Hepatitis C - Treatment

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What methods of treatment, including medication, have you received for your hepatitis C?

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What is the treatment for hepatitis C infection?

There are six genotypes of hepatitis C, and they may respond differently to treatment. Careful screening is necessary before starting treatment to determine the best treatment for the patient.

Combination antiviral therapy with interferon injection and oral ribavirin (Rebetol, Copegus, Ribasphere, RibaPak, Moderiba) has been the mainstay of hepatitis C treatment in the past. Unfortunately, interferon is not widely available globally, it is not always well tolerated, some virus genotypes respond better to interferon than others, many people who take interferon do not finish their treatment, and only 60% of patients respond to the treatment. This means that while hepatitis C is generally considered to be a curable disease, for many people this was not a reality.

Pegylated interferon: Interferons are a family of naturally occurring proteins that are produced by the body to fight viral infections. To produce pegylated interferon, the interferon is processed by attaching ethylene glycol to it. This process is called pegylation and it slows the elimination of interferon from the body so that its effects are more prolonged. There are currently two types of pegylated interferons.

  • pegylated interferon alpha 2b (Peg-Intron A), and
  • pegylated interferon alpha 2a (Pegasys).

Both pegylated interferon alpha 2b and 2a; are given as a subcutaneous injection once a week.

Optimally, pegylated interferon therapy should be combined with oral ribavirin. In persons who cannot take ribavirin, monotherapy with pegylated interferon may be used; however, monotherapy has been shown to achieve sustained virologic response rates of only25%. Older preparations (nonpegylated forms) of interferon are even less effective than pegylated interferon.

Ribavirin: The antiviral agent, ribavirin (Rebetol, Copegus), is a nucleoside analogue that is taken by mouth. Nucleoside analogues are man-made molecules that closely resemble the biochemical units that make up genetic material (RNA and DNA). Ribavirin works by fooling the virus into using it instead of the normal building blocks of RNA, thereby slowing viral reproduction. Ribavirin has not worked well when used alone for hepatitis C.

Combined pegylated interferon and ribavirin: Combined therapy with both pegylated interferon and ribavirin produces a sustained virologic response or cure in 28% to 50% of patients with genotype 1. (Genotype 1 is the most common genotype in the U.S., but also the most resistant to treatment.) For unknown reasons, response rates are lower in African American persons and higher in Caucasians. In patients with genotype 2, sustained response rates are higher (76% to 82%). Duration of therapy depends on the genotype. Recommended duration of treatment for Genotype 1 is 48 weeks and for genotype 2 and 3 is 24 weeks.

Combination therapy is associated with more side effects than therapy with pegylated interferon alone. (See below.) In research studies, up to 20% of patients receiving combination therapy required a reduction in the doses or discontinuation of therapy because of the side effects. Nevertheless, combination therapy represented significant progress in the treatment of chronic hepatitis C.

Some patients treated successfully with combination therapy still have detectable virus after 24 weeks of treatment. Few of these patients go on to have a sustained response. Therefore, patients on combination therapy should have hepatitis C virus RNA measured at 24 weeks of therapy. In those who are still positive for the virus at that time, consideration is given to stopping treatment, since the chance of a sustained response with further treatment is small.

Return to Hepatitis C (HCV, Hep C)

See what others are saying

Comment from: brooke, 55-64 Female (Patient) Published: October 16

I contacted hepatitis C in my early 20s through blood transfusions. At first I was really sick, but didn't know anything about hepatitis C. My stomach was in pain and I couldn't get around. I had a son. The symptoms disappeared then, followed by about 40 years of relative good health. I had fairly good eating habits except for chocolate and sugar (addictions) and caffeine (I didn't start drinking coffee until my 50s). Then I went to China for three years to work and when I returned and got a checkup, which I had not done in many years, my levels were almost 6 million. I took off on the Pacific Crest Trail across Oregon, for the second year with my good friend, and I think that really helped mentally, but the food wasn't the best. However, I have extremely bad acid reflux and choking on my food, rashes on my legs, and puffy places on my ankles. I am exhausted and weak and that depresses me since I am a really active person. My son has bought me the Dr. Schulze detox program and I have been doing this for 2 weeks. I believe that it will kick it. I am 62, I have 7 kids and 11 grandkids. Hang in there you all, there is no power greater than faith and love, so let us stick together. I will soon find out if I can take the new drug that everyone says is so great. I will do whatever I can to regain my physical freedom.

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Comment from: MOMMA T, Female (Patient) Published: January 21

I was diagnosed with hepatitis C genotype 1A with stage 4 liver cirrhosis. My viral load was 500,000 plus, which is not good either. I was told I had hepatitis C. Let me tell you, it devastated me to say the least. What I did find out is that there is treatment out there with a 96 to 100 percent cure rate. I am not talking about a temporary fix to this disease, but a permanent cure. It is very expensive but with my gastroenterologist, primary doctor and pharmacy all pulling for me, I was able to get the medicines and funding for what insurance didn't cover, and I was out a total of USD 5.00 for each medicine I take. This is a huge savings of approximately USD 33,000 per month. So, there is a medicine out there, yes. It is called Harvoni. It does work, and I have very little side-effects so far. I have been taking it for about 2 weeks now and looking forward to my first 4 week bloodwork to see how much it has dropped on my viral load. Don't give up, to any and all of you fighting this horrible disease.

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