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Hepatitis C shows significant genetic variation in worldwide populations, evidence of its frequent rates of mutation and rapid evolution and changes that may help it evade attack from an infected person’s immune system. In order to prescribe a treatment plan with the highest chances of success, a person must have their particular Hepatitis C genotype and subtype identified.
Trials have defined several key components of therapy, namely the appropriate dose of the drugs, the optimal duration of therapy and the need for a different regimen for patients with genotype 1 and genotype 2 and 3 infections. Interferons are a group of naturally occurring proteins that form an essential part of the immune system.
In its naturally occurring form, alpha interferon is produced by the body to fight infections, notably flu, and is responsible for many of the symptoms associated with flu, such as headaches, fever and shivering. Different formulations have been studied differently in patients with different severity of disease.
Ribavirin is a synthetic antiviral nucleoside analogue that works very successfully with interferon but is ineffective against hepatitis C on its own. In the majority of cases ribavirin is used alongside interferon for the treatment of hepatitis C.
The most effective pharmaceutical treatment for hepatitis C consists of taking two drugs, pegylated interferon and ribavirin, and is known as dual or combination therapy. Although treatment is more effective during acute infection treatment can and should be offered to people with moderate liver damage and those with compensated cirrhosis. HCV treatment is more effective when given during acute infection and treatment should be offered to people with moderate liver damage, since they are at risk of progression to cirrhosis. Until recently it was generally thought that treating people with HCV-induced decompensated cirrhosis with pegylated interferon was not worthwhile as the response rates tended to be low, the risks of severe side effects and the possibility that treatment might accelerate the deterioration of the liver.
Once in case of Blood transfusion like blood treatment issues, worldwide very strict and safe methods have been directed — the spread of this Hepatitis C from one person to another has reduced.
In about 80% of the patients, there are no symptoms, even after Hepatitis C is present in the body.
In these people also, even though virus remains inside the body, immediately there are no symptoms. Essentially in persons above 40 years, people infected with Hepatitis C, people with drinking habits, in addition to this having Hepatitis B or HIV, due to different reasons people taking medicine that suppress the immune system … liver may quickly damage. Secondly, if Hepatitis C gets into the body, Diabetes, Lichen planus, sever kidney disease Glomerulonephritis, Thyroid sickness like other problems may arise. Also, if you get doubt – whether it is already present in the body?… if it is present, checking whether it becomes long-term illness, taking correct treatment and relieving it from the body is very necessary. Once Hepatitis C enters into our body, to fight against and send it out, our body produces antibodies.
Once we do this test, whether the virus still remains in the body or not is definitely known. Once it is determine that the virus is present in the body… it is necessary to know, what type this virus belongs is important for treatment. In this way, what type of Hepatitis C virus is present in the blood is confirmed… depending upon that treatment is given. New – Daily Sofosbuvir tablets, Ribavirin tablets, every week Interferon injections – For 12 weeks, if given is enough. Till now– Every week Interferon injections, daily Ribavirin tablets – For 24 weeks it has to be given. In near time, without the necessary of Peginterferon and Ribavirin, in less time giving successful treatment will become a reality. Disclaimer: Health Dummy website is designed for educational purposes only and is not intended to serve as medical advice. This journal is a member of and subscribes to the principles of the Committee on Publication Ethics. Discuss preferred therapies for initial treatment of patients with genotype 1a or 1b chronic HCV. List the preferred therapy for retreatment of patients with HCV genotype 1a or 1b chronic infection who have previously failed therapy.
Baseline Resistance Testing: When considering the use of elbasvir-grazoprevir, pre-treatment NS5A resistance testing is recommended for patients with HCV genotype 1a to detect the presence of virus with NS5A resistance-associated variants (RAVs) at the amino acid positions M28, Q30, L31, or Y93. Treatment of type 2 diabetes mellitus by viral eradication in chronic hepatitis C: Myth or reality? There are six basic genotypes of HCV, with 15 recorded subtypes, which vary in prevalence across different regions of the world. Additionally, knowing the exact strain of HCV is helpful in defining its epidemiology, which can inform individually tailored treatment approaches.


