HCV Treatment and Monitoring Guide

Treatment

Ultimately the primary goal of HCV treatment is a cure. Another goal is to reduce the amount of virus in the blood, preventing and/or slowing progression of the disease and further damage to the liver.

Your body naturally produces the chemical, alpha interferon. One of the things that it does is boost the antiviral activity of the immune system. All of the currently approved treatments for chronic hepatitis C are made with some form of alpha interferon. Alpha interferon does not attack HCV directly but helps other cells release chemicals that protect them from attack.

Interferon

Alpha interferon

can be used either alone or combined with an anti-HCV drug called ribavirin. Combination therapy is much more effective in reducing the hepatitis C viral load to undetectable levels than alpha interferon alone. As a result, it has become the standard of care.

Pegylated interferon is a form of alpha interferon that stays in the body longer than regular interferon. The advantage is the drug does not have to be taken as often. Regular interferon is injected three times a week, while pegylated interferon is taken once a week.

There are two types of pegylated alpha interferons: peg-interferon alfa-2a and alfa-2b. The major difference between the two is how they are dosed. The dose of alfa-2a is the same for all patients, regardless of weight or size. The dosing of alfa-2b is based on an individual's weight.

Short-term side effects of interferon can include flu-like symptoms such as fever, chills, headache, muscle and joint aches and fast heart rate. Side effects that can develop later include tiredness, hair loss, low blood count, trouble with thinking, low white blood cell count (neutropenia), moodiness and depression. Severe side effects are rare but can include thyroid disease, depression with suicidal thoughts, seizures, acute heart or kidney failure, eye and lung problems, hearing loss and blood infection.

Ribavirin

Ribavirin is in the drug category called nucleoside analogues. It is an oral medication taken twice a day. Using ribavirin alone has not been shown to be effective against hepatitis C, but when it's combined with alpha interferon, studies show greater effectiveness than when using alpha interferon alone.

Anemia can develop while taking ribavirin and may result in kidney failure. However, it has been shown that anemia may go away once the treatment is stopped. In addition, some doctors may prescribe Epoetin Alfa (Procrit), a medication used to treat anemia. Some anti-HIV drugs should be avoided when taking ribavirin.

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