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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 bodys 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.
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