What is the treatment?
There are now several treatments available for Hepatitis C and
the decision on which treatment to use may be based on a variety of
factors.
Currently in Scotland treatment may include the use of pegylated
interferon and Ribavirin. Other medications may be added, or
prescribed as an alternative, depending on which genotype and the
level of damage the virus has caused to the liver.
Listed below is a brief description of the treatments currently
available.
Pegylated interferon helps healthy cells to defend themselves
against the virus and stops the virus from multiplying. Pegylated
interferon is given by injection once a week.
Like pegylated interferon, Ribavirin works by preventing the
virus from reproducing. Ribavirin is an oral medication.
Direct Acting Antivirals
Protease
Inhibitors
If you have been diagnosed with genotype 1 or 4 Hepatitis C you
may be prescribed a protease inhibitor to accompany other Hepatitis
C medications. Protease inhibitors work by preventing the Hepatitis
C virus from replicating. The following protease inhibitors are
currently available in Scotland. (Drugs ending in the suffix
'previr' are protease inhibitors.)
Polymerase Inhibitors (NS5b
inhibitors)
Polymerase inhibitors may be prescribed with pegylated
interferon and Ribavirin, or as part of an all oral treatment
(treatment without interferon). Polymerase inhibitors work by
directly attacking the viral DNA and preventing replication. The
following polymerase inhibitors are available in Scotland. (Drugs
ending in the suffix 'uvir' are polymerase inhibitors.)
NS5a
inhibitors
NS5a inhibitors may be prescribed with pegylated interferon and
ribavirin, or as part of an all oral treatment (treatment without
interferon). NS5a inhibitors interfere at several stages of the
lifecycle of the Hepatitis C virus. The following NS5a inhibitors
are available in Scotland. (Drugs ending in the suffix 'avir' are
NS5a inhibitors.)
These are combinations of two or more of the drugs types listed
above in one pill taken as an all oral treatment. There are not
currently any available in Scotland but the SMC is considering the
following:
- Harvoni (combination of sofosbuvir and ledipasvir)
- Viekira Pak (combination of 3-4 medications)
Other direct acting antivirals are currently being processed for
licensing around the world and will start to become available in
Scotland in 2016.
You can view upcoming submissions for new treatments for
Hepatitis C to the Scottish Medicines Consortium here.
Living with treatment
It's worth thinking about how being on treatment might affect
your life. Plan and think about whether you'll need any help or
support when you are living with treatment.
What are my chances of success?
It is very difficult to give exact figures for the chances of
success, because there are so many factors that have an impact on
treatment, including your viral genotype, gender, how long
you've had the virus, genetic
factors (including your IL28B
genotype), age, ethnicity and even weight.
With the wide variety of treatment options now available and
depending on some of the factors mentioned above, your chance of
clearing the virus may be over 90%.