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Ask the Doc 4464 Ask the Doc
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February 09, 2012
A:
Your question is a timely one. There have been recent advances in the treatment of hepatitis C, as well as anticipated ones. These offer hope that you may be cured of your chronic hepatitis.
I’m assuming your hepatitis virus is genotype 1. If so, you had a 50 percent chance that the ribavirin/interferon combination you were placed on would wipe out the virus. Unfortunately, it sounds like you were on the wrong side of even odds. ,
Today, a person can find out if they are responding to ribavirin/interferon with a blood test done 12 weeks after starting the therapy. The blood test, called a viral load, measures the amount of hepatitis C virus in your blood.
At this time, you and your doctor can consider one of two new antiviral drugs -- telaprevir and boceprevir. These drugs are called protease inhibitors. When either drug is added to the combination of interferon and ribavirin, someone once unresponsive to double therapy has a 30% chance of a lasting viral response (like a cure) with triple therapy. The percentage is less if chronic hepatitis has advanced to cirrhosis.
Triple therapy comes with risks. Anemia is already common with interferon and ribavirin alone. When you add a protease inhibitor, the risk of anemia is even greater. Rash is another common side effect. And there are still the potential common side effects of interferon — fatigue and depression.
There is good news. Even newer and better antivirals for hepatitis C are well along in the pipeline. If your liver biopsy shows only mild hepatitis after failed double therapy, some liver experts would have you consider waiting. The reason: if you failed triple therapy, the virus might become more resistant to future new therapies.
Clearly, there is great hope for you. So talk with your doctor about what course to follow.

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