The best treatment results have been obtained using a combination of two medicines: peg-interferon (pegylated interferon) and ribavirin. Treatment should be given or directed by a qualified physician.
Peg-interferon
Interferon is a naturally occurring chemical in the body that helps fight Hep C infection and protects cells from HCV. Peg-interferon is an engineered form of basic interferon with a polyethylene glycol (PEG) molecule attached to it to keep the blood levels of the drug higher for longer periods of time. This increases its presence and activity in the body. It is injected under the skin once a week.
There are two forms of this drug. Peg-interferon alpha-2b is known as Pegetron (when sold in combination with ribavirin) or Unitron Peg (when sold on its own) and is made by Schering-Plough. Peg-interferon alpha-2a is called Pegasys and is made by Hoffman-La Roche. Both types of peg-interferon have been shown to effectively treat Hep C in people.
The best treatment results have been obtained using a combination of pegylated interferon and ribavirin.
Ribavirin
Ribavirin is an antiviral medication that is a weak HCV fighter on its own but when combined with peg-interferon it is quite effective at helping reduce or eliminate HCV from the body. It is taken orally twice a day in a pill form and the dose used depends on the patient’s weight (usually between 800–1,200 mg/day).
Schering-Plough makes ribavirin in pill form, which it markets together with peg-interferon in a combination called Pegetron. Hoffman-La Roche makes ribavirin in pill form called Copegus, which is sold with Pegasys. Both versions are the same drug and are effective at treating Hep C when combined with peg-interferon.
Length of Treatment
Treatment duration is determined by the genotype of the hepatitis C virus. Treatment for genotype 1 lasts 48 weeks (one year). Currently, genotypes 4, 5 and 6 are treated the same way as genotype 1. About 45% of people with genotype 1 will clear the virus. People with genotypes 2 and 3 respond better to the medications and are treated for 24 weeks (six months). About 80% of people with genotype 2 or 3 will eradicate the virus.
Treatment success is predictable as early as four to 12 weeks into treatment. A doctor will usually do a viral RNA test at four weeks and at 12 weeks. If the virus is undetectable at four weeks it is called rapid virological response (RVR). If at least 99% of the virus is cleared from the body at 12 weeks, it is called early virological response (EVR). Obtaining RVR or EVR is highly predictive of successful treatment. If a person does not get EVR at 12 weeks, it is likely their treatment will be stopped, as this person is not responding to treatment and will not achieve a sustained virological response. If a person does achieve EVR, the full course of treatment (as per genotype) will be completed to ensure that the virus is eradicated from the body.
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