Interferons operate in two primary ways, firstly they directly hinder the replication process of the virus and secondly they enhance the immune response. As a treatment for hepatitis C, it is synthetically produced in a laboratory and administered by injection under the skin in doses considerably higher than occur naturally. As a result, its effectiveness decreases, allowing the hepatitis C virus to multiply in between injections. PegIntron is a powder that has to be reconstituted with purified water, both of which come in separate vials. They have not been compared directly, and so it is difficult to know whether one may be better than another in different circumstances.
Its efficacy when used with interferon was first noted in 1990 and since 1998 it has been incorporated into standard treatment for hepatitis C. Ribavirin comes in 200mg pill or capsule form and is taken orally, twice daily, with dose dependent on patient weight and genotype. People with compensated cirrhosis can be treated, but treatment is less likely to be effective, and side effects may be worse. However, recent studies suggest that treatment may help carefully selected patients with decompensated cirrhosis, who have not previously had treatment and who currently have few options other than liver transplantation.
It is a virus that mainly spreads through blood and other bodily fluids from one person to another.
But in some of these people …, after 20-25 years, liver becomes hard (cirrhosis), and it may also completely fail. That’s why once Hepatitis C is affected, and if it stays in the body for long duration… identifying it quickly and providing necessary treatment is important. That’s why first to know whether these antibodies (Anti-HCD antibodies) are present in the blood or not?
If the virus is not present, that means it has come in the past and gone away, our body has successfully got rid of it and we will not have any problem with it, is the meaning.
To make to available for less cost, the respective company has given Indian companies the opportunity to manufacture generic drugs. Previously worked for different software companies like TCS, MSS, EDIS etc, before landing in Teaching job. The information provided on this site should not be used for diagnosing or treating a health problem or disease.
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The presence of one or more of these high-fold change RAVs requires adding ribavirin to the regimen and extending the course of elbasvir-grazoprevir to 16 weeks. There appears to be little difference in the severity of disease or outcome of patients infected with different genotypes. Patients with genotype 1 infection who fail to achieve an early viral response at 12 weeks have a less than five per cent chance of achieving a sustained viral response.
They hinder the replication process by binding to receptors that are present on nearly all cell types and preventing a virus from entering the cell and replicating within it. Pegylation is a process whereby a large molecule chain is attached to the interferon to slow the rate at which it is broken down. Ribavirin inhibits viral growth, has anti-viral properties and interrupts the way hepatitis C absorbs genetic material when it replicates. Significantly this virus is transmitted, if a person already has this Hepatitis C in his blood. Only in some people, slight jaundice, lack of huger, slight fever, nausea like symptoms are present. But if it still remains in the body, the issue has become chronic, to get rid of it or to avoid problem due to it, necessary treatment is necessary.
That’s’ why depending upon the genotype, the treatment and the methods to be followed will change.
He lists the various side-effects of the drugs and also how to treat yourself from Hepatitis C in 2015. Genotype 1 infection has been historically difficult to treat, but multiple recent studies have shown SVR rates greater than 90% in these genotype 1 patients using well-tolerated, all-oral regimens consisting of new direct-acting antiviral agents. In general, the baseline HCV RNA value does not influence the treatment choice or duration.
Genotypic resistance testing is commercially available through several laboratories and typically costs less than $1000.
The recommended four regimens for genotype 1a or 1b are listed by groups by level of evidence, then in alphabetical order.


