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Hepatitis C Management: Frequently Asked Questions

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Volume 8 – Treatment
February 10, 2005

My doctor has advised treatment for hepatitis C, but the thought of giving myself shots fills me with fear. Is there a pill I can take instead?

Interferon can only be administered by injection, which absorbs through the tissue. Just as diabetic patients self-inject insulin, a hepatitis C patient will feel comfortable with this skill and will master it after a few administrations.

Can I come to your office to get the shots?

Most insurance companies do not cover those types of visits. This is your disease and you need to take charge of it.

I have received 6 months of treatment with pegylated interferon and ribavirin. My viral count has declined from 2 million IU/ml prior to treatment to 10,000 IU/ml with pegylated interferon and ribavirin. My doctor is telling me to stop treatment. Is she correct?

Your doctor is correct. You have not been able to render the virus undetectable with 6 months of using the best regimen currently available. If the only goal of therapy is to achieve a sustained viral remission, then this treatment course has failed. The only other thing to keep in mind is whether there are other "secondary" reasons to consider continuing the treatment, either in its current or in a modified fashion.

Will this treatment cure me? Does interferon cure hepatitis C, or does it just place the disease in remission?

This treatment can cure the infection. When a patient responds to treatment, rendering the virus undetectable 24 weeks beyond the last dose of medication received, the chances of the virus coming back later are less than 5%. If the virus remains undetectable 2 years after treatment, the chance of a spontaneous relapse is almost zero.

What other treatments are available if I choose not to take this treatment?

If you choose not to receive the standard treatment (peg-IFN and ribavirin), there are no alternative treatments. Your doctor will follow you to make sure you and your liver are not having any major problems. You can always decide to try the treatment medications.

Does viral load (HCV-RNA) reflect the severity of the disease?

Viral load does not reflect severity of liver disease. The most important clinical implication of high viral load is its potential negative impact on achieving response to antiviral therapy.

Are there three types of hepatitis C, and which are contagious? What does the word "genotype" mean? Are genotypes of hepatitis C different diseases?

Hepatitis C has six different genotypes with minor differences in their molecular structure. They all cause similar liver disease and are not related to the severity of liver disease. They do affect responsiveness to antiviral therapy, with genotypes 2 and 3 being most sensitive and genotype 1 the least sensitive to therapy.