor Carole Longson, Director of the NICE Centre for Health Technology Evaluation, said: “Hepatitis C is a major public health challenge. It is difficult to diagnose, with estimates suggesting around 50% of people with the condition in England remain undiagnosed. Even when people are diagnosed, the long duration and potentially unpleasant side-effects of current interferon-based treatments can discourage people with the disease from completing the full course, or even from seeking treatment in the first place. We are very pleased to recommend not only one, but three new treatment options for chronic hepatitis C. This is good news, not just for people with chronic hepatitis C, but also because having more effective treatments for the condition could reduce the spread of the virus.”

It is recommended that access to the drugs used to treat hepatitis C is managed through the specialised commissioning programme put in place by NHS England with prescribing decisions made by multidisciplinary teams/centres to ensure that treatment is prioritised for patients with the highest unmet clinical need.

People whose treatment with daclatasvir, ledipasvir-sofosbuvir, or ombitasvir-paritaprevir-ritonavir with or without dasabuvir, is not recommended in the respective NICE guidance, but was started within the NHS before this guidance was published, should be able to continue treatment until they and their NHS clinician consider it appropriate to stop.

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