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