What is the treatment?

There are now several treatments available for Hepatitis C and the decision on which treatment to use may be based on a variety of factors.

Currently in Scotland treatment may include the use of pegylated interferon and Ribavirin. Other medications may be added, or prescribed as an alternative, depending on which genotype and the level of damage the virus has caused to the liver.

Listed below is a brief description of the treatments currently available.

 

Pegylated interferon plus Ribavirin

Pegylated interferon helps healthy cells to defend themselves against the virus and stops the virus from multiplying. Pegylated interferon is given by injection once a week.

Like pegylated interferon, Ribavirin works by preventing the virus from reproducing. Ribavirin is an oral medication.

 

Direct Acting Antivirals

Protease Inhibitors

If you have been diagnosed with genotype 1 or 4 Hepatitis C you may be prescribed a protease inhibitor to accompany other Hepatitis C medications. Protease inhibitors work by preventing the Hepatitis C virus from replicating. The following protease inhibitors are currently available in Scotland. (Drugs ending in the suffix 'previr' are protease inhibitors.)

Polymerase Inhibitors (NS5b inhibitors)

Polymerase inhibitors may be prescribed with pegylated interferon and Ribavirin, or as part of an all oral treatment (treatment without interferon). Polymerase inhibitors work by directly attacking the viral DNA and preventing replication. The following polymerase inhibitors are available in Scotland. (Drugs ending in the suffix 'uvir' are polymerase inhibitors.)

NS5a inhibitors

NS5a inhibitors may be prescribed with pegylated interferon and ribavirin, or as part of an all oral treatment (treatment without interferon). NS5a inhibitors interfere at several stages of the lifecycle of the Hepatitis C virus. The following NS5a inhibitors are available in Scotland. (Drugs ending in the suffix 'avir' are NS5a inhibitors.)

 

Combination therapies

These are combinations of two or more of the drugs types listed above in one pill taken as an all oral treatment. There are not currently any available in Scotland but the SMC is considering the following:

  • Harvoni (combination of sofosbuvir and ledipasvir)
  • Viekira Pak (combination of 3-4 medications)

Other direct acting antivirals are currently being processed for licensing around the world and will start to become available in Scotland in 2016.

You can view upcoming submissions for new treatments for Hepatitis C to the Scottish Medicines Consortium here.

 

Living with treatment

It's worth thinking about how being on treatment might affect your life. Plan and think about whether you'll need any help or support when you are living with treatment.

 

What are my chances of success?


It is very difficult to give exact figures for the chances of success, because there are so many factors that have an impact on treatment, including your viral genotype, gender, how long you've had the virus, genetic factors (including your IL28B genotype), age, ethnicity and even weight.

With the wide variety of treatment options now available and depending on some of the factors mentioned above, your chance of clearing the virus may be over 90%.

 

See also

Hepatitis C Trust: Treatment

Hepatitis C Scotland

http://www.hepcscotland.co.uk

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