Turning the Corner in Hepatitis C Treatment (cont.)
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."
In cases where a person has acute hepatitis C -- meaning that he or she has recently been infected - Worman does advise quick treatment because it's likely to work in the early stages. However, he and other experts don't see many cases of acute hepatitis. Most of the people newly diagnosed with hepatitis C have had the virus for a long time.
One frustrating aspect of the disease is that it's hard to predict how it will develop in any one person. While many people will go decades without problems, others will have faster progression of the disease. No one knows why. Currently, the only good way to find out how a person is doing is with periodic liver biopsies.