OVERVIEW
An estimated 3% of the world’s population carry hepatitis C virus (HCV). Most people infected with HCV have no symptoms at all. In fact, most people don’t know they have the disease until liver damage shows up, decades later, during some type of routine medical tests.

Hepatitis C is generally considered to be the most serious of six identified hepatitis viruses that cause the liver to become inflamed resulting in its ability to function.

Over time, if untreated, HCV can lead to liver cancer, liver failure or irreversible and potentially fatal scarring of the liver (cirrhosis). The primary mode of transmission for HCV is contaminated blood. High-risk patient populations include persons who have:

• Consumed illicit IV or intranasal drugs (cocaine)
  
• Received a blood transfusion or organ transplant prior to 1992
  
• Exposed themselves to infected blood (healthcare workers)
  
• Received clotting factor concentrates prior to 1987
  
• Received hemodialysis
  

To date, no vaccine is available for HCV. A blood test is the only way to determine if you have HCV. A small number of people infected with hepatitis C fight off the virus on their own without permanent damage. For the rest, the disease slowly attacks the liver, resulting in development of chronic hepatitis.

HCV infection produces no signs or symptoms during the earliest stages. When it does, they are generally mild and flu-like in nature:

• Fatigue
  
• Nausea
  
• Poor appetite
  
• Muscle / Joint Pain
  
• Liver tenderness
  

It is not uncommon for symptoms to appear decades later, even if chronic hepatitis has developed. During this period of time, it is still possible to transmit the virus to others.


TREATMENT

A diagnosis of HCV does not necessarily mean that treatment is needed. The National Institute of Health (NIH) recommends treatment for HCV if you have:

• A positive test result indicating hepatitis C virus is circulating in your bloodstream.
  
• A biopsy that indicates significant liver damage
  
• Elevated levels of the liver enzyme alanine aminotransferase (ALT)
  
  

DRUG THERAPIES

The standard of care for HCV treatment is weekly injections of pegylated interferon alfa combined with twice-daily oral doses of ribavirin—a broad-spectrum antiviral agent. The goal of this combination therapy has been shown in clinical trials to remove up to 50% of people with genotype 1 HCV (the most common genotype found in the U.S.) and in up to 80% of those with genotypes 2 and 3.

Genotype 1 HCV usually requires a course of relatively high-dose medications for 48 weeks. Genotype 2 or 3 requires a lower dose and a 24-week course of treatment.

Pegasys^® (pegylated interferon alfa-2a)
Subcutaneous Injection
Hoffman-La Roche, Inc.

Peg-Intron^® (pegylated interferon alfa-2b)
Subcutaneous Injection
Schering Corporation

Ribavirin^® (various manufacturers)
Oral