Turning the Corner in Hepatitis C Treatment (cont.)
Understanding Hepatitis C
Almost 4 million people in the U.S. are infected with hepatitis C, according to the CDC. Most don't know they have it. Hepatitis C causes few symptoms. Indeed, many of the people who are infected have had the virus for years. They may have contracted it from a blood transfusion or organ transplant before 1992, when supplies began to be screened for the disease.
There are at least six different subtypes of the hepatitis C virus. While no one type is more dangerous than another, they do respond differently to treatment. Hepatitis C Type 1 is the most common type in the US. Unfortunately, the medications we have don't work as well with Type 1 as with other subtypes of the virus.
Current Hepatitis C Treatment
For years, the standard hepatitis C treatment was a combination of injected interferon and the oral antiviral drug ribavirin. Recently, a new form of interferon -- peginterferon, or pegylated interferon -- has become the standard of care. It's a significant step toward better treatment.
"Combination treatment with pegylated interferon and ribavirin is giving us appreciably better results than what we used to get," says Berk.
Interferon is a manufactured version of certain natural proteins that fight viruses. Peginterferon, or pegylated interferon, is modified so that it stays in the body longer than standard interferon. Because the drug stays at more constant levels in the body, patients need only one injection a week instead of three.
Hepatitis C treatment with peginterferon and ribavirin achieves a "sustained response" up to 54% of people, which means that the virus has been eliminated from their blood after stopping treatment. People with hepatitis C types 2 and 3 have sustained response rates of about 80%; people with type 1 have rates of up to 50%. As far as we know, a sustained response means that the illness is cured, says Berk.
Berk also believes that hepatitis C treatment is better now because doctors now use various hormones that can counteract drops in blood cell counts, a common side effect of treatment. In the past, these side effects might make a doctor reduce the dose, or stop treatment altogether. Now it's possible to correct the side effects and carry on.
In cases where a person can't tolerate the effects of ribavirin, it's possible to use pegylated interferon on its own. However, the treatment is less effective. Ribavirin by itself doesn't work.
The Trouble With Treatment
While hepatitis C treatment has come a long way, there are still drawbacks. For a person who's newly diagnosed, a 54% cure rate may not sound great. After all, it means that about one out of two people won't respond to treatment.