Hepatitis C: Medications

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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:

• Peginterferons, which are similar to a protein your body makes to fight off infection
• Combination antiviral therapy with interferons and ribavirin, which increases your chances of getting rid of the virus in your body

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.

Last updated:	August 27, 2007
Author:	Maria G. Essig, MS, ELS
Reviewed By:	Kathleen Romito, MD - Family Medicine, W. Thomas London, MD - Hepatology
Editors:	Susan Van Houten, RN, BSN, MBA, Pat Truman, MATC