Easier hepatitis C treatment

Hepatitis C treatment is hard to complete, but new antiviral drugs are making it easier and more effective. Learn more about these new treatments.

By Mayo Clinic Staff

Although chronic hepatitis C has been treatable for some time, only a minority of those who start treatment can stick with it long enough to wipe out the virus. That's about to change, thanks to new medications and greater awareness of the disease. Here's an overview of recent developments in hepatitis C treatment.

What treatments are available for chronic hepatitis C infection?

Doctors treat chronic hepatitis C infection with antiviral drugs. These drugs act in different ways to eliminate hepatitis C virus from your liver and blood.

In recent clinical trials, several new antiviral drugs have shown high levels of effectiveness against hepatitis C infection. Two of these drugs have received Food and Drug Administration (FDA) approval, and more should be available soon. Because of these developments, guidelines for treating chronic hepatitis C are changing rapidly.

The types of antiviral drugs used to treat chronic hepatitis C infection are:

  • Drugs with general antiviral properties. These include interferons — specifically, peginterferon alfa-2a (Pegasys) and peginterferon alfa-2b (Intron A) — and ribavirin (Rebetol, Copegus, others).
  • Direct-acting antiviral agents. These include simeprevir (Olysio), sofosbuvir (Solvadi) and several other drugs not yet approved by the FDA.

Each type of anti-hepatitis C drug weakens hepatitis C virus at a different point in its life cycle. For this reason — and because many studies have shown that combination therapy increases effectiveness — treatment with two or three drugs at once is necessary. With new antiviral drugs, however, treatment of chronic hepatitis C is generally becoming simpler, easier to tolerate, more likely to result in a cure and, in some cases, a shorter length of treatment.

What is the role of interferon alfa-2b (Intron A) in treatment of chronic hepatitis C infection?

Interferon alfa-2b, in combination with ribavirin, is still part of the FDA-approved treatment regimen for chronic hepatitis C-infected people with certain genotypes of hepatitis C virus. (Viral genotypes are genetically distinct forms of a virus. There are six genotypes of hepatitis C virus.)

A large proportion of people with hepatitis C, however, are unable to take interferon alfa-2b, including anyone with:

  • An autoimmune disease, particularly autoimmune hepatitis
  • Actively progressing liver disease
  • A history of interferon alfa-2b intolerance or allergy to polyethylene glycol (PEG), a compound added to interferon alfa-2b to boost its antiviral effect
  • Depression or a history of depression
  • A heart condition or history of a heart condition
  • A blood abnormality, such as too few red blood cells (anemia) or platelets

Even those who can take interferon alfa-2b safely may have trouble completing a course of treatment. Interferon alfa-2b is available only by injection, typically given once a week. Serious side effects include blood abnormalities, psychiatric problems and persistent fatigue. Also, anyone treated with the drug requires regular medical visits to manage side effects.

Recent studies of new antiviral drug combinations, including some without interferon alfa-2b, have had excellent results. Additional clinical trials should soon produce enough data to justify a sharp turn away from interferon-based treatment of chronic hepatitis C. Until that happens, talk to your doctor about any concerns you may have before starting treatment. For some people, it may be best to postpone treatment until a better tolerated regimen is approved.

Aug. 26, 2014 See more In-depth