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Treatment General Information • Which drugs are used depends on the type of hepatitis C virus (called genotype) you have, how much damage you have in your liver, and any previous treatment for hepatitis C you may have had. • For all patients with hepatitis C, pegylated interferon and ribavirin are recommended. • If patients have genotype 1 hepatitis C, then they could also use telaprevir or boceprevir in addition to the pegylated interferon and ribavirin. • For patients with genotype 2 or 3, only pegylated interferon and ribavirin are used. Pegylated Interferon Ribavirin Telaprevir Boceprevir Interferon • Interferon is a medicine that helps your body’s immune system to attack infected liver cells and to protect healthy liver cells from new infection. • Pegylated interferon is taken by injection once a week. Ribavirin • Ribavirin is a medicine that can fight certain viruses, though, by itself, it does not work against hepatitis C. • It is taken in pill form and in combination with pegylated interferon. Telaprevir and Boceprevir • Telaprevir and boceprevir are anti-viral drugs. • They work directly on the hepatitis C virus itself to stop it from replicating. • These drugs need to be used in combination with pegylated interferon and ribavirin. How long does treatment take? • In general, treatment lasts 24 to 48 weeks. • Treatment duration depends on the genotype of your hepatitis C virus, the severity of your liver disease, prior hepatitis C treatment response, and how you respond to the treatment along the way. • If the treatment is not working or if you have too many side effects, your provider may stop your treatment early. How effective is treatment? • Your response to treatment depends on several factors, such as what genotype you have, age, race, weight, extent of liver damage, amount of virus in the blood (viral load), whether you have HIV infection, and whether you were treated in the past and did not have a successful response. • In general, all patients treated for the first time have around a 40-60% chance of being “cured.” Benefits of Treatment • Anti-viral treatment for hepatitis C is successful if there is a permanent absence of the virus after treatment is completed. The medications may also benefit you even if you do not permanently clear the virus – they may still: – Decrease the amount of liver damage – Slow the progression of liver disease – Reduce the chance of liver cancer Side Effects • • • • • • • • • • Fatigue Flu-like symptoms Nausea or vomiting Decreased appetite Weight loss Depression Irritability Hair loss Problems sleeping Dry, itchy, or irritated skin • Shortness of breath • Changes in vision • Decreased red and white blood cells and platelets • Sore throat • Thyroid problems • Rash • Bad taste in the mouth • Diarrhea Alternative Treatments • Currently there is not enough research to tell if alternative treatments really help people with hepatitis C. • In fact, some herbal supplements can be dangerous for people with liver disease. • Various forms of relaxation through meditation or yoga can have an overall positive impact on your health and well-being. Taking Medications • If you start hepatitis C treatment, then it is important to take your medication as directed. The treatment can be difficult and has some unpleasant side effects. • If you are concerned about these, talk with your health care provider. Skipping injections or not taking your pills properly can greatly reduce the chances of clearing the virus. Herbs to Avoid • • • • • • • • • • • • Artemisia • Atractylis gummifera • Bush tea • Callilepis laureola • Chaparral leaf (creosote bush, • greasewood) • Comfrey (Symphytum officinale) Crotalaria • Germander • Gordolobo yerba tea • Heliotropium • Jin-Bu-Huang • Kava • Kombucha mushroom (tea) Ma-Huang (Ephedra sinica) Margosa oil Mistletoe Pennyroyal (squaw mint oil) Tansy Ragwort (variation of Ragwort) Sassafras Senecio aureus Senna Skullcap Symphytum Valerian root