Greg Jefferys Hepatitis C blog deals with all the issues associated with hepatitis C
Donald Trump probably never contracted Hepatitis C however his, apparently, remarkable recovery from COVID 19 is directly linked to the direct-acting antiviral drugs developed as part of the quest to cure Hepatitis C.
Because of the connection between the drugs used for the treatment of the Hep C virus and the treatment of the COVID 19 virus and because I am watching my country (and many others) imploding because of lockdowns and COVID 19 fear-mongering I am diverting some of my writing to look at the COVID 19 virus and its close connection to the Hepatitis C virus
Hepatitis C (HCV) and SARS-CoV-2 (COVID 19) are what scientists call +ve sense RNA viruses. In plain English, that means “quite similar viruses”. For this simple reason, it would be logical to assume that direct-acting antiviral Hep C drugs (nucleotide analogues) proven to work for HCV might also work on SARS-CoV-2. In simple terms, the same factors that make these antiviral drugs effective against the Hep C virus should also work on the COVID 19 virus.
So when the COVID 19 pandemic hit scientists looked at Hep C drugs including Sofosbuvir, Daclatasvir, and Remdesivir.
All of them showed promise against coronaviruses but GILEAD SCIENCES moved forward with Remdesivir only. There was a reason for GILEAD making such a strange choice but that is another story.
When President Trump was hospitalized with a COVID 19 infection the one thing that was certain was that he would have the best medical attention and advice available on the planet.
The world waited to hear what treatment he was given.
When the news of Donald Trump’s treatment was released there was a bit of confusion and a number of so-called “experts” started criticizing Trump’s treatment. “Unproven,” some said. “Experimental” and “Reckless” others said.
Hang on… Let’s get real here: we are talking about the President of the USA; no-one is going to use experimental or unproven medication on the US President. They are going to use the treatment regime that can be expected to give the highest chance of a cure and complete recovery.
So, what was actually used to treat Donald Trump’s Coronavirus infection? If you are fighting a virus obviously you use an antiviral drug, they chose Remdesivir.
Remdesivir is a direct-acting antiviral drug made by Gilead Sciences in 2009, as part of their Hepatitis C research program.
Remdesivir did not work against Hepatitis C as hoped, but ever on the lookout for profits Gilead tried “re-purposing” Remdesivir on a number of other viral diseases including Ebola virus disease and Marburg virus infection. In the early stages of the pandemic, Remdesivir was found to significantly reduce recovery times (though not mortality) for COVID-19 patients in a clinical trial.
So it would seem the sooner Remdesivir is administered the more effective it will be. (This is what happened to Trump, he was given Remdesivir immediately.)
In August 2020, Remdesivir received emergency authorization by the U.S. FDA for patients with severe cases.
President Trump also received the steroid dexamethasone, which reduces inflammation in the lungs. Lung inflammation inhibits oxygen absorption, which is the big problem for people battling COVID 19.
Dexamethasone is not experimental, unproven, or only used for critically ill patients. Dexamethasone has been in general and widespread use for nearly 50 years for a wide variety of ailments and has been on the World Health Organization’s list of essential medications since 1977. Trials at Oxford University showed that dexamethasone is useful in treating severe COVID-19 cases, reducing the mortality rate by at least 20 percent.
“I think we were all astonished to see how effective it was,” said the University of Oxford’s Richard Haynes, who ran the trial.
The only treatment that President Trump received that could actually be called an experimental drug was a mixture of two monoclonal antibodies from Regeneron. This drug is meant to treat non-hospitalized patients and boost the patient’s immune response, decreasing viral load. It is generally considered safe.
If we put aside the Regeneron, which has only had very small trials done and may or may not be useful we are looking at a very simple treatment regime that is almost certainly the optimum treatment for a person infected with COVID 19; it looks like this:
A Direct-Acting Antiviral drug plus Dexamethasone
Whilst Remdesivir was used for Trump it is probably not the most effective antiviral drug for using generally on COVID 19. Firstly because it’s expensive and secondly because it needs to be given intravenously. That is to say, Remdesivir needs to be injected as a liquid directly into the patient’s bloodstream. Also, Remdesivir is expensive, at around US$5,000 per treatment.
Remdesivir is also difficult to get. At the moment every dose of Remdesivir is being purchased by the US government.
Fortunately, there is a mounting body of evidence that suggests that the direct-acting antiviral drug combination of Sofosbuvir + Daclatasvir is a better treatment option than Remdesivir.
Firstly because it’s as effective as Remdesivir in stopping the COVID 19 virus from replicating.
Secondly because its cheap, with treatment costing less than $90.
Thirdly because it’s a pill that can be taken once or twice a day.
Fourthly because it’s readily available in almost every country on the planet.
In vitro research in laboratories shows both Sofosbuvir and Daclatasvir, together and separately are effective against COVID 19.
In the last few months, a number of human trials have got underway. Some have been completed and all results, at this stage, are very promising.
So it just may be that we already have a cheap and effective treatment for COVID 19 that is readily available and that no one is using.
At the moment it looks like a 14-day treatment using Sofosbuvir 400 mg + Daclatasvir 60 mg once a day may be enough to stop the COVID 19 virus from replicating.
It may be that the same dose is taken twice a day could be more effective or it may be that Sofosbuvir 200 mg + Daclatasvir 30 mg taken twice a day may be the best option. At this stage, it is not certain. Current trials are based on using Sofosbuvir 400 mg + Daclatasvir 60 mg once a day.
The use of Dexamethasone has been primarily on critically ill patients however it may be that early intervention with Dexamethasone, at the first sign of lung inflammation, is a better option, given that dexamethasone is a well-understood medicine.
Logic and intuition and conventional wisdom all suggest that early medical intervention is better than waiting until a patient becomes critically ill.
As mentioned before a 2-week treatment with Sofosbuvir + Daclatasvir would cost less than US$90.
The same length of treatment with Dexamethasone would cost around US$10.
So, the entire treatment may cost less than US$100.
Actually, it is possible that there will never be an effective vaccine for COVID 19. The Coronavirus is structurally a very similar virus to the Hepatitis C virus, for which there has never been a vaccine made.
Drug companies and governments have been working on developing a vaccine for the Coronavirus family of viruses for decades without success.
Same for HIV… no vaccine after more than 30 years of research.
A vaccine might be created but it also may be the case that there will never be a COVID 19 vaccine. A cure is just as likely as a vaccine and certainly much, much cheaper.
So the solution to the COVID 19 pandemic may be this: “Diagnose, treat, cure.”
An effective treatment program combined with good hygiene and sensible social distancing removes the need for lockdowns and other draconian ways of dealing with the virus.
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