DOCTOR'S VIEWS ARCHIVE


Topic: Hepatitis C, June 2000

Dr. Lee:
What treatments are available to date for Hepatitis C?

Dr. Edward Block:
Well, there are now several treatments available. The initial medication that was first released for treatment of hepatitis C was interferon. Interferon is an injectable agent that was initially recommended to use for Hepatitis C patients. Unfortunately, the success rate was somewhat limited.

Fortunately, over the last several years we have been able to introduce a second drug, which is known as ribavirin (an antiviral drug). We have found that this drug used alone was actually not terribly beneficial, but when given in combination with interferon the two together seemed to have better efficacy than interferon alone in eradicating the Hepatitis C virus.

Dr. Lee:
So now we have two treatments, one is interferon, alone. And, the other treatment is interferon in combination with oral ribavirin, correct?

Dr. Edward Block:
Yes.

Dr. Lee:
Let's have a discussion on what constitutes treatment success?

Dr. Edward Block:
Well, what we would like to see is complete eradication of the Hepatitis C virus. We use the Hepatitis C RNA test to detect the virus in the blood of an individual. Failure to detect Hepatitis C RNA in a patient six months after stopping treatment likely indicates virus eradication. So, 6 months following treatment, Hepatitis C RNA test is repeated. Treatment success would be defined as the disappearance of the Hepatitis C RNA in the blood of the treated individual.

Dr. Lee:
Also, in that patient other liver tests such as SGOT (ALT) and SGPT (AST) will also have returned to normal with successful treatment, am I correct?

Dr. Edward Block:
Yes that is correct. Although we would prefer to use the disappearance of Hepatitis C RNA from the blood as the 'gold standard' of determining treatment success. Because in some individuals, SGOT and SGPT can go up and down, independent of the presence or absence of the virus.