This is a little bit about the only THREE treatments currently available for treatment for Hep C. PLEASE NOTE that there are serious side effects, and some people outrightly CANNOT TAKE THEM.

Ribavarin and interferon together is commonly known as COMBO therapy.

Pegylated Interferon has only been approved in the last couple months by the FDA. It shows great promise, and so far about 60 % of people taking it become "undetectable" in a very short time. Undetectable means that the virus is in your blood, in such small quantities, that blood work looking for it cannot find it!

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Treatment Approaches for Hepatitis C

At present, the treatment approach recommended by the National
Institutes of Health for patients newly diagnosed with chronic
hepatitis C is to use pegylated alpha interferons in combination
with the antiviral drug ribavirin. The agents used in this treatment
approach are discussed below

Alpha Interferons

All the currently approved treatments for chronic hepatitis C
include some form of natural or synthetic (manmade) alpha interferon.
Alpha interferon is a protein made naturally by your body to boost
your immune system and to regulate other cell functions. Most forms
of alpha interferon only stay in the body for one day but they can
be modified to make them stay in the body for a longer time
(see Pegylated Alpha Interferons below).

The interferon molecule does not kill viruses directly. Instead, it
makes healthy cells less susceptible to the effects of the virus
and prevents the virus from infecting healthy cells. Alpha interferon
is a type of biologic therapy (sometimes called biotherapy).
Biologic therapy involves administering natural substances produced
in the body (by humans and other mammals) to treat disease. Although
some alpha interferons are also used for the treatment of some
cancers, they are not typically considered chemotherapy since
chemotherapy involves administration of chemicals to treat cancer.


Alpha interferons are either used alone (referred to as monotherapy)
or in combination with an antiviral agent called ribavirin (referred
to as combination therapy) for the treatment of chronic hepatitis C.
Combination therapy has been found to be significantly more effective
in reducing the hepatitis C viral load to undetectable levels than
alpha interferon monotherapy. Because of this, combination therapy
with an alpha interferon and the antiviral drug ribavirin has
become the standard of care for the treatment of chronic hepatitis C.

Alpha interferon-based therapy is not right for all patients with
chronic hepatitis C. This treatment is associated with serious side
effects including problems with pregnancy, mental health problems
and suicide, heart, blood and/or body organ problems. Patients must
discuss the possible benefits and side effects of treatment with
their physician.

Talk to your doctor about treatments for chronic hepatitis C.

Pegylated Alpha Interferons

Pegylated alpha interferons are made by attaching a large water-soluble
molecule called polyethylene glycol (abbreviated PEG) to the alpha
interferon molecule. Attachment of PEG increases the size of the
interferon so it takes longer for the body to get rid of it. It also
helps protect the interferon molecule from getting broken down by
the body's enzymes. One advantage to the longer lifetime in the body
(referred to as half-life) is that the drug does not have to be
taken as often. Regular alpha interferons are usually injected
three times per week but pegylated alpha interferons only need to
be taken once per week. Also, studies have shown that pegylated
alpha interferons are more effective in producing a sustained viral
response in patients with chronic hepatitis C than their
nonpegylated counterparts.

Currently, there are two types of pegylated alpha interferons available:
peginterferon alfa-2a and peginterferon alfa-2b. Although both these
agents are effective in the treatment of chronic hepatitis C, there
are differences in size, pegylation type, half-life, route of
clearance from the body, and dosing between these two pegylated
alpha interferons. This is because the method of pegylation and the
type of PEG molecule used in the process can affect how the interferon
molecule behaves in the body and how it is cleared from the body.

A major difference between these two pegylated interferons is in
the dosing. The dose of peginterferon alfa-2a is the same for all
patients, regardless of weight or size. The dosing of peginterferon
alfa-2b is individualized based on a person's weight. If your doctor
chooses to treat you with pegylated alpha interferons, make sure
you ask the following questions.

Questions to Ask Your Doctor About Pegylated Alpha Interferons:

1. What are the risks and benefits of pegylated interferons versus non-pegylated
interferons?
2. Is the pegylated alpha interferon I'm receiving dosed by weight?
3. How long does this pegylated alpha interferon stay in my body?
4. What is the significance of the size of the peginterferon molecule?
5.What important information do I need to know before starting any of these
therapies?

Getting all the information you can about your hepatitis C therapy
can help you understand how it will work and what to expect in
terms of side effects and treatment results.

WARNING:Alpha interferons cause or aggravate fatal or life-threatening
neuropsychiatric, autoimmune, ischemic, and infectious disorders.
Patients should be monitored closely with periodic clinical and
laboratory evaluations. Patients with persistently severe or
worsening signs or symptoms of these conditions should be withdrawn
from therapy. In many but not all cases these disorders resolve
after stopping interferon therapy.

Ribavirin
Ribavirin is an antiviral drug that is used with manufactured forms
of alpha interferon for the treatment of chronic hepatitis C.
Ribavirin belongs to a group of drugs called nucleoside analogs,
which are believed to prevent viruses from multiplying. Studies
have found that the combination of ribavirin and some forms of
alpha interferon help to reduce the amount of virus found in a
patient's blood (called "viral load.")

Ribavirin by itself has not been shown to be effective against the
hepatitis C virus, but in combination with forms of alpha interferon,
it is much more active than alpha interferon alone.

Ribavirin, however, is known to cause severe birth defects, so it
cannot be used by pregnant women or by men whose partners are
pregnant. Patients cannot begin combination therapy until a
negative pregnancy test has been obtained just before the start of
therapy. Moreover, male as well as female patients who are being
treated with combination therapy must use at least 2 forms of
contraception to avoid pregnancy during treatment and for 6 months
after treatment stops.

Ribavirin also causes a marked reduction in certain blood cells so
patients with a history of heart attacks or significant heart
disease should not take ribavirin-based combination therapy.

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I can PROMISE you that any of these treatments are NOT EASY! They have as many side-effects as taking chemo for cancer! Many people have to abandon them after a few months! But some people breeze through it. The only way you can know if you can tolerate the treatment, is to try it for awhile.

You MUST be closely monitored by a competant doctor throughout!

All My Love,
Menolly