Hepatitis: A Brief History
I grew up and completed my training in the Northeast, but I came to Texas in 1990—the dawn of the hepatitis C era. In 1989, the hepatitis C virus was first identified, allowing testing for the first time to identify what had formerly been called the non-A, non-B virus. Over the past two decades at UT Southwestern, I have been privileged to watch our Center go from the initial naïve efforts in the early 1990s with a 5 percent cure rate, to the current effective treatments that deliver a 70-80 percent cure rate. Each new innovation, each clinical trial over two decades, provided additional information and ultimately greater success, building on prior accomplishments.
What strikes me as fascinating and unique is that patients with hepatitis C, even those with ongoing disease for 20 or more years, can get the disease not only under control but eradicated for life with these new treatments. There are few viral infections that we can honestly say are cured with treatment, but such is the case for increasing numbers of hepatitis C patients. For me, dealing with the cause of the disease directly is more satisfying than trying to take care of the problems caused by hepatitis C once they have occurred.
What is also important to me is to personalize each patient’s care. Not every patient with hepatitis C should be treated. Each one needs to be carefully evaluated on a number of levels: How much damage has the virus done, if any? Is the treatment likely to cause other untoward effects? How can we best arrive at cure, or is cure not necessary or possible in this person? What will the treatment cost in financial terms but more importantly, in quality of life terms?