Treating your hepatitis quickly is the most important thing you can do. Unless your body has fought off the infection by itself, treatment may be your only hope of controlling chronic hepatitis B or C. Sometimes the treatment takes a long time, and it does not help everyone, but because this disease can get worse over time, it is very important to get proper treatment and follow-up.

How interferon works

Interferon is currently cleared by the Canadian Health Protection Branch (HPB) and the U.S. Food and Drug Administration (FDA) for treating chronic hepatitis B or C. [Note: Interferon is the general name of the drug. There are different forms of interferon, just like there are different-forms of pain relievers like aspirin or ibuprofen. Interferon is also be combined with ribavirin for treatment of hepatitis C. This combination is sold commercially as Rebetron].

One way the drug interferon works against chronic hepatitis is by protecting your healthy, uninfected cells from being taken over by the virus. Interferon is actually a natural substance that your body normally makes to help defend itself against invaders. But your body sometimes doesn't make enough natural interferon to help you defeat the infection. Giving you additional interferon as a drug may make a difference. Interferon can also work in other ways, such as helping your body's immune response against the virus and infected cells.

Treating hepatitis B

About 90% of adults are able to fight off acute hepatitis B infection completely without having to take interferon, and they suffer no long-term effects from the disease. However, between 5% and 10% of adults with hepatitis B cannot get rid of the virus. Some of these people will become carriers, which means that they don't become sick themselves but they can still infect other people. Others will have chronic hepatitis B for the rest of their lives, which means that the virus will continue to attack liver cells.

Currently, the drug is indicated for use in patients 18 years and older.

One way that interferon works is by stimulating the immune system's attack on the infected liver cells. As a result, the patient may actually have a period during treatment in which his or her symptoms are worse than before. Remember, the virus makes your immune system attack healthy liver cells. This process is called a flare. It may be a good sign because it occurs more often in responders than non-responders in patients being treated for chronic hepatitis B

Before treating any patient for hepatitis B, a doctor will check to determine that there is virus currently present in the patient's blood and that the patient's liver is being damaged. As we noted earlier, if the patient is too sick, the therapy may do more harm than good. The level of virus in your blood before treatment, as shown by a hepatitis B virus DNA test (HBV DNA), may help predict whether or not you are likely to be helped by interferon. People with less virus seem to get more benefit from interferon than those with higher levels of virus.

How Ribavirin works

Ribavirin belongs to a group of drugs called nucleoside analogs, which are believed to prevent viruses from multiplying. Studies have found that the combination of Ribavirin Capsules and INTRON A Injection helps to reduce the amount of virus found in a patient's blood (called "viral load").

Treating hepatitis C

The antibodies that your body produces to defend against hepatitis B work much better than those directed at hepatitis C. As a result, your body more often needs help beating chronic hepatitis C. Again, your doctor will try to see just how much damage your liver has had before starting your therapy. The interferon is usually given 3 times a week, while the Ribavirin capsules are taken twice daily. Treatment often lasts much longer for chronic hepatitis C than for chronic hepatitis B; it may take anywhere from 6 months to 2 years for your treatment to be completed. During treatment, your doctor will carefully follow your ALT level and HCV-RNA levels and do other tests to see if your liver is getting better through treatment.

These benefits may include periods of remission and a lower risk of developing cirrhosis and/or liver cancer. So it is very important that you stick to your treatment for as long as it takes to see if you are improving. Often your doctor can tell after about 3 months of treatment for hepatitis B and about 6 months of treatment for hepatitis C whether or not treatment is helping you. At that point, he or she may recommend that you stop the drugs if they don't seem to be working, or your doctor may change your treatment.

Coping with side effects

Almost everyone who uses interferon and or Ribavirin notices side effects, some of which are unpleasant. But you should not let that discourage you from using them. Some of the side effects of interferon are similar to the symptoms of hepatitis, so you may use some of the same approaches to handle these problems whenever they arise. There are also ways to lessen the unpleasant effects that are due only to interferon, which are usually the worst during the first few weeks of treatment. After that they tend to lessen.

