Treating Hepatitis C

Interferon is an immunity-boosting protein that your body makes. It is naturally made by many different cells in your body, including liver cells, to help you fight off disease. The first Interferon therapy was approved by the FDA in 1992.

What is Interferon therapy?

Therapy with Interferon is used to treat Hepatitis B or C. The treatment involves giving yourself injections of a genetically-manufactured type alfa Interferon to boost your immune system to fight the Hepatitis virus. There are several brands of Interferon. Because each is slightly different, the amount taken of each brand is different.

How does Interferon work?

While we know that Interferon boosts immunity to fight Hepatitis effectively, we're not sure exactly how it does this. For example, it may attack the virus directly, or instead it may help your body's immune system indirectly to fight off diseased cells.

Will Interferon cure the Hepatitis B Virus (HBV) or the Hepatitis C Virus (HCV)?

At this time, there really is no known guaranteed cure for Hepatitis B or C, only treatment with Interferon to keep the disease under control. So, while this treatment destroys the virus in about 10% of patients, in most cases, Interferon works by regulating the advancement of the virus to minimize liver damage.

How long will I have to take Interferon?

Generally, the recommended course of treatment (and one approved by the FDA) lasts from 6 to 24 months. Because people's reactions to Interferon vary, your treatment may be shorter or longer. Your doctor will decide how long you need to stay on therapy for the medication to be most beneficial to you.

How do I know if the treatment is working?

At the end of 3 months your doctor will test your blood again to measure the amount of virus or antibodies. (HCV RNA by PCR, QUANTITATIVE) If the levels have not dropped, you may not be responding to treatment. At that point, your doctor may decide to change your therapy.

Why did my doctor prescribe Interferon for me?

Your doctor feels that your condition probably won't improve anytime soon without treatment. And without treatment, you run the risk of permanent liver damage. Your doctor recommended Interferon therapy foryou because there is scientific information showing it has helped other people with chronic Hepatitis (HBV and HCV), making it worthwhile to give to you.

How do I take Interferon?

At this time, all FDA approved Interferon for use against Hepatitis C must be injected from once to several times a week. These Interferons may be administered by either subcutaneous (under the skin) or intramuscular (into muscle) injection. If they would be taken in pill form the stomach acids would destroy these types of Interferon, and would be of little value. There is a pill form of an alpha Interferon, but it is still experimental and lacks FDA approval for use in the treatment of Hepatitis C. The best places to inject are thighs, outer part of upper arm, and abdomen. To avoid possible rash, redness, dryness and/or itching at injection site, change site of injection every time you inject. Use exactly as prescribed. Do not stop using this medication, or increase or decrease your dose without consulting your doctor. Be sure to follow your doctor's instructions.

Each package of Interferon contains a patient instruction sheet. Read the instructions carefully and make sure you understand how to prepare the injection, use a disposable syringe, and give the injection. Ask your physician or pharmacist about the proper disposal of used syringes.

Are there any side effects I should know about?

Among the most common side effects of therapy with Interferon are mild to moderate 'flu-like' symptoms, such as fever, muscle and joint aches, and chills. Headache, diarrhea, mental confusion and short term memory loss are also side effects that are affecting patients taking Interferon. Fatigue is another common side effect and is usually the worst one. Don't be afraid if you experience them-they can be common at the start of therapy and lessen after the first few weeks. Some people also report nausea or loss of appetite. Others feel tired,irritable, or depressed, which may be caused by either the disease or Interferon. Ask your Doctor about these or any other side effects or problems with your therapy. He or she can suggest ways to handle them. It is important to remember that even though you might feel bad, side effects can mean that the treatment is working.

It should be noted that some people have little or no side effects at all and, if present, side effects lessen over the course of treatment. The most frequently reported side effects include:

Fatigue, headache, muscle/joint pain, flu like symptoms, nausea/vomiting, injection site reactions-(rash/brusing/itching), fever, chills, diarrhea, partial hair loss, depression, irritability, diarrhea, insomnia and loss of appetite.

Other more serious side effects include:
Depression; suicidal thoughts; confusion; numbness or tingling of fingers, toes and face; trouble concentrating; irregular heartbeat. If you experience any of these side effects, notify your doctor immediately.

Are there any helpful hints in dealing with my Interferon therapy?

Interferon therapy is very individual and you should do whatever you feel comfortable doing. Take your injections when they will inconvenience you the least, so that you may sleep through most of the side effects.

If recommended by your doctor:
1. Acetaminophen (NOT Ibuprofin) may be taken to reduce fever or aches and pains half an hour to 1 hour before injection.
2. Drink plenty of fluids to avoid dehydration.
3. Dress warmly, keep an extra blanket at the foot of the bed, and increase room temperature during and after administration to help you deal with chills.
4. Rework your schedule so that you can accomplish important daily activities when you're feeling rested. Set realistic goals, and above all, try to maintain a positive attitude.

Where do I get help about Interferon therapy?

If you have any questions or concerns about your condition or treatment, be sure to discuss them with your doctor. Your doctor has been provided with full prescribing information by the manufacturer. There are currently three pharmaceutical companies that make Interferon that are FDA approved for use in treating Hepatitis C. (Schering-Plough, AMGEN, and Roche Labs).

Find out more about Interferon:

There are several brands of Interferon, INTRON A® (Schering Interferon alfa-2b, Biological Response Modifier) - prescribed at 3mu 3 times a week.

AMGEN's Interferon alfacon-1, (Consensus INFERGEN®)- prescribed at 3mu, 5mic, 9mic, and 15mic 3 times a week.

ROFERON®-A (Roche Interferon alfa-2a, Biological Response Modifier) - prescribed at 3mu 3 times a week.

Recombinant interferon alpha-2b (Intron A/Schering), ribavirin (Virazole/ICN Pharmaceuticals), ursodeoxycholic acid (Actigall/Summit Pharmaceuticals)- REBETRON® - Combination therapy of INTRON A® and Ribavirin - prescribed at 3mu-5mu INTRON A® 3 times a week and 1000-1200mg Ribavirin daily. (Ribavirin is in pill form). REBETRON® is given as a 6 month treatment, INTRON A® is given as a 1 year treatment, along with ROFERON®, and INFERGEN® is given as an 18 month treatment.

Many Dr's are now prescribing the higher dosage and some are also prescribing daily dosing for the first 30 days.