Medications
Antivirals are the only medicines used
to treat long-term (chronic)
hepatitis C. These medicines can help prevent the
hepatitis C
virus from damaging your liver. If these medicines
work for you, you may have no more virus in your body and less inflammation and
scarring in your liver.
Medication Choices
The following antiviral medicines are used to treat
chronic hepatitis C:
What To Think About
Antiviral medicines for
hepatitis C may not be recommended if you:
- Drink alcohol or use IV drugs. (Although you
cannot take antiviral medicines if you use IV drugs, you can take antiviral
medicines if you are using methadone.)
- Have advanced
cirrhosis.
- Have severe
depression or other mental health problems. The
antiviral medicines used to treat hepatitis C can make mental health problems
worse.
- Are pregnant or might become pregnant. Two forms of birth
control must be used during treatment and for 6 months after treatment.
- Have an autoimmune disease such as
lupus,
rheumatoid arthritis, or
psoriasis, or certain medical problems such as
advanced diabetes, heart disease, or seizures.
The U.S. National Institutes of Health has made
recommendations on
who
should receive antiviral treatment for hepatitis C.5 For example, treatment is recommended for people who are at
least 18 years old, have detectable levels of the virus in their blood, and
have significant liver damage confirmed by a
liver biopsy.
Only a few clinical trials
have tested antiviral medicines in children. The results suggest that they work
about as well in children as in adults. Combination therapy using interferon
and ribavirin is now approved by the U.S. Food and Drug Administration (FDA)
for use in children ages 3 to 17 years.
Medicines for hepatitis C
are expensive and can cause many serious side effects, such as constant
fatigue, headaches, fever, nausea, depression, and
thyroid problems.
The length of your
treatment depends on what hepatitis C genotype you have. Genotype 1 generally
is treated for 1 year and genotypes 2 and 3 generally are treated for 6 months.
If you have genotype 1 and your viral load does not show signs of improvement
after 3 months of treatment, your treatment may be stopped.
It is important to weigh the benefits of medicines for hepatitis
C against the drawbacks. You most likely do not need to make a quick decision
about treatment, because hepatitis C progresses very slowly. Talking with your
doctor can help you decide whether medicines are right for you. For more
information, see:
Should I have antiviral therapy for hepatitis
C?
Treatment effectiveness
Peginterferon—a newer,
longer-acting form of interferon—combined with ribavirin is now considered
better than standard interferon combined with ribavirin.
Medicines to treat hepatitis C do not work for everyone. Chronic hepatitis C
infection is cured or controlled in about half of the people who are treated
with a combination of peginterferon and ribavirin.6
Studies have shown that treatment works for up to 50% of people with genotype 1
and up to 80% of people with genotype 2 or 3.7
Most people who are known to have an acute hepatitis C infection get
treated with medicine. In these cases, treatment for acute hepatitis C may help
prevent long-term (chronic) infection, although there is still some debate over
when to begin treatment and how long to treat acute hepatitis C.3, 4
Sometimes treatment does not permanently lower
the amount of virus in your blood. But some studies have shown that treatment
may still reduce scarring in your liver, which can lower your chances of
developing cirrhosis and liver cancer.5, 2
If you have tried
interferon in the past and did not get good results, talk to a doctor who is a
liver specialist (hepatologist). The hepatologist will be able to tell
you about newer combinations of peginterferon with ribavirin or new,
experimental medicines.