What are the current treatments for chronic hepatitis C.?

All patients with chronic hepatitis C should be evaluated by a specialist for possible treatment with these agents. In general, adults less than 70 years old with evidence of active inflammation on liver biopsy and without advanced cirrhosis are good treatment candidates. Indications for treatment of patients with very mild disease on liver biopsy are less clear. Such individuals should be considered for possible participation in clinical studies. Patients with advanced cirrhosis secondary to hepatitis C should be referred referred for evaluation for possible liver transplantation. Source(s): http://www.cumc.columbia.edu/dept/gi/hep...

One of the only approved treatments for chronic hepatitis C, especially for patients with consistently elevated liver enzymes or mild-to-moderate liver damage, is the biological drug interferon alpha, marketed as Intron A by Schering Corp. and Roferon-A by Roche Laboratories Inc. Amgen Inc. also has an approved drug derived from interferon alpha called Infergen. Hepatitis C patients must inject interferon themselves, usually three times a week. In about 25 percent of patients, the drug has a pronounced effect, reducing HCV to very low levels in the blood. However, if the drug is ineffective after three months, doctors probably will discontinue it.

Doctors also may prescribe Rebetron, a Schering product that combines interferon with the antiviral drug ribavirin. Approved last June for patients who have relapsed after interferon therapy and expanded in December to include patients never treated with interferon, this combination therapy appears to suppress blood levels of HCV more effectively than a first or repeat course of interferon alone. In clinical trials, about 45 percent of relapsed patients treated with the combination sustained reduced HCV levels for six months after discontinuing therapy, compared with 5 percent of relapsed patients who were retreated with interferon alone. These results were reinforced by a study published last Nov. 19 in the New England Journal of Medicine showing the combination to be significantly more effective in suppressing HCV levels.

"We've learned from research in other viral diseases that combination therapies rather than [a single drug] may offer the best potential for effective treatment," says John Hutchison, M.D., medical director of liver transplantation at Scripps Clinic and Research Foundation.

Bill Ruttman, 44, a Lansdale, Pa., hepatitis C patient, has taken the combination treatment since last October. As a result, his HCV levels have dropped to undetectable levels, and his once-elevated liver enzyme levels have "normalized," which he says is good news because for now, he feels the disease has been slowed down. "I'm extremely happy in that regard," he says.

Ruttman's successful therapy has come at a price, however, because of Rebetron's side effects. He suffers from extreme fatigue and has to nap often during the day, and he sleeps restlessly at night. He also has bouts of depression and is currently unable to work. His side effects are typical of those experienced by patients taking interferon alone as well as the combination therapy.

Because side effects can be serious, patients should be closely monitored by their doctors. Ribavirin can cause anemia, and interferon is associated with both psychosis and suicidal behavior, though the latter occurs in 1 to 2 percent of patients. Both interferon and ribavirin present significant potential risks for pregnant women, including possible fetal death or malformations. Female patients and female partners of male patients must not become pregnant while receiving this therapy and for six months after completing therapy.

Some patients who take interferon or the combination complain of flu-like side effects such as fever, chills and body aches. Many side effects, such as muscle aches and low-grade fever, can be managed. Some side effects may be reduced by giving the drug at night or lowering the dosage. Side effects are often more severe during the first few weeks of treatment, especially after the first injection.

Patient Elaine Moreland says her interferon therapy caused "just about every one of the [side effects] listed in the drug handout sheets--severe muscle cramps, hair loss, nervousness, heart palpitations, fatigue, sweating, headaches, and blurry vision." Ultimately, she says, treatment was stopped because it wasn't working. Because of the potential side effects, she is holding off on further therapy in the hope that improved treatments may soon be available. "I'm waiting to see what comes down the pike unless signs start to point to serious progression of my disease."

Currently, chronic hepatitis C patients who do not respond to therapy have few options. In many, cirrhosis or other damage will eventually cause the liver to stop functioning. In these cases, a liver transplant is the only recourse. However, even new livers often become infected with the virus. But because HCV usually progresses slowly, says Jay Hoofnagle, many transplant recipients can live normal lives for many years despite the infection.
alfa interferon + ribavirin
Actually Car Craze and Dimoon's answers are a little outdated. The current treatment for hepatitis C is an improved version of interferon, called pegylated interferon, which is a shot taken once a week. This shot is used in conjunction with Ribavirin, pills which are taken daily. Length of treatment is determined by which genotype you have. Genotype 1 is more resistant to the medication, so it requires a longer treatment time (about a year). Genotypes 2 & 3 respond better to treatment, and usually need treatment for 24 weeks, however, geno 3 has been showing a relapse rate so some physicians are treating genotype 3's for a year, too. This treatment is a mild form of chemotherapy. It does have some side effects, but they are manageable. I did the old treatment with the shots 3 times a week plus the pills. The side effects were somewhat harsher then; people seem to be doing better on the pegylated interferon. I have seen many people succeed on this treatment; I'm one of them. I've been undetectable for 6 years. I also facilitate a support group for the last 5 years. Best wishes to you.
HCV educator, advocate, and survivor
my husband has been diagnosed with chronic hep c for 9 years unfortunately as a drinker there is no treatment for him unless he can stop drinking.But we know of a friend who had treatment of injections into liver three times a week with worse side effects and it did not cure his hep c.I must stress this friend is not a drinker.Also having been with my husband for 12 years i myself have not contracted hep c.Although you should use protection with partners.