Hepatitis C: Interferon/ribavarin side effects

DOCTOR'S VIEWS ARCHIVE

Topic: Hepatitis C, June 2000

Dr. Lee:
What are the side effects of interferon/ribavirin combination ?

Dr. Edward Block:
There are unfortunately side effects that make treatment somewhat difficult. There are side effects that are unique to interferon and others that are unique to ribavirin.

The most common side effects are flu like symptoms and fatigue. This will complicate treatment in 60% to 70% of patients. This is felt to be largely related to interferon.

The other common side effects include a decrease in the white blood count, as well as in the platelet count (a blood clotting element). These are felt to be interferon side effