The Centers for Disease Control and Prevention estimates that 3.2 million Americans are living with chronic hepatitis C. Hepatitis C is a contagious disease that infects the liver and causes inflammation, preventing the liver from properly functioning. Hepatitis can cause mild illness or can cause lifelong disease and serious complications. Options are available to treat hepatitis C.
Options for Treatment
An individual with a diagnosis of hepatitis C does not automatically need to be treated. These individuals do not have significant liver abnormalities resulting from the hepatitis C virus and can have routine blood tests to closely monitor for declining liver function. Other individuals will need to be treated with a combination of the antiviral medications alpha interferon and ribavirin. If an individual's liver has been severely damaged by hepatitis C, a liver transplant may be necessary.
Combination Therapy
Alpha interferon is an antiviral drug used to normalize liver function tests, improve liver inflammation and reduce the replication of the virus. Ribavirin is an antiviral drug that when used alone is not effective in treating hepatitis C, but when combined with alpha interferon, the success rate of treatment increases. Combination therapy with both medications is the recommended treatment for hepatitis C.
According to the National Digestive Disease Information Clearinghouse (NDDIC), combination therapy leads to rapid improvement in 70 percent of patients. Long-term improvement occurs when the hepatitis C virus RNA cannot be detected during and after treatment; however, some individuals treated with combination therapy who were negative at the end of treatment will have recurrences. The NDDIC estimates that 55 percent will have a sustained response to treatment with both medications as opposed to 35 percent who were treated with only interferon. Alpha interferon should only be used as monotherapy when certain contraindications prevent ribavirin from being used.
Doses/Duration
Standard interferon must be given several times a week and causes levels of the medication to fluctuate in the body. Peginterferon has replaced standard interferon and according to the NDDIC, is given once a week by injection, which provides a constant level in the blood. Ribavirin is given twice a day and is taken orally. The dose of ribavirin is based on body weight. Treatment for 48 weeks is recommended for individuals being treated with peginterferon only. Combination treatment is used for 24 to 48 weeks.
Side Effects
As with any medication, there are side effects of ribavirin and peginterferon. Common side effects of peginterferon include fatigue, muscle cramps, headache, nausea, vomiting, fever, irritability, depression and weight loss. These side effects are not life-threatening, can be managed and may go away as treatment progresses. Ribavirin can cause anemia, fatigue, irritability, rash and cough. Ribavirin should not be used in individuals with a history of anemia, coronary disease or vascular disease because deaths from heart attacks and strokes have been reported.
Liver Transplant
Individuals with severe liver damage may require a liver transplant. An individual may receive a liver from a deceased individual or from a living donor. A transplant does not cure hepatitis C and treatment with antiviral medications continues after the transplant because hepatitis C is likely to recur.
