The Hepatitis C Treatment Series: Part 1, Before You Start Hepatitis C
TreatmentWhat treatments can I get by prescription from my doctor?
There are three treatments that have been approved by the Food and Drug
Administration (FDA) for hepatitis C virus infection:

Interferon alone
(called interferon monotherapy)
Interferon is a protein that causes your body's immune system to attack infected
liver cells and to protect healthy liver cells from new infection. There are
several brands of interferon made by different drug companies.
Interferon combined with ribavirin
(called combination therapy)
Overall, combination therapy is much more effective than interferon monotherapy.
If you have already had monotherapy treatment and it didn't work, you may want
to think about combination therapy or experimental treatments.
Note: Combination therapy is not right for all patients with hepatitis C. You
must talk with your doctor about the risks and benefits of this therapy before
you decide to try it. Long-acting interferon
(called pegylated interferon therapy)
This is a new kind of interferon. The FDA has recently approved it for patients
who have never been treated before for hepatitis C.

Long-acting interferon combined with ribavirin
(often called peg-riba)
This combination treatment has been approved by the FDA for patients who have
never been treated before for hepatitis C. How long does treatment take?
Treatment time varies. It depends on whether you get your medicine from your
regular doctor or through a clinical trial. In general, standard combination
therapy lasts between 24 and 48 weeks, with six months of follow-up after
treatment has ended. Sometimes, if the treatment is not working or if you have
too many side effects, your doctor may stop your treatment early.
If you are part of a clinical trial for new medicines, the treatment time will
depend on the study design. Your doctor, nurse, or clinical trial coordinator
will explain the schedule to you before your treatment begins. How can treatment
help me?
Hepatitis C treatments can remove (or clear) the hepatitis C virus from your
blood, but this does not happen in all patients. If this does not happen, there
are still some ways that treatment can help you. The treatment can:

decrease the amount of liver damage
lower the amount of hepatitis C virus in your blood
improve your overall well-being and quality of your life
lower your alanine aminotransferase (ALT) liver enzyme level
I've heard my doctor talk about different responses to treatment. What are they,
and what do they mean?
There are three types of response to treatment that describe how treatment works
for the patient, including the following:

Treatment naive
This means that you have not yet taken medicine to treat hepatitis C.

Responders (or sustained responders)
This means that the treatment worked while you were taking the medicine and
seemed to work even after you stopped taking it.
Non-responders
This means that the treatment did not work. Some of the different kinds of
non-responders include the following:



Relapsers (or transient responders)
The treatment only worked as long as you took it. When you stopped taking the
medicine, the hepatitis C virus came back.



Breakthrough non-responders
The treatment worked in the beginning and then stopped working.




Complete non-responders
The treatment did not remove (or clear) the virus from your blood.


What will make the treatment more likely to work?
Not everyone will have the same results from hepatitis C treatment. These are
some things that can affect the treatment and how well it works, including the
following:

Viral genotype

Not all hepatitis C viruses are exactly the same. We know of six different
genotypes for hepatitis C. Some of them respond better to treatment than others.
Viral load

This is the amount of virus in your blood. If you have lower levels of virus in
your blood when you start treatment, you may have a better chance of getting rid
of the virus.

Note: A high viral load does not necessarily mean you have worse liver damage.
Iron

If you have less iron in your blood or in your liver cells, your treatment may
work better. Iron levels can be checked with a blood test or a liver biopsy.

Gender

Hepatitis C treatment works slightly better for women than for men.
Age

If you got the virus before the age of 40, the chance of treatment working for
you may be better than if you became infected in older age.

Length of infection

You may have a better chance of clearing the virus from your body if you haven't
been infected with the hepatitis C virus for very long

Do I have to get a liver biopsy to start treatment?
Sometimes your doctor may ask you to have a biopsy before you start treatment.
This tells how much damage there is in your liver and can help you decide when
to start treatment. Your doctor may also ask you to have a biopsy after
treatment is finished.
When should I start treatment?
It is a good idea to talk about treatment with your doctor and family first.
Only you can decide when to start. In general, doctors suggest treatment if you

have high liver enzymes, especially ALT levels;have a test that showed hepatitis
C virus in your blood;have a liver biopsy that showed damage (or fibrosis) or
inflammation;have NOT used alcohol or other drugs for at least six months.
If I want to start treatment, what should I do now?
If you want to start treatment for hepatitis C, speak with your VA doctor. It is
a good idea to talk about any concerns you have before you start treatment. Your
doctor and you will decide if treatment is right for you and which medicines
might work.




Sandra Tara Balduf (Ane)

Frontline Hepatitis Awareness

Support for patients and educational materials

http://frontline-hepatitis-awareness.com

1-866-Hep-GoGo 866-437-4646




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