Hepatitis C - Treatment Side Effects Experience

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

Common side effects of interferon or pegylated interferon include:

  • flu-like symptoms,
  • hair thinning, and
  • depression.

Depression may be serious and is common enough that patients should be monitored for this side effect, and often lead to discontinuation of the drug. Depression (if pre-existing) also is one of the most common reason to not treat patients.

Interferons may cause transient bone marrow suppression resulting in reduced white blood cell and/or red blood cell counts (leucopenia and anemia, respectively). Reductions in white blood cell counts may cause increased susceptibility to infection. Growth factors (erythropoietin) can be used to improve the anemia associated with interferon. 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.

The side effects of direct acting antivirals have fewer and more tolerable. The most common and significant side effects of direct acting antivirals include:

  • fatigue (feeling tired, lacking of energy),
  • headache, and
  • trouble sleeping (insomnia)

Boceprevir (Victrelis) also may cause (in the addition to the above):

  • irritability,
  • gastrointestinal upset, and
  • anemia.

Sofosbuvir (Sovaldi) also may cause:

  • less fatigue,
  • headache

Sofosbuvir has a minimal effect on blood counts.

The most common side effects of Simeprevir (Olysio) are:

  • itching,
  • skin rash, and
  • photosensitivity.

Simeprevir also has significant interactions with other medications. Certain medications that affect the levels of drug-eliminating enzymes in the liver, known as cytochrome P450, can affect levels of simeprevir in the body and make simeprevir less effective or more toxic.

Ledipasvir/sofosbuvir (Harvoni) is very well tolerated with the most common side effects being fatigue and headache.

The combination of ombitasvir, paritaprevir and ritonavir tablets with dasabuvir tablets (Viekira Pak) is also very well tolerated, and the most commonly reported side effects are:

  • fatigue,
  • trouble sleeping, and
  • itching.

These side effects usually do not require discontinuation of therapy and are self-limiting after completion of therapy

Return to Hepatitis C (HCV, Hep C)

See what others are saying

Comment from: a friend, 45-54 Female (Patient) Published: October 31

I found out I had hepatitis C 20 years ago but in the last couple of years my levels were elevated and I ended up on interferon and developed cirrhosis of the liver, stage 4. It was the hardest year of my life being on that treatment and it did a lot of damage to my teeth, you lose your hair (which of course grows back) and I got a lot of scarring from itching. The treatment has a lot of side effects and I will say causes major depression and suicidal thoughts. You need to have a lot of support which I didn't. I ended early (some people do the 6 month treatment and others have to do the yearlong treatment). I would say one needs to take good care of oneself while on the treatment. It did work for me but I'm just now, 13 months later, getting over the trauma of being on the treatment. Well, you have to do it or die from liver problems. I get checked every 3 months to see how I'm doing.

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Comment from: krystalblue, 55-64 Female (Patient) Published: December 12

It has been 11 years of recovery for me. I did the yearlong treatment which also most killed me. I lost over 50 lb., plus loss of hair which is so normal. I was stage 4 liver failure. Today I test as if I never suffered hepatitis C. Thanks modern science. My main concern is the memory loss and long term lack of concentration. My doctor told us of the memory loss but you always figure it would return, but still is deeply affected.

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