Turning the Corner in Hepatitis C Treatment (cont.)

Also, hepatitis C treatment is less effective in some populations. For reasons that no one understands yet, African-Americans are less likely to benefit from treatment. And the treatments may not be safe for people with other medical conditions -- such as kidney failure, heart disease, or pregnancy. Interferon can also be expensive; according to the American Academy of Family Physicians, it can cost $6,000 per year.

Even when hepatitis C treatment works, it can be difficult. Therapy lasts from 24 to 48 weeks. It requires weekly injections and regular check-ups. While pegylated interferon causes less severe side effects than older drugs, it can cause flu-like symptoms, fatigue, depression, muscle aches, and hair loss. More severe side effects are rare. Ribavirin can also cause potentially serious anemia.

"A lot of people come in expecting the treatment to be awful," says David Thomas, MD, professor of medicine at Johns Hopkins School of Medicine. "But it's often not so bad."

Also, while the length of treatment -- up to a year -- might seem daunting, Thomas encourages his patients to look at it in smaller steps.

"Within a couple of months of starting treatment, we can usually tell if it's working," Thomas says. He explains that if tests show that treatment isn't working after a few months, it's very unlikely that a full year's worth will do any good. As a result, your doctor may suggest stopping treatment.

But if treatment is working after a few months, there's almost a 70% chance that a full cycle of treatment will cure the disease, says Thomas. So a person has a good idea if treatment will work before committing to a whole year of it.

Who Needs Hepatitis C Treatment?

Before a person gets caught up in the pros and cons of treatment, it's important to consider a more basic question: do you need treatment at all? In many cases, you don't.

"A lot of people and even some doctors act like hepatitis C is cancer," says Howard J. Worman, MD, associate professor of medicine at Columbia University's College of Physicians and Surgeons. "They behave as if you'll get sick and die if you don't treat it right away. But that isn't what hepatitis C is like."

Since hepatitis C may not cause problems for decades, if at all, merely having the virus is no reason to begin treatment. Instead, doctors usually consider hepatitis C treatment in people who have high viral levels and biopsies that show fibrosis, or scarring of the liver.

"Deciding whether to get treatment is almost never an emergency," Worman tells WebMD. "It's usually not even urgent. People should take their time in deciding what to do."


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