If at all possible, you may want to take a week or two off work when you begin treatment. Since the side effects are typically the worst during the first 2 weeks, it may help to stay at home or at least plan to rest more. If your home life is busy, try to have others take over some of the chores. Or, if possible, get some temporary help for the first week. Do whatever you can to make it easier on yourself; you are more likely to stick with the treatment once you make it through the most difficult time - the first 2 weeks.

Because the side effects tend to occur 4 to 6 hours after the injection, many people have found that taking the injection before bedtime allows them to sleep through the worst of it. However, you should see how quickly your own side effects occur. Then you can make up your own time schedule. You may be able to adjust the injection schedule around your work week as well. For example, if you work Monday through Friday, and you receive 3 injections a week, you can arrange to get your injections on Tuesday, Thursday, and Saturday. This way, you will have side effects on only 2 of your workdays. You'll need to take your injections at the same time and on the same day each week.

Drinking plenty of fluids (without caffeine or alcohol) may help relieve the side effects. It is especially important to drink water or clear fruit juices (apple, cranberry, or grape) right before and right after receiving the injection.

Some people take over-the-counter pain relievers 1 hour before their injection to help relieve side effects. Others have found that 1 tablet of the pain relievers 2 or 3 hours after the injection works better in relieving the side effects. It is important that you talk to your doctor before taking any over-the-counter or prescription medication for side effects. (Remember, alcohol and acetaminophen [an ingredient in some over-the-counter pain relievers, and many drug combinations used for colds] taken together and cause a condition called fulminant hepatitis, which can lead to fatal liver failure. Clearly, you should never combine these two substances, and talk to your doctor about any medications you take.)

Some medication can have bad effects when taken during interferon therapy. You must tell your doctor about any other medications, including vitamins or any herbal remedies you take regularly for your health. Some medications don't work as well if they are taken with another drug, or can cause a bad reaction, so it is important that your doctor knows about any other medicines you are using while you are getting interferon.

You can try relieving headaches with massage, heat applied to the back of the neck, or just resting. Fever can sometimes be reduced by sponging yourself with lukewarm water (don't use cold or hot water). Eating can be a problem if you are nauseous or just have no appetite. You may want to eat several small meals throughout the day, or have some healthy snacks on hand for nibbling when you feel up to it. Food is very important to keep yourself well nourished during treatment.

Your emotional well-being is also important to getting you through this, so be aware of the symptoms of depression and other troubling feelings. Indeed, very infrequent reports of suicidal behavior (ideation, attempts, and completed suicides) have been associated with interferon treatment.

Good oral hygiene, such as using mouthwash and brushing your teeth several times a day, may help get rid of the metallic taste. There isn't much you can do about hair thinning, but your hair loss will be mild and it will stop falling out and grow back once the interferon therapy is completed. In the meantime, you might want to get a hairstyle that makes your hair look more full, use hair extensions, or experiment with caps and scarves.

More serious side effects can also occur, so report any changes in your health to your doctor. If you have little appetite or are losing weight, or vomiting, you need to contact your doctor immediately. It is especially important that your bone marrow - a part of your body that makes immune cells for you - keeps working correctly during therapy. Sometimes interferon makes the bone marrow slow down production of certain blood cells. If this happens, your doctor may reduce your dose of interferon, or give you a brief break from therapy.

Rebetron combination therapy could cause serious birth defects and harm (including death) to your unborn fetus. If you or your partner are pregnant, you should not receive Rebetron combination therapy. Pregnancy should not be planned while you or your partner are on therapy and for 6 months after therapy.

An important point that bears much repeating is that you should not drink alcohol while you are undergoing therapy. You are, after all, trying to defend your liver against a serious infectious disease, and drinking can cause damage to your liver that is very much like the damage that viral hepatitis causes. There are even some reports that drinking alcohol while you are on therapy may affect how well treatment works

Alternative treatments for hepatitis

Many people, particularly those who do not improve with interferon, also try alternative therapies, including homeopathy, herbs, vitamins, acupuncture, or special diets. You need to be very careful before using any alternative therapies, particularly herbs or other "natural" medicines that you may have heard about, such as ginseng or licorice root. Such therapies have not been tested in the same way as a prescription drug, and some of these alternative medicines can hurt you, particularly if you have hepatitis. These products are usually sold as "food supplements" or "vitamins." As a result, they are not regulated or monitored as closely as prescription drugs.