Dr. Gretchen Arnoczy is a board certified infectious diseases physician who treats patients in FirstHealth hospitals and FirstHealth's Infectious Diseases and Travel Medicine Clinics.
A pet peeve of mine is the claim of a "miracle drug."
The entire COVID-19 news cycle felt like it was awash in "miracle drugs," but as a clinician who treated patients with COVID, the promises rarely held up. If you listened to the news, every new treatment was either miraculous or toxic.
For the vast majority of medications we used (and use) to treat COVID-19, neither of those descriptions was accurate.
The reason I hate when people call a treatment a "miracle drug" is because it's usually a sales tactic. An overstatement of a medicine or treatment with a small or theoretical benefit. It's usually salesmanship. And I resent it. Because there ARE miracle drugs and they deserve respect.
My personal favorite classes of miracle drugs are antiretrovirals for HIV infection and the new direct-acting antivirals for Hepatitis C.
I've talked about HIV medicines before, but for those of you who don't know HIV is a fatal disease that used to kill young people in the prime of their lives.
Something happened in 1995. Honestly? A miracle. In the late 1980s and early 1990s, there were fundraising galas, concerts, benefits, prayer circles and advocacy groups all hoping and praying for effective treatments and cures for HIV. In 1995, at the big HIV scientific meeting, those prayers started to be answered. New medicines called protease inhibitors were being combined with other HIV medicines and they were achieving complete suppression of the virus.
It was a complicated, difficult treatment back then. And it wasn't a cure. People called it the "cocktail." We learned how to coach patients through the long list of unpleasant side effects and complicated dosing schedules to keep them alive. We are still searching for a cure. But the medicines have gotten friendlier. Most of my patients now take one pill a day with very few side effects. Some of my patients get shots every two months and avoid pills altogether.
I remember taking care of a patient who dropped out of college in the early 90s when he was diagnosed with HIV. He resigned himself to his impending death and didn't see the point in planning for the future. When I met him 25 years later he was finishing his degree and opening a retirement account, now preparing for that old age he never expected to see.
I remember another patient I met who was born with HIV in the early 90s. Without treatment, babies born with HIV generally didn’t survive.
But she did. She survived her babyhood and childhood, began taking medicine and stayed on meds - she is now in her 30s with her own healthy, happy, HIV-negative kids. Her children are miracles. A generation that never would have existed. She is a miracle. HIV medications are miracle drugs.
My newest favorite miracle drugs are the latest treatments for Hepatitis C.
Hepatitis C is a virus that can be spread through blood and causes liver disease. More than 70% of people who get infected develop a chronic infection, and the treatments for it used to be absolutely harrowing. The old treatments included a medicine called interferon. This is the hormone your body produces when you have the flu. It kills viruses but it also makes you feel like you have the flu.
Back then, we could cure about 30-40% of hepatitis C cases if people took these treatments for a year. But it meant that patients felt like they had the flu for a full year.
It could also induce all sorts of other terrible things, like psychiatric illnesses, kidney failure and low blood counts. We had to check blood tests often to make sure patients weren’t getting toxicity from the medicines. Attempting to cure Hepatitis C was a major undertaking and frequently not successful.
I remember a heartbreaking story. A surgeon had a needlestick and got hepatitis C. He started the old, terrible treatments back in the mid-2000s. This surgeon became psychotic while taking interferon. He was hospitalized in the psychiatric unit of the hospital where he worked, and when he returned to work his career as a surgeon depended on regular psychiatric check-ins. All from a needlestick.
The flu for a year. The possibility of psychosis. And a 60-70% chance he'd still have the virus at the end of it. That is a hard sell. But the alternative was a high chance of liver failure - truly a no-win situation. Then, in 2011, another medical miracle.
There are now complete treatments for hepatitis C that don't include interferon. New medicines have been discovered and developed that can cure hepatitis C, more than 95% of the time, in 2 or 3 months. Medicines with almost no side effects. Medicines that are so safe we usually don't even have to check labs while patients take them. Miracle drugs.
FirstHealth Infectious Diseases started treating hepatitis C in 2023. Finally crawling out after being buried in work from COVID-19, we became excited about the breakthroughs in hepatitis C treatments. We had just hired a third doctor. We finally had bandwidth again. It was time to start a new adventure. When we started treating Hepatitis C, like a light through the darkness, I remembered how much fun it is to CURE something!
A patient with a 70% chance of severe liver disease can now get rid of that pesky risk factor in a single season. Diagnosed when the spring flowers are blooming, cured before the first Pumpkin Spice latte. This is the kind of thing I went into medicine for. Miracles.
The Lord works in mysterious ways, and sometimes it's medicines.
FirstHealth ID offers treatment for Hepatitis C through our outpatient clinic. For more information contact us at (910) 715-7882.
