Hepatitis C Treatment -
Past, Present and Future

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The goal of Hepatitis C treatment is to prevent difficulties from the HCV infection through the total elimination of the HCV infection.

Total elimination is characterized as the absence of the Hep C virus for at least six months after treatment has ended.

The first Hepatitis C treatment was standard (alpha) interferon. Initially used by itself, it had limited success at eliminating the Hep C virus. When it was decided to administer the standard alpha interferon in combination with ribavirin, success rates improved dramatically.

Interferons are natural proteins produced by the cells of our immune system in response to challenges by foreign agents such as viruses, parasites and tumor cells. They assist the immune response by inhibiting viral replication within host cells, activating natural killer cells and macrophages, increasing antigen presentation to lymphocytes, and inducing the resistance of host cells to viral infection.

Ribavirin is an anti-viral drug which is active against a number of DNA and RNA viruses.

With the combination of interferon and ribavirin, most Hepatitis C Treatment now consists of two stages.

Initially, the first stage was an injection of interferon three times a week, with the second stage consisting of taking ribavirin in pill form, two to three times daily.

There are a number of side effects associated with Hepatitis C treatment with interferon. These include but are not limited to flu-like symptoms including headaches, fever, fatigue, loss of appetite, nausea, vomiting, depression, and thinning of hair. Treatment with interferon may also interfere with the production of white blood cells and platelets by depressing the bone marrow. Periodic blood tests are required to monitor blood cells and platelets.

There are also side effects associated with taking ribavirin, such as causing sudden, severe anemia. Women should avoid pregnancy for at least six months following treatment with ribavirin as birth defects have been linked to taking it.

Before attempting to treat side effects such as flu-like symptoms including headaches, fever, fatigue, loss of appetite, nausea, vomiting, and depression it is very important to discuss your symptoms and the right management approach with your doctor.

Pain relief medication, both over-the-counter and on prescription, is generally considered acceptable for temporarily treating these types of side effects - but there are exceptions.

Some over-the-counter pain medicines that haveacetaminophen in them are potentially harmful to the liver. The use of pain medication in people with chronic Hepatitis C should first be discussed with your doctor.

The problem with standard interferon is that the body breaks it down too quickly, making it difficult to keep a consistent amount of the drug in the system. This led to the development of new pegylated interferons, which break down much more slowly and are consequently more effective.

The current standard Hepatitis C treatment consists of a once-a-week shot of pegylated interferon, along with daily antiviral pills, ribavirin. Results concluded from the use of pegylated interferon, along with daily antiviral pills, ribavirin, has proven to cure more patients and cause less side effects. It should be noted that the severity and type of side effects will differ from person to person.

As with any unsolved medical mystery, the Hepatitis C virus continues to be studied and various treatment regimes are being created in hopes of finding the “silver bullet” to finally eradicate this highly mutative disease. Like those that came before them, there are a couple more Hepatitis C treatments that seem to hold promise.

The first are two thymus gland derivatives, specifically thymosin fraction 5 and thymosin a-1, which are cytokines that produce specific reactions in the cells of the body, including within the thymus gland itself. These thymus-derived proteins appear to be able to change a person’s response to an HCV infection. There are currently a number of clinical trials using Thymosin a-1 that have led to the approval of this medication in more than 20 countries for the treatment of patients with viral hepatitis C infection. Combination therapy with interferon is currently being studied in the US in a large clinical trial.

The second is an effort to target specific sites in the HCV genome. This approach has been studied extensively over the last 9 years. From these studies, scientists have been able to identify various HCV protein products involved in viral replication, translation, and packaging.

Discovery - One specific enzyme, the HCV RNA-dependent RNA polymerase, is responsible for the replication of the entire HCV genome.

This discovery brings with it the hope that it may now be possible to develop a drug to specifically target this enzyme and prevent the replication of the hepatitis C virus.

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