One genotype cannot change into another, but it is possible for a person to catch more than one genotype at the same time, or to catch a different genotype from that they were previously infected with. However, genotype can have a bearing on the course and outcome of treatment and people with genotypes 2 and 3 are more likely to respond to interferon treatment. Patients with genotype 2 and 3 infection who achieve a rapid viral response (HCV RNA negative) at four weeks can receive 12 or 16 weeks of pegylated IFN and ribavirin therapy with similar results to 24 weeks of treatment. This molecule chain is made up of essentially inactive chemicals and does not change the basic nature of the interferon but it allows consistent levels of the drug to circulate in the body and consequently maintain a consistent attack on the virus. People with decompensated cirrhosis cannot be safely treated for hepatitis C, which is when a liver transplant is usually the only possible option. So, without taking proper care, doing blood transfusion, using needles used by another person, mixing of another person’s blood during kidney dialysis, in this way this virus spreads. In countries like USA, 1st type is more significantly seen, while in our country, 3rd type is more mainly seen.
If you have or suspect you may have a health problem, you should consult your health care provider. The use of these direct-acting antiviral agents has been complicated by the high price of therapy. Historically, genotype 1 hepatitis C has been considered the most difficult to treat hepatitis C genotype. The significantly lower cost of elbasvir-grazoprevir compared with other DAAs may lower the barrier to this pre-treatment testing.
Ultimately, the choice of a particular regimen will be influenced by cost, insurance coverage, pill burden, potential drug interactions, use of ribavirin, relevant comorbid conditions, and the patient and provider preferences. It is possible to be re-infected with the same genotype after successfully clearing the virus with treatment.
It also means that, whereas standard interferon needs to be taken 3 times a week, pegylated interferon only has to be injected once a week. In this way, once this virus injects into the body, in about 15-45% people in 6 months, it completely comes out of the body. So in the test if it is identified that this antibody is present in our body – it means that in the past we have been infected with this virus.
For this doctors do liver functioning test (LFT), complete blood test, the way blood hardens related test, ultrasound scanning tests for stomach like other tests are conducted. But whether the virus has gone out or still remains in the body is not ascertained in this test.
In late 2013 and most of 2014, the standard of care for initial therapy of genotype 1 consisted of peginterferon plus ribavirin plus either sofosbuvir or simeprevir.
Drug interactions may also influence the choice of therapy, particularly for HIV-coinfected patients.
Since 2015, the standard of care for genotype 1 consists of all-oral therapy with a combination of direct-acting antiviral agents (DAAs).
Efficacy data and FDA labeling for this population is based solely on mathematical modeling.
In 2016, the new oral DAAs for treatment of HCV genotype 1 include daclatasvir plus sofosbuvir, fixed-dose elbasvir-grazoprevir, fixed-dose ledipasvir-sofosbuvir, fixed-dose ombitasvir-paritaprevir-ritonavir and dasabuvir, and simeprevir plus sofosbuvir. All of these regimens are FDA approved for the treatment of genotype 1 HCV and are safe, highly effective, and usually require a relatively short duration in therapy. That’s why another test is done.\r\n\r\n\r\nHCV RNA –\r\nOnce we do this test, whether the virus still remains in the body or not is definitely known. But if it still remains in the body, the issue has become chronic, to get rid of it or to avoid problem due to it, necessary treatment is necessary.\r\nWhat type –\r\nOnce it is determine that the virus is present in the body… it is necessary to know, what type this virus belongs is important for treatment. In countries like USA, 1st type is more significantly seen, while in our country, 3rd type is more mainly seen.\r\n\r\nBetter than 1st type, 2nd , 3rd genotype varieties are better cured by treatment. That’s’ why depending upon the genotype, the treatment and the methods to be followed will change.\r\nIs it Damaged?\r\nIf the virus already rests in the body, is the liver affected by it? For this doctors do liver functioning test (LFT), complete blood test, the way blood hardens related test, ultrasound scanning tests for stomach like other tests are conducted.\r\n\r\nIn this way, what type of Hepatitis C virus is present in the blood is confirmed… depending upon that treatment is given.\r\nAlso before starting the treatment –\r\nhow are the blood cells?
Side effects were too many.\r\n\r\nNew – Daily Sofosbuvir tablets, Ribavirin tablets, every week Interferon injections – For 12 weeks, if given is enough.
Side effects were there.\r\n\r\nNew – Daily one Sofosbuvir tablet, Ribavirin tablets – For 12 weeks, if given is enough.



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