Yes, with 50 to 80 per cent success rates. The primary treatment currently available to people with hepatitis C is a combination of pegylated interferon and ribavirin. This combination therapy not only aims to eliminate the virus, but also to prevent chronic hepatitis C infection progressing to cirrhosis and other serious liver disease.

Overall, about 60% of people treated with a combination of pegylated interferon and ribavirin will clear hepatitis C from their blood, achieving a sustained viral response 6 months after completing the course of treatment. This means that the virus is not detectable with a PCR test (PCR negative result). For people with genotype 2 or 3, about 80% clear the virus with combination therapy, for those with genotype 1, about 50% clear the virus.

What does the treatment involve?

Combination therapy involves a weekly injection of interferon – usually self-administered – for 24 weeks (for genotype 2 or 3) or 48 weeks (for genotype 1). In addition, ribavirin capsules are taken daily. The course of treatment must be continuous.

How much will it cost?

Combination therapy treatment is government subsidised to people who meet the S100 criteria:

• Documented chronic hepatitis C infection (repeated hepatitis C antibody positive and PCR positive).
• Female patients not pregnant or breastfeeding; female partners of male patients not pregnant.
• Both patient and partner using effective contraception (one for each partner) to prevent pregnancy during treatment and up to 6 months after treatment ends.
• Must be 18 years or older.

Compliance to the treatment regimen is important to gain the best chance of viral clearance. People need to consider whether their drug and alcohol use is stable enough to support treatment compliance or whether they need to postpone treatment until there is more stability in their lives.

If you have genotype 1, severe fibrosis or cirrhosis, treatment will last for 48 weeks. In these instances, if a PCR test shows that the virus is still present after the first 12 weeks, the treatment will stop. For people with genotypes 2 and 3, or less severe liver damage, treatment will last for 24 weeks.

Pegylated interferon monotherapy is available for people who cannot take ribavirin. This treatment involves taking pegylated interferon on its own and is available under the government subsidised scheme.

If you are considering therapy, your general practitioner can refer you to your nearest treatment centre, which is usually located within a gastroenterology unit at a major hospital.

Are there any side effects?

Side effects of combination therapy vary for each person. Some people report no side effects while others may have flu-like symptoms, such as fever, chills, muscle aches and headaches. These are usually experienced in the first few months of treatment. Other side effects may include becoming forgetful, short-tempered, tired or depressed. Fortunately most side effects disappear once treatment has stopped.

Interferon has been associated with depression and suicide ideation in some people, and people with a history of depression should have a psychiatric assessment prior to treatment. Many treatment centres also use antidepressants with combination therapy to maintain compliance.

A potentially serious side effect of ribavirin is anaemia, and blood counts are monitored very closely, especially in the first few weeks of treatment, and doctors may reduce the ribavirin dose if necessary. Life-threatening complications are rare.

It is difficult to predict how people might respond to treatment, and what side effects might be experienced. Having few side effects does not mean that the treatment is not working.

Some people are anxious about commencing treatment with combination therapy because the interferon needs to be injected. Treatment centres should provide training for safe self-administration of interferon at home. Sharing these concerns with a friend, counsellor or nurse may reduce anxiety and help solve the problem. You could also discuss treatment issues with your Hepatitis Council.

Where can I get more information?

Not everyone with hepatitis C needs treatment, and there can be many factors to weigh up to decide whether it is right for you at this time. You can speak to your GP or liver specialist about treatment. The Hepatitis Council in your state or territory can provide written information about a range of treatment issues, can answer many of your questions and talk to you about any concerns you have, and most Hepatitis Councils can put you in touch with other people who have been on treatment, so you can talk to them about their experiences.

If you decide to use combination therapy, the support of family, friends, co-workers and your partner (if you are in a relationship) will be invaluable.

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