Old HCV drugs: peg interferon and ribavirin

Modern HCV drugs (DAAs)

Modern oral HCV drugs – called direct acting antivirals (DAAs) – have very few side effects.

DAAs involve taking one or two pills a day, usually for 12 weeks which cure more than 95% of people.

However, your doctor needs to know about any new symptoms so that these can be managed.

Ribavirn can cause side effects including feeling tired and nauseous. Pegylated interferon is associated with much more difficult side efects.

More information about side effects from ribavirin and pegylated interferon is included below.

Ribavirin – still used with some DAAs

Ribavirin (RBV) is a nucleoside analogue similar to some HIV drugs (“nukes”).

Ribavirin is an oral drug, given as pills or capsules, twice daily. It is usually dosed by body weight. Brand names for ribavirin include Copegus, Rebetrol and Ribasphere.

On its own, ribavirin does not directly work against HCV or HIV. However, it improves the response to pegylated interferon (PEG-IFN) treatment. RBV is also used with some DAA combinations, especially in people with cirrhosis.

Pegylated interferon – not recommended in HIV positive people

Interferon is a man-made version of a chemical that your body already produces. It works directly against HCV but also stimulates the immune system to fight viruses. PEG-IFN is a weekly injection.

There are two types of peginterferon, both given by injection.

  1. Alpha-2a (trade name Pegasys and manufactured by Roche). This comes as a liquid and is stored in the refrigerator. All adults use the same dose.
  2. Alpha-2b (trade names PegIntron or ViraferonPeg and manufactured by Merck). This comes as a powder that has to be reconstituted with purified water, both of which come in separate vials. The dose of PegIntron depends on your body weight.

However, side effects can be severe and treatment takes 6 to 12 months.

Ask your doctor how he/she will treat your side effects. With the right planning and support, their impact can be reduced.

Support from other people with HCV, friends, and family before and during HCV treatment plays a key role in coping with this.

The i-Base guide HIV and Your Quality of Life is about avoiding and managing side effects and other complications of HIV drugs.  It is just as relevant for HCV treatment.

This guide provides more detail about ways to manage most of the side effects listed below including depression, mood changes, diarrhoea, fatigue, nausea, weight loss, skin problems and insomnia.

It is also available online and in PDF format.

First HCV protease inhibitors – boceprevir and telaprevir

Boceprevir and telaprevir were the first DAAs to be approved.  They are no longer manufactured because of too many difficult side effects.

Last updated: 17 August 2017.