Protease Inhibitors
Protease Inhibitors can significantly boost the success rate of
treatment and in some cases may shorten the amount of time you need
to be on treatment when added to interferon and ribavirin
treatment.
The length of your treatment will be determined using response guided
therapy. Tests will be done at various times throughout
treatment to see how well you are responding. This ensures that you
don't have to stay on treatment any longer than necessary.
Telaprevir and Boceprevir
What are they and who are they for?
Protease inhibitors work by preventing the Hepatitis C virus
from replicating.
If you have Hepatitis C genotype 1 or 4, you may be prescribed
Boceprevir or Telaprevir in addition to peg interferon and
Ribavirin.
How long does treatment take?
You may be treated with a 4 week lead-in of Pegylated Interferon
and Ribavirin or treatment with the addtional drug may begin
immediately. You will then be given the usual Hepatitis C RNA test to look for a Rapid Viral
Response (RVR).
If you achieve Rapid Viral Response after the 4 week lead in
your doctor will have a discussion with you about whether you
should simply continue with dual therapy treatment or add a
Protease Inhibitor to the treatment. The discussion
will be around your likelihood of achieving a Sustained Viral Response (SVR) - meaning that
you are cured - and the possible side effects involved in adding a
Protease Inhibitor to your treatment.
If you are prescribed a Protease Inhibitor your progress will be
monitored throughout (Response Guided Therapy or RGT) and this may
have an effect on the duration of your treatment and whether the
Protease Inhibitor should be stopped if you are experiencing
particularly bad side effects.
Protease Inhibitors can often reduce the duration of Hepatitis C
treatment for genotype 1 patients and have been shown to increase
cure rates. However, in some people side effects can be
significant.
Are there any side effects?
More serious side effects caused by Telaprevir may include skin
rashes. If you develop a rash during treatment with Telaprevir
please inform your treatment provider as a small minority of those
who develop a rash may have to stop treatment immediately.
Boceprevir is likely to increase anaemia in many patients, but
should this happen it can be treated by reducing the amount of
Ribavirin taken.
Protease inhibitors will not decrease general side effects
caused by standard therapy with Interferon and Ribavirin.
Simeprevir
What is it and who is it for?
Simeprevir is the latest protease inhibitor to become available
in Scotland. It can be prescribed for any Hepatitis C genotype. It
is a pill taken once daily with food.
How long does treatment take?
Simeprevir is taken for 12 weeks alongside pegylated interferon
and Ribavirin, which is taken for either 24 or 48 weeks depending
on your genotype and other factors, such as whether you have
previously not responded to treatment or relapsed.
If you have genotype 1 or genotype 4 infection and are
intolerant to or ineligible for interferon treatment you may be
treated with simeprevir alongside sofosbuvir for 12 weeks.
Are there any side effects?
You may experience side effects such as fatigue, headache, flu
like symptoms nausea or anaemia. However, for most people side
effects with simeprevir are mild.
Using protease inhibitors with some drugs (such as
diazepam) can dramatically increase the effect of that drug. If
used without consultation with a medical practitioner this could be
life threatening.