Do you also need to follow these principles when taking antiviral medication for hepatitis C

The emergence of hepatitis C will spread certain viruses, so patients must take some antiviral drugs. This is to prevent themselves from being infected by these viruses and to prevent hepatitis C from damaging the liver, internal organs, lung function, and gastrointestinal function. It can also prevent the virus from being transmitted to others. Only when the human body resists the virus can the virus be completely defeated. Therefore, when taking antiviral drugs for hepatitis C, you must pay attention to the plan and principles, and also pay attention to the time required.

Treatment

1. Antiviral treatment regimen

Before treatment, it should be determined whether the patient's liver disease is caused by HCV infection. Only patients with hepatitis C confirmed to have positive serum HCV RNA require antiviral treatment. The most effective antiviral treatment currently recognized is the long-acting interferon PEG-IFNα combined with ribavirin, which is also the standard regimen (SOC) for the treatment of chronic hepatitis C approved by EASL. The second most effective treatment is ordinary IFNα or combined IFN and ribavirin therapy, both of which are better than IFNα alone. Polyethylene glycol (PEG) interferon α (PEG-IFNα) is an inactive, non-toxic PEG molecule cross-linked on the IFNα molecule, which delays the absorption and clearance of IFNα after injection. It has a long half-life and effective blood drug concentration can be maintained by dosing once a week.

The direct-acting antiviral (DAA) protease inhibitor boceprevir (BOC) or telaprevir (TVR), in triple therapy with interferon and ribavirin, was approved for clinical use in the United States in May 2011. It is recommended for patients infected with HCV genotype 1 to improve the cure rate. BOC, after meals, three times daily (every 7-9 hours), or TVR, after meals (not low-fat meal), three times daily (every 7-9 hours). HCV RNA should be closely monitored during this period. If virological breakthrough occurs (serum HCV RNA rises by >1 log after the lowest value), the protease inhibitor should be discontinued.

2. Treatment of general hepatitis C patients

(1) Acute hepatitis C: There is clear evidence that interferon treatment can reduce the chronicity rate of acute hepatitis C. It can be started 8-12 weeks after the onset of acute hepatitis caused by HCV infection, and the course of treatment is 12-24 weeks. The optimal treatment regimen has not yet been definitively determined, but early treatment is more effective for patients with genotype 1 and high viral load (>800,000 logIU/ml).

(2) For patients with chronic hepatitis C, the severity of liver disease should be assessed before treatment. Patients with recurrent abnormal liver function or obvious inflammatory necrosis (G≥2) or moderate or severe fibrosis (S≥2) in liver biopsy are more likely to progress to cirrhosis and should be given antiviral treatment.

(3) Hepatitis C cirrhosis ① For patients with compensated cirrhosis (Child-Pugh A grade), although their tolerance and efficacy to treatment are reduced, it is recommended that they be given antiviral treatment under close observation in order to stabilize their condition and delay or prevent the occurrence of complications such as liver failure and HCC. ② Patients with decompensated cirrhosis: Most of them find it difficult to tolerate the adverse reactions of IFNα treatment, and those who are able should undergo liver transplantation.