Examples
| peginterferon alfa-2a |
Pegasys |
| peginterferon alfa-2b |
Pegintron |
How It Works
Peginterferons are a complex family of
proteins that are produced by the body and that help
you fight disease. They also can stop viruses from multiplying and damaging the
body.
Peginterferon is given as a shot once a week to treat
long-term (chronic)
hepatitis C.
Peginterferons most often
are combined with another medicine called ribavirin for the best results.
Sometimes they are given without ribavirin. A person may not be given
ribavirin if he or she has
anemia, a heart problem, or a kidney problem.
Why It Is Used
Peginterferons may be used to treat
chronic hepatitis C if you have:
- Liver
enzyme levels that remain elevated for more than 6
months. This indicates that you probably have long-term, chronic liver
inflammation caused by the hepatitis C
virus.
- Detectable levels of hepatitis C
virus in your blood.
- Evidence of
significant liver damage. This is detected with a
liver biopsy.
How Well It Works
For many years, combination therapy
with interferon and ribavirin was the standard treatment. Now, the combination
of peginterferon and ribavirin is considered the best treatment for hepatitis
C.
How well treatment works is measured by whether you still have
the virus in your blood 6 months after treatment. If you are treated with
interferons alone (interferon monotherapy), treatment generally works 10% to
20% of the time.1 When interferons or peginterferons
are combined with ribavirin, treatment works anywhere from 40% to 80% of the
time.1 Treatment is more likely to work if:
- You have a low level of the hepatitis C virus
in your blood when treatment starts.
- You have
genotype 2 or 3.
- You have a small amount
of liver damage when treatment starts.
- You do not have
HIV.
- You do not abuse alcohol.
Side Effects
Side effects from interferon,
peginterferon, and ribavirin are common. If your side effects are severe, you
may need to stop treatment. Some side effects may decrease as treatment
continues.
Common side effects of combination antiviral therapy include:
- Fatigue, headache, muscle and joint aches,
fever, or chills.
- Nausea, loss of appetite, or weight
loss.
- Irritability,
insomnia, or confusion.
-
Depression
.
-
Thyroid
problems.
- Hair loss or skin rash.
- Low levels of
red cells,
white cells, and
platelets in your blood.
If you develop anemia as a result of taking ribavirin, your
doctor may prescribe a medicine called erythropoietin to help your body create
more red blood cells.
Most side effects go away when you stop
taking the medicines.
See Drug Reference for a full list of side
effects. (Drug Reference is not available in all systems.)
What To Think About
Treatment for chronic hepatitis C
lowers the chance of liver cancer.2
You
will need routine follow-up visits with a liver specialist during treatment.
The specialist will order blood tests to check your liver enzyme levels and to
see whether the virus is still multiplying.
A person with normal
or slightly elevated liver enzyme levels but whose liver biopsy shows little or
no liver damage may choose not to have antiviral treatment. Instead, a doctor
can monitor these conditions with periodic
liver function tests and a liver biopsy every 3 to 5
years.
Even if the initial treatment does not get rid of the virus,
your doctor may advise you to continue antiviral treatment, because it may
reduce liver inflammation. For some people with significant liver damage,
antiviral therapy may slow the progression of liver damage or make
liver cancer less likely. If you already have
cirrhosis, some studies show that antiviral therapy
can help you live longer.3
If it is
possible that you are pregnant, you will need a pregnancy test. Women and men
who are taking ribavirin need to avoid getting pregnant or fathering a child,
because this medicine can damage a developing fetus. Women who could become
pregnant and their partners must use two reliable forms of birth control during
treatment and for 6 months after treatment, to avoid pregnancy.
Only a few clinical trials have tested antiviral medicines in children.
Results suggest that they work about as well in children as in adults.
Combination therapy using interferon and ribavirin is now approved by the U.S.
Food and Drug Administration for use in children ages 3 to 17 years.
If you are
obese or have
diabetes, you may need to delay treatment until you get your
weight or blood sugar under control.
If you have tried interferon
in the past and did not get good results, talk to a doctor who is a liver
specialist (hepatologist). The hepatologist will be able to tell
you about newer combinations of peginterferon with ribavirin or new,
experimental treatments.
The long-term health effects of
combination antiviral therapy are not known at this time.
Complete the new medication information form (PDF)(What is a PDF document?) to help you understand this medication.
References
Citations
-
Hoofnagle JH (2008). Chronic
hepatitis C. In L Goldman, D Ausiello, eds.,
Cecil Medicine, 23rd ed., pp.
1113–1116. Philadelphia: Saunders
Elsevier.
-
Shiratori Y, et al. (2005). Antiviral therapy for
cirrhotic hepatitis C: Association with reduced hepatocellular carcinoma
development and improved survival. Annals of Internal Medicine, 142(2): 105–114.
-
Dienstag JL (2005). Chronic viral hepatitis. In GL
Mandell et al., eds., Mandell, Douglas, and Bennett's Principles and Practice of Infectious Diseases, 6th ed., vol. 1, pp.
1441–1464. Philadelphia: Elsevier/Churchill Livingstone.
Credits
|
By
|
Healthwise Staff |
|
Primary Medical Reviewer
|
Kathleen Romito, MD - Family Medicine |
|
Specialist Medical Reviewer
|
W. Thomas London, MD - Hepatology |
|
Last Revised
|
July 13, 2009 |
Hoofnagle JH (2008). Chronic
hepatitis C. In L Goldman, D Ausiello, eds.,
Cecil Medicine, 23rd ed., pp.
1113–1116. Philadelphia: Saunders
Elsevier.
Shiratori Y, et al. (2005). Antiviral therapy for
cirrhotic hepatitis C: Association with reduced hepatocellular carcinoma
development and improved survival. Annals of Internal Medicine, 142(2): 105–114.
Dienstag JL (2005). Chronic viral hepatitis. In GL
Mandell et al., eds., Mandell, Douglas, and Bennett's Principles and Practice of Infectious Diseases, 6th ed., vol. 1, pp.
1441–1464. Philadelphia: Elsevier/Churchill Livingstone.