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Urgent Question on treating acute Hep C
Jan 26, 2005

Urgent Question: I may be in the acute phase of Hepatitis C, having possibly contracted it on Nov 8, 2004 (10 weeks ago). I am waiting on blood test results (PCR RNA, ALT/AST, Hep C AB). I understand that the cure rate is nearly 100% if I start treatment as soon as possible. What treatment protocol is used in such a case? From what I've read, 24 weeks of PegInterferon (injected once a week) is used without Ribavarin. Is this correct? Do you know the optimal dose?

Thank you for your help!

Response from Dr. McGovern

You are correct in saying that if you treat hepatitis C in the "acute stage" the chance of cure is much higher than when you have chronic infection.

Not all people need treatment for acute hepatitis C since the virus can sometimes clear on its own. It will be important to get the HCV RNA level back to see if it appears if the virus is at a low level. Noone knows the exact "window period" which is the optimum time to treat, but most hepatologists and infectious disease clinical researchers suspect that it may be about 4 months. If there is time to get one more HCV RNA level to confirm whether the virus is persisting or clearing prior to treatment, would be quite helpful.

The best way to treat acute hepatitis C has not been well-studied. Most patients are receiving pegylated interferon monotherapy with good results. The little data published on this so far, suggests that pegylated interferon, in standard doses, is sufficient. Other studies will be examining the effect of ribavirin also. For now, using pegylated interferon by itself is completely reasonable. Dr. McGovern



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