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Current and Future Medications for Hepatitis C (cont.)

Antiviral Medication Treatment

The goal of antiviral treatment is to suppress the virus so much that it becomes undetectable in the blood. The US National Institutes of Health has issued treatment guidelines for chronic HCV infection. The guidelines recommend that patients be treated with a combination of an injectable medicine called pegylated interferon alpha (Pegasys, PEG-Intron) and an oral antiviral drug called ribavirin (Virazole) because this combination is more effective than either drug alone. Specifically, certain pegylated interferons, for example, peginterferon alfa-2a (Pegasys), have improved sustained response rates. (Pegylation is a chemical process that makes the interferon last longer in the body, and sustained response means complete disappearance of the HCV for at least six months after stopping treatment.)

The protease inhibitors telaprevir (Incivek - This drug was discontinued by the manufacturer, but will be available until October 2014) and boceprevir (Victrelis) are in another class of medications that have been approved for the treatment of genotype type 1 HCV. (HCV has several subtypes, called genotypes as previously described). These protease inhibitors are given in combination with peginterferon alfa and ribavirin for the treatment of genotype 1 chronic HCV to adult patients with compensated (stable) liver disease, including cirrhosis. They are used for patients who have never received treatment or who have been previously treated with interferon-based treatment but have never achieved a sustained response. In many cases, adding a protease inhibitor also shortens the overall duration of treatment. Genotype 1 is the most common type of HCV infection and may require therapy for at least a year, whereas shorter treatment is possible with genotype 2 and 3 infections.

Medical and Pharmacy Editor:

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