Hepatitis C, Facts about Combination Therapy: Interferon and Ribavirin | Hepatitis Central

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Facts About Combination Therapy: Interferon and Ribavirin

What is rebetron?

Rebetron is a combination of two drugs – Rebetol (ribavirin) and Intron A (an engineered version of alpha interferon).

Is rebetron available?

The Food and Drug Administration (FDA) approved the combination of ribavirin and interferon on June 3, 1998.

How effective is rebetron?

Drug trials have shown a higher response rate in patients taking the combination of ribavirin and interferon than those taking interferon alone. Tests have also shown that the combination can cure some patients who have either relapsed after interferon monotherapy or did not respond at all to interferon. Recent results of a study show that relapsers to interferon achieved a 49% response rate when treated with 24 weeks of rebetron.

However, trials of 12-18 months are necessary for doctors to be able to effectively determine exactly how much the combination therapy improves upon interferon.

What is ribavirin and how does it combat the virus?

Ribavirin is a nucleoside analogue. It stimulates the T cells in the body to fight the virus. Interferon attacks the virus by interfering with its ability to copy itself and spread throughout the body. The combination of ribavirin and interferon should be effective in both containing the virus and strengthening the body’s immune system.

How do I know if I am eligible for rebetron?

While the following guidelines are important, the best advice is to talk to your doctor.

Patients are candidates for interferon if they meet three criteria:

1. blood tests positive for HCV antibodies

2. abnormal concentration of alanine aminotransferase (ALT) in the bloodstream.

3. chronic inflammation of the liver

Patients are ineligible for ribavirin if they suffer from anemia or ischemic heart disease. Pregnant women and nursing mothers are also ineligible because ribavirin can harm fetuses and infants.

How will I know if I am cured?

The main indicator of a cure is the sustained response (SR). An SR means that ALT levels are normal and there are no traces of HCV RNA in the bloodstream for at least six months after treatment. In the past, SR rates have not been very high for one main reason: HCV comes in three genetic types. Interferon is most effective against genotypes 2 and 3. However, 70-80 percent of Americans with Hepatitis C have genotype 1. Dependent upon the patient population, rebetron therapy produces a two- to ten-fold increase in sustained response rate compared to interferon monotherapy.

Last Updated: 1998