If you had a course of treatment for hepatitis C and are not "cured" when can you try again?"?

First, some background.





Currently available Hepatitis C treatment includes Pegylated Interferon - an immunomodulator (stimulated the immune system) and Ribavirin (a nucleoside agent - unknown mechanism). Pegylated Interferon is taken once weekly via subcutaneous injection and the ribavirin is taken orally, usually twice a day (dose varies based upon body weight and HCV genotype).





There are several Hepatitis C genotypes or varietes of HCV. Genotypes 1 and 4 generally require longer treatment (usually a minimum of 48 weeks) while genotypes 2 and 3 can be treated for 6 months or less - new studies have examined 14 or 16 week regimens.





Interferon can be difficult to tolerate - it causes tiredness, muscle aches, decreased blood cells to name a few side effects. Ribavirin can also cause side effects and sometimes the dose needs to be reduced.





The liklihood of response is around 50% for genotypes 1 and 4 (meaning that about half the people treated for 48 weeks will clear the Hepatitis C virus). For genotypes 2 and 3, the response rates are higher and can approach 90% (many more people are able to clear the virus.





Factors such as genotypes 1 or 4, high viral load (amount of virus in the body), alcohol use, cirrhosis (scarring of the liver), older age, male sex, and heavey body weight may contribute to a worse response.





There are investigational agents currently being studies, including VX950 and SCH 503034 (HCV protease inhibitors) as well as polymerase nucleoside inhibitors (NM283 or valopicitabine). Currently, these are all being studied in combination with Pegylated Interferon. Contact an academic medical center or visit http://www.clinicaltrials.gov to find studies for which you may be eligible.





Make sure you received optimal therapy the first time around - pegylated interferon, highest tolerable dose of ribavirin, support with growth factors (neupogen and epogen if necessary). If you did, then consider a clinical trial. Other options include retreatment with the same regimen for a longer period of time. There are also studies using higher doses of Pegylated Interferon for the first 12 weeks.





Also, some doctors use a diferent type of interferon called Infergen - it usually has to be injected daily at higher doses.





Talk with a hepatologist at an academic university hospital for advice and information on the latest therapies.





Good luck and best wishes for treatment success and SVR!

If you had a course of treatment for hepatitis C and are not "cured" when can you try again?"?
talk to your MD
Reply:It depends on how advanced the liver disease is.My friend was in end stage liver disease and the treatment x 2 did not work.He had a transplant 6 years ago.He took a year of the newest treatment post transplant and the treatment failed.Unfortunately unless you catch Hep C in the early stages there is no cure for it.It is however a slowly progressive disease.My friend contacted the Hep C in 1968 and did not have advanced liver disease until 1998.