Hepatitis C is a liver disorder caused by an infection with the hepatitis C virus. It is generally a chronic condition that may have severe symptoms, but some people will not notice any effects for many years. Effective treatment of the hepatitis C infection usually involves a combination of medications including ribavirin and one of the interferons.
Alpha Interferon
Alpha interferon was the first medication approved for the treatment of hepatitis C. It is a naturally occurring protein released by the body to combat viral infection. Several recombinant forms of interferon are available, including alpha-2a and alpha-2b, administered by subcutaneous injection three times weekly for 24 to 48 weeks. Side effects are often severe and include flu-like symptoms such as headache, body aches, fatigue, and chills, along with others such as insomnia, anorexia, weight loss and hair loss. Some patients may experience psychiatric illness including severe depression, which may increase the risk of suicide. Alpha interferon use, both as monotherapy and in combination with ribavirin, was the mainstay of treatment for many years but has been largely replaced by newer interferon medications.
Consensus Interferon
Consensus interferon is biogenetically engineered interferon that differs slightly from standard alpha interferons. In the treatment of hepatitis C, it is administered by injection on a daily basis and is thought to provide a more constant level of interferon. It may be effective for treating hepatitis C in patients who have not responded to other therapies. Consensus interferon has side effects similar to those of alpha interferon including muscle aches, fatigue, nausea and psychiatric changes.
PEG Interferon
Recent improvements in the treatment of hepatitis C include the addition of polyethylene glycol (PEG) to the interferon molecule. PEG interferon is different from alpha interferon in its duration of activity. Because of changes to the molecule, it needs to be given only once weekly. PEG interferon is also more active at inhibiting the virus. It also tends to have a milder side effect profile but may still carry the risk of developing flu-like symptoms, anorexia, weight loss and psychiatric changes. It may be used as a single-agent medication but is often more effective when combined with ribavirin.
Ribavirin
Ribavirin is an oral medication that demonstrates antiviral activity for many viruses but shows little effect on the hepatitis C virus unless combined with interferon. The combination of an interferon with ribavirin may dramatically increase the effectiveness of interferon. Therefore most patients are given both medications unless there are specific reasons for not using ribavirin. Side effects of ribavirin may be difficult to differentiate from those of interferon but may include fatigue, irritability, headache, hair loss, nausea and psychiatric changes. A physician should be consulted if easy bruising, darkened urine or bloody stools are noted, as these may be signs of more serious side effects.
