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Hepatitis C: Treatments

Infectious liver disease caused by the hepatitis C virus for which there is no vaccine and which commonly becomes chronic. Now the most common cause of cirrhosis in the United States. NIH - National Institute of Diabetes and Digestive and Kidney Diseases and National Library of Medicine

About Treatments for Hepatitis C

Depending on the amount of damage to your liver, your medical history, and your preferences, you and your doctor may decide on one of the following treatment plans:

  • Treatment right away. If your liver has a lot of damage, your doctor may suggest you have treatment right away.
  • Waiting and followup. If your liver does not have a lot of damage and you do not need treatment right away, your doctor may suggest you wait. Some people wait years before starting treatment. If you decide to wait, your doctor will probably want to check your liver on a regular basis to see if and possibly when you might need treatment.

Before deciding how to treat your chronic hepatitis C infection, some doctors may first suggest a liver biopsy. During a liver biopsy, the doctor removes a tiny piece of your liver to look for signs of damage or disease. The results of the biopsy help the doctor decide if you need treatment... Read more about Hepatitis C: Treatments

What works? Research summarized

Evidence reviews

Treatment with peginterferon versus interferon in Chinese patients with chronic hepatitis C

Higher sustained virological response (SVR) rates after treating with peginterferon than after treating with interferon have been obtained in some randomized clinical trials (RCTs) in Chinese patients with chronic hepatitis C (CHC). However, the numbers of patients included in these clinical trials were too small to draw a clear conclusion. Therefore, a new meta-analysis including a large number of patients was needed to compare peginterferon with interferon in the treatment of Chinese CHC patients. A search of Medline, the China National Knowledge Infrastructure, the Wanfang Database, and the China Biomedical Database for relevant articles published between 1966 and 2009 was performed. RCTs comparing the use of peginterferon and interferon for the treatment of Chinese patients with CHC were assessed. Of the 236 studies screened, 18 RCTs including 1,148 patients (659 treated with peginterferon therapy and 489 treated with interferon therapy) were analyzed. The total SVR rates obtained in patients treated with peginterferon were significantly higher than those obtained in patients treated with interferon (64% vs. 40%; relative risk, 1.56; 95% confidence interval: 1.28-1.91; p < 0.01), but the difference between the peginterferon α-2b and interferon α-2b treatments was not significant. Withdrawal rates were similar between patients treated with peginterferon and interferon. Chinese patients with CHC have a greater likelihood of achieving an SVR with peginterferon α-2a.

A comparison of peginterferon alpha-2a and alpha-2b for treatment-naive patients with chronic hepatitis C virus: a meta-analysis of randomized trials

BACKGROUND: The standard treatments for chronic infection with the hepatitis C virus (HCV) are peginterferon α-2a or α-2b plus ribavirin, but it remains unclear if one has a better efficacy and safety profile.

Treatment of chronic hepatitis C in haemophilic patients with interferon and ribavirin: a meta-analysis

This review evaluated the efficacy of interferon (IFN) and ribavirin in the treatment of chronic hepatitis C in haemophilic patients and concluded that the pattern of response in HCV-infected haemophiliacs is similar to that in the general HCV-infected population. The reliability of the conclusions is limited by the weak evidence base and incomplete reporting of the review process.

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Summaries for consumers

Simeprevir (Olysio) for chronic hepatitis C: Simeprevir (Olysio) for hepatitis C (genotype 1) for relapsed hepatitis C (genotype 1)

In 2014, the Institute for Quality and Efficiency in Health Care (IQWiG, Germany) assessed the advantages and disadvantages of simeprevir in combination with peginterferon and ribavirin for treating chronic hepatitis C compared with conventional therapies.The following results apply to people who have chronic HCV infection who experienced a relapse after an initially successful treatment and who were not infected with HIV. One study compared treatment using simeprevir in combination with peginterferon alfa and ribavirin, with treatment using only peginterferon alfa and ribavirin.The results of these studies show that the following factors can influence the effectiveness of simeprevir:HCV genotype 1a and 1b: There are 6 different main types of the hepatitis C virus, which can be further divided into 60 subtypes called genotypes. Different medications are not equally effective against the various genotypes. Genotype 1a is more prevalent in the U.S., while genotype 1b is more common in Europe, for example.Q80K polymorphism: Simeprevir inhibits a protein that hepatitis C viruses need to reproduce. This protein may mutate, making simeprevir less effective. This mutation is referred to as the Q80K polymorphism.

Simeprevir (Olysio) for chronic hepatitis C: Simeprevir (Olysio) for hepatitis C (genotype 1) that has been treated unsuccessfully

In 2014, the Institute for Quality and Efficiency in Health Care (IQWiG, Germany) assessed the advantages and disadvantages of simeprevir in combination with peginterferon and ribavirin in treating chronic hepatitis C compared with standard therapies.The following results apply to people with chronic HCV infection who have previously been treated unsuccessfully and are not infected with HIV. One of the studies compared the drug simeprevir with telaprevir. Both drugs were used in combination with peginterferon alfa and ribavirin.

Simeprevir (Olysio) for chronic hepatitis C: Simeprevir (Olysio) for hepatitis C (genotype 1) without previous treatment

In 2014, the Institute for Quality and Efficiency in Health Care (IQWiG, Germany) assessed the advantages and disadvantages of simeprevir in combination with peginterferon and ribavirin for treating chronic hepatitis C compared with conventional therapies.The following results apply to people with chronic HCV infection with or without cirrhosis, who have not had any previous treatment and are not infected with HIV. Three studies compared treatment using simeprevir in combination with peginterferon alfa and ribavirin, with treatment using only peginterferon alfa and ribavirin.The results show that the following factors influence the effect of simeprevir:Q80K polymorphism: Simeprevir inhibits a protein that hepatitis C viruses need to reproduce reproduction. This protein may mutate, reducing the effectiveness of simeprevir. This mutation is referred to as Q80K polymorphism.IL28B genotype (CC or CT/TT): Interleukin-28B (IL28B) is a protein messenger used by the immune system to fight viruses. The body produces one of two variants of this messenger substance, referred to as genotypes CC and CT/TT. Studies show that people who have the CC variant may be able to fight off HCV better than people with the CT/TT variant.

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More about Hepatitis C: Treatments

Photo of an adult

Also called: Hepatitis C Virus, Hep C, Viral hepatitis C, HCV

Other terms to know:
Cirrhosis, Viruses

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