Hepatitis C (cont.)
In this Article
How are relapses and nonresponders treated?
- The optimal treatment for nonresponders and relapsers is
not well established.
- A minority of nonresponders (6% to 12%) will respond to a
second course of pegylated interferon and ribavirin.
- Patients initially treated
with older interferon alpha monotherapy can be considered for the therapy of
either pegylated interferon alpha monotherapy or pegylated interferon alpha plus
ribavirin therapy.
- Newer preparations of interferon such as 'consensus
interferon' and albumin interferon are being studied and show promise in persons
who did not respond to combination therapy.
Despite the failure to achieve
sustained virologic response, treatment may slow the progression of HCV to
cirrhosis, although this has not been shown for certain.
Should individuals with acute hepatitis C be treated?
When people first acquire HCV, the infection is said to be 'acute'. There is
no standard approach to treatment for acute HCV. Most patients with acute HCV do
not have symptoms, so they are not recognized as being infected. However, some
have low-grade fever, fatigue or other symptoms that lead to an early diagnosis.
Others who become infected have a known exposure to an infected source, such as
a needlestick injury, and are monitored closely. Treatment decisions should be
made on a case-by-case basis. However many experts prefer to hold treatment for
several months to see whether the patient eliminates the virus without
treatment.
What are the side effects of treatment for hepatitis C virus?
Flu-like symptoms, hair thinning and depression are common side effects of
interferon or pegylated interferon. Depression may be serious and is common
enough that patients should be monitored for this side effect.
Interferons may
cause transient bone marrow suppression resulting in reduced white blood cell counts and hemoglobin. Reductions in white blood cell counts may
cause increased susceptibility to infection. Death rarely occurs as a result of
therapy, but may occur from progressive liver failure in patients with advanced cirrhosis.
Certain side effects are attributed to the addition of
ribavirin to interferon, including nausea, cough, shortness of
breath, rash, itching, insomnia, and loss of appetite.
Ribavirin also causes anemia due to the
destruction of red blood cells (hemolysis). This anemia is usually mild but can
become clinically significant. Ribavirin particularly may cause destruction of
red blood cells (hemolysis) in people with kidney failure. Anemia improves with
a reduction in the dose of ribavirin.
Ribavirin also accumulates in the
testicles and ovaries
and causes birth defects in animals. Although no birth defects have been
reported in humans as yet, both men and women should use contraceptive measures
to avoid pregnancy during and for at least six months
after ribavirin treatment.
Next: What about liver transplantation for hepatitis C? »
- interferon - Describes the medication interferon (Roferon-A, Intron-A, Rebetron, Alferon-N, Peg-Intron, Avonex, Betaseron, Infergen, Actimmune, Pegasys), a drug used in managing many diseases that involve the immune system.
- Liver Blood Tests - Learn about liver blood tests used to detect liver damage disease such as fatty liver, cirrhosis, hepatitis, Tylenol liver damage, and more. This includes measuring the aminotransferases enzymes (AST and ALT levels)
- Diabetes - Learn about type 1 and 2 diabetes (Diabetes Mellitus) symptoms including increased urination, thirst, weight loss, fatigue, nausea, vomiting, skin infections, and blurred vision. Causes and diagnosis information is provided in the information.
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