New Hepatitis C Drugs Looking Better
The international trial showed that people infected with the hard-to-treat type should be encouraged to stick with high-dose ribavirin for the full 48 weeks of combination treatment. People with easier-to-treat types of the hepatitis C virus get excellent results when they shorten treatment to 24 weeks, even if they take a lower dose of ribavirin as part of the combination therapy. And some of these patients may need only 12 weeks of treatment.
"We are getting close, at least, to the ability to have early predictors of response," Jensen says. "In patients who are having a good response, we don't have to continue. We can stop at 12 weeks and only continue in patients in whom the likelihood of sustained viral response is not as high."
The findings are very reassuring. However, many doctors who treat hepatitis C infection already are treating patients differently depending on the type of virus they carry. Curt H. Hagedorn, MD, is director of hepatology at Atlanta's Emory University.
"Three years ago, a lot of us weren't looking at the type of virus," Hagedorn tells WebMD. "But now it is standard, because people with genotypes 2 and 3 get only 24 weeks of treatment. If they are having toxicities, we consider pressing on in those patients because they have such a high long-term response. We are being much more careful about giving full doses of ribavirin. It is very toxic."
Hagedorn notes that doctors are getting better at treating these toxic effects so that patients can complete their treatments.
And not everybody suffers all of the toxic effects. Bill Kenney, a 47-year-old maintenance supervisor from Chicago, was one of the patients treated in the Jensen study. He was infected with the harder-to-treat genotype 1 form of hepatitis C virus.
"I started treatment on New Year's Day 1999," Kenney says. "By week 12 I was negative for the virus. I've been negative ever since. The side effects were very mild. I did have insomnia, but the nausea and aches and fever and chills I just did not get. ... I finished treatment at Thanksgiving that year and have been negative ever since. I feel tremendously grateful and very lucky."