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Combination antiviral therapy helps
prevent the virus that causes
hepatitis C from reproducing in the body. Peginterferon and ribavirin often are combined for treatment. A protease inhibitor or a nucleotide analog inhibitor may be given along with peginterferon and ribavirin or with ribavirin alone.
The length of
your treatment depends on what hepatitis C genotype you have. Genotypes 1
and 2 generally are treated for 12 weeks, and genotype 3 generally is treated for
12 or 24 weeks. If your viral load does not improve after initial treatment, a different set of medicines may be used.
Combination antiviral therapy is
prescribed for people who have ongoing (chronic) hepatitis C infection. It may
be given to people who have never had treatment or when the first set of medicines has
failed to cure the infection.
How well treatment works is measured by
whether you still have the virus in your blood after treatment.
Combination antiviral therapy is more likely to
be effective if you:
All medicines have side effects. But many people don't feel the side effects, or they are able to deal with them. Ask your pharmacist about the side effects of each medicine you take. Side effects are also listed in the information that comes with your medicine.
Here are some important things to think about:
or other emergency services right away if you have:
Call your doctor if you have:
Common side effects of this medicine include:
If you develop
anemia as a result of taking ribavirin, your doctor
may prescribe a medicine called erythropoietin to help your body create more
red blood cells.
See Drug Reference for a full list of side effects.
(Drug Reference is not available in all systems.)
You will need regular follow-up
visits with a liver specialist during treatment. The specialist will order
blood tests to check your liver enzyme levels and to see whether the virus is
Peginterferon and other interferons may be given
without ribavirin if you have anemia or heart or kidney problems.
Even if the initial treatment does not eliminate the virus,
your doctor may advise you to continue antiviral treatment, because it may
inflammation. For some people with significant liver
damage, antiviral therapy may slow the progression of liver damage or make
liver cancer less likely.8, 9 If you already have
cirrhosis, some studies show that antiviral therapy
can help you live longer.10
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 for use in children ages 3 to 17 years.
If you are obese or have poorly controlled diabetes, you may need to delay treatment until you get your
weight or blood sugar under control.
Medicine is one of the many tools your doctor has to treat a health problem. Taking medicine as your doctor suggests will improve your health and may prevent future problems. If you don't take your medicines properly, you may be putting your health (and perhaps your life) at risk.
There are many reasons why people have trouble taking their medicine. But in most cases, there is something you can do. For suggestions on how to work around common problems, see the topic Taking Medicines as Prescribed.
If you need to take this medicine, talk to your doctor about how you can prevent pregnancy.
For women: Do not use this medicine if you are pregnant or planning to get pregnant.
Follow-up care is a key part of your treatment and safety. Be sure to make and go to all appointments, and call your doctor if you are having problems. It's also a good idea to know your test results and keep a list of the medicines you take.
Complete the new medication information form (PDF)(What is a PDF document?) to help you understand this medication.
Pawlotsky JM, McHutchinson J (2012). Chronic
viral and autoimmune hepatitis. In L Goldman, A Shafer, eds.,
Goldman's Cecil Medicine, 24th ed., pp.
973–979. Philadelphia: Saunders.
Poordad F, et al. (2011). Boceprevir for untreated chronic HCV genotype 1 infection. New England Journal of Medicine, 364(13): 1195–1206.
Bacon BR, et al. (2011). Boceprevir for previously treated chronic HCV genotype 1 infection. New England Journal of Medicine, 364(13): 1207–1217.
McHutchison JG, et al. (2009). Telaprevir with peginterferon and ribavirin
for chronic HCV genotype 1 infection. New England Journal of Medicine, 360(18): 1827–1838.
McHutchison JG, et al. (2009). Telaprevir and peginterferon with or without ribavirin for chronic HCV infection. New England Journal of Medicine, 360(18): 1839–1850.
Simeprevir (Olysio) for Chronic
Hepatitis C (2014). The Medical Letter
On Drugs and Therapeutics, 56(1433): 1–2.
Koff RS (2014). Review article: The efficacy and safety of sofosbuvir, a novel, oral nucleotide NS5B polymerase inhibitor, in the treatment of chronic hepatitis C virus infection. Alimentary Pharmacology and Therapeutics, published online January 6, 2014. DOI: 10.1111/apt.12601. Accessed February 12, 2014.
Singal AK, et al. (2010). Antiviral therapy reduces risk of hepatocellular carcinoma in patients with hepatitis C virus-related cirrhosis, Clinical Gastroenterology and Hepatology, 8(2): 192–199.
Morgan RL, et al. (2013). Eradication of hepatitis C virus infection and the development of
hepatocellular carcinoma: A meta-analysis of observational studies. Annals of Internal Medicine, 158(5, Part 1): 329–337.
Dienstag JL (2010). Chronic viral hepatitis. In GL
Mandell et al., eds., Mandell, Douglas, and Bennett's Principles and Practice of Infectious Diseases, 7th ed., vol. 1, pp.
1593–1670. Philadelphia: Churchill Livingstone Elsevier.
Current as of:
June 4, 2014
E. Gregory Thompson, MD - Internal Medicine
& W. Thomas London, MD - Hepatology
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