Antivirals for Hepatitis B, C and D Viruses
Hepatitis B virus and hepatitis C virus are the commonest causes of chronic liver disease in the world. Hepatocellular carcinoma which is caused by these viruses can be prevented by vaccination or by antivirals. There are a number of antivirals that can be used to treat patients infected with these viruses.
Hepatitis B
Alpha interferon
5 to 10 million unit three times a week for 3 to 6 months.
It is given by subcutaneous injection.
Pegylated interferon
For the dose seek advice from the manufacturers.
It is given once a week ( it has long half-life).
NB: interferon is contraindicated to treat patient with decompensated liver disease.
Lamivudine
v 100 mg po daily
Adefovir
v 10 mg po once daily
Indications
Ø These drugs are used to treat chronic hepatitis B virus infection.
Specific criteria to start treatment include
Hepatitis D
Alpha interferon
v 5 to 10 million units three times weekly for 3 to 6 months.
NB: Contraindicated in patient with decompensated liver disease.
Indications
Ø Chronic hepatitis D virus infection.
Hepatitis C
Alpha interferon
v 3 million units three times a week for 6 to 12 months
Pegylated interferon
Once a week (it has long half-life)
Combined therapy
v Ribavirin 1gm daily and interferon alpha or pegylated interferon
Indications
Ø Chronic hepatitis C virus infections
Ø Recently acquired infection( between 6-12 month)