Quality of life and risk reduction are key
What are the basic aims when treating hepatitis C?
Essentially, these are to achieve acceptable levels of alanine aminotransferase (ALT) in the blood, combined with a clearance of the hepatitis C virus from the body. I define this as undetectable HCV-RNA in the blood for at least six months after treatment has been stopped. Obviously, the wider point is that treatment hopefully not only improves the quality of a patient's life but also reduces the risk of developing cirrhosis or hepatocellular cancer in the long-term.
What has been the standard treatment for chronic hepatitis C patients?
Until recently, the only licensed treatment here has been interferon alpha. Its precise antiviral action is unclear but it appears to alter host cell metabolism. Meta-analyses suggest some 47 per cent of patients respond to this treatment (often within three months) when given at a dose of three million subcutaneous units three times a week. Unfortunately, more than half of these patients relapse within six months of stopping treatment and so combination therapy is the logical next step.