Hepatitis C Infection (HCV, Hep C)

  • Medical Author:

    Sandra Gonzalez Gompf, MD, FACP is a U.S. board-certified Infectious Disease subspecialist. Dr. Gompf received a Bachelor of Science from the University of Miami, and a Medical Degree from the University of South Florida. Dr. Gompf completed residency training in Internal Medicine at the University of South Florida followed by subspecialty fellowship training there in Infectious Diseases under the directorship of Dr. John T. Sinnott, IV.

  • Medical Author: Siddharth Bansal, MD
    Siddharth Bansal, MD

  • Medical Author: Ashwani Singal, MD, MS, FACG
  • Medical Editor: Jay W. Marks, MD
    Jay W. Marks, MD

    Jay W. Marks, MD

    Jay W. Marks, MD, is a board-certified internist and gastroenterologist. He graduated from Yale University School of Medicine and trained in internal medicine and gastroenterology at UCLA/Cedars-Sinai Medical Center in Los Angeles.

blood test hepatitis C std lab

Quick GuideHepatitis C Pictures Slideshow: Transmission, Symptoms and Treatment

Hepatitis C Pictures Slideshow: Transmission, Symptoms and Treatment

What are the side effects of treatments for hepatitis C infection?

Side effects of interferon or pegylated interferon

  • The most common side effects of interferon or pegylated interferon include fever, flu-like symptoms, and depression. Patients must be monitored closely for depression. Risk of suicide is a reason to avoid interferons.
  • Interferons also reduce white blood cell and/or red blood cell counts (leucopenia and anemia, respectively). This may cause increased susceptibility to infection. Interferons also increase the risk of certain cancers. Death rarely occurs as a result of therapy, but may occur from progression of liver failure in patients with advanced cirrhosis.

Side effects of ribavirin

  • Ribavirin most commonly causes anemia due to destruction of red blood cells (hemolysis). This can be severe enough that people with heart disease may suffer a heart attack from insufficient blood flow, so people with heart disease should not receive this drug. Anemia improves with a reduction in the dose of ribavirin. Injected growth factor (erythropoietin) that stimulates the production of red blood cells often is used to improve the anemia associated with ribavirin. Ribavirin also accumulates in the testicles and ovaries and causes birth defects in animals. Although no birth defects have been reported in humans, both men and women should use contraceptive measures to avoid pregnancy during and for at least six months after ribavirin treatment.

Side effects of DAAs

Compared to these drugs, the side effects of DAAs are far fewer and more tolerable. These side effects usually do not require discontinuation of therapy and are self-limiting after completion of therapy.

  • The most common and significant side effects of boceprevir (Victrelis), sofosbuvir (Sovaldi), and ledipasvir/sofosbuvir (Harvoni) include
  • The most common side effects of simeprevir (Olysio) include
  • Simeprevir has significant drug interactions with other medications. Certain medications can affect levels of simeprevir in the body and make simeprevir less effective or more toxic.
  • The combination of ombitasvir, paritaprevir, and ritonavir tablets with dasabuvir tablets (Viekira Pak) is very well tolerated, and the most commonly reported side effects are
    • fatigue,
    • trouble sleeping, and
    • itching.
  • The combination of elbasvir and grazoprevir (Zepatier) is well-tolerated. Most common side effects include
    • fatigue,
    • headache, and
    • nausea.
    • It may be used with ribavirin, which adds the side effect of anemia.
    •  About 1% of people in studies may develop elevated liver enzyme blood tests last into treatment or afterward, so these tests are closely monitored.
  • Use of milk thistle should be discussed with the treating doctor, because it interacts with several DAAs.
Medically Reviewed by a Doctor on 4/12/2016

Subscribe to MedicineNet's Newsletters

Get the latest health and medical information delivered direct to your inbox!

By clicking Submit, I agree to the MedicineNet's Terms & Conditions & Privacy Policy and understand that I may opt out of MedicineNet's subscriptions at any time.

VIEW PATIENT COMMENTS
  • Hepatitis C - Diagnosis

    What kinds of tests did you have to diagnose hepatitis C?

    Post View 20 Comments
  • Hepatitis C - Symptoms

    What symptoms did you experience with hepatitis C?

    Post View 30 Comments
  • Hepatitis C - Treatment and Medications

    What methods of treatment, including medication, have you received for hepatitis C?

    Post View 11 Comments
  • Hepatitis C - Treatment Side Effects Experience

    Describe the side effects associated with your treatment for hepatitis C.

    Post View 8 Comments
  • Hepatitis C - Experience

    Please share your experience with hepatitis C infection.

    Post View 2 Comments

Health Solutions From Our Sponsors