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    Treatment Choices for Hep C

    By
    WebMD Feature
    Reviewed by Jennifer Robinson, MD

    It's not often that doctors use terms like "revolutionary" and "groundbreaking" when they talk about medications. But that's exactly what they're doing -- and with much enthusiasm -- when they talk about today's treatments for hep C.

    "There is no question, we're amid a revolution in hepatitis C treatment," says William D. Carey, MD, a senior hepatologist at Cleveland Clinic in Ohio. "There is nothing in my 40 years of professional life that comes close to this." 

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    Coping With Hepatitis C

    Living with a chronic disease like hepatitis C can be depressing and nerve-wracking. It can also interfere with your relationships. "People with hepatitis C experience a lot of stigma," says Alan Franciscus, executive director of the Hepatitis C Support Project in San Francisco. "It can be really hard." You may avoid talking to friends or family about the disease because you're worried about how they'll react. You may feel a temptation to pull away from people you care about rather than risk them...

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    The Problem With Traditional Therapy

    Hepatitis C is a contagious viral disease and the No. 1 cause for liver cancer and liver transplants.  Treatment involves removing the virus from your body and preventing liver damage. It can be cured, but until just a few years ago, that wasn't easy or comfortable. 

    For nearly two decades, people with the condition received shots of a medicine called interferon. Along the way, doctors learned that adding a pill called ribavirin worked better. Together these two medicines became known as "traditional dual therapy."

    But that duo didn't do a great job of curing the disease. That's because neither worked against the cause of hep C. Instead, they amped up your immune system to help it fight the virus. It’s the same way your body gears up when you get another bug, like the flu.

    Some people’s bodies were able to get rid of the virus, but not everyone's could. Cure rates, especially for someone with liver scarring, "were 50% at best," says Ryan Ford, MD, assistant professor of medicine at Emory University School of Medicine.

    To make things worse, the side effects of this treatment were a lot like the ones that come with chemotherapy. People got fevers and flu-like symptoms, they lost bone marrow, and had big drops in their white and red blood cell counts. Sometimes they needed blood transfusions. 

    "Basically, liver doctors and gastroenterologists started to feel like they were cancer doctors," Ford says. "But this was all we had. We put people through this chemotherapy-like regimen for a year and then tossed a coin to see if it worked. It was terrible."

    But necessary. Although severe side effects often caused people to drop out of -- or completely avoid -- treatment, doctors urged them to stay with it.  Hepatitis C can lead to permanent and life-threatening liver damage if you don't take meds for it.

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