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.