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There are 2 different kinds of Pegylated interferons. One is called Pegintron
and the other is called Pegasys. They both are injected once a week. Both of them require a tablet called ribavarin to
be taken with the injection for better treatment results. However, there are significant differences between the two.
Pegintron has to be adjusted for the persons weight while Pegasys is given as a fixed dose once a week.
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Treatment involves taking one of the Pegylated interferons with a tablet called Ribavarin. The tablets are taken
twice daily while the injection is taken once a week. |
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Treatment is more likely to be successful if the patient has a low viral
level compared to a high viral level. (We can actually measure the number of viruses in the blood stream of a patient
by a test called Hepatitis C virus PCR quantitative). A low viral load is if the viral load is less than 750,000
International units or less than 2 million copies of the virus. |
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A common question asked is what are my chances of success. That is
very difficult to answer since it depends on number of viruses, type of virus, duration of having the virus,
amount of damage to the liver, ethnic background etc. In general response rate is better when patients have a
low viral load, less fibrosis and inflammation to the liver, shorter duration of having the virus and in Caucasians. |
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There are many studies which have shown different results for different
treatment regimens. Based on the studies done for approval of each of the drugs I have compiled a chart to show
some of the results in various situations. |
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| Type of Virus |
PEG intron at 1.5 mcg / kg + Ribavarin at 10.6 mg /kg |
PEgasys 180 mcg + Ribavarin |
| Type 1, High viral load |
Response rate is 30% |
Response rate is 41-46% |
| Type 1 Low viral load |
Response rate is 72% |
Response rate is 54% |
| Type 2 virus |
Response rate is more than 81% |
Response rate is more than 79% |
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It should be noted that there are NO
DIRECT comparison trials between the 2 regimens. |
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Side effects of medications are quite
extensive. They include hair loss, visual problems, flu like symptoms, body aches,
fever, chills, cough and shortness of breath, thyroid abnormalities, weight loss,
depression, suicidal tendencies, drop in white count, hemoglobin and platelet count.
Moreover, ribavarin can cause a baby to be born deformed (if a baby is conceieved while
on treatment or upto 6 months later). This means that all patients should use at least
2 forms of contraception while on treatment. As you can see, treatment is not an easy option. |
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Since the treatment has a lot of side effects,
each patient treatment should be individualized. |
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At times, patients may need treatment to counter the side
effects. This includes using medications for depression, Provigil or ritalin for severe fatigue,
Epogen to increase the hemoglobin, Neupogen to increase the neutrophil count etc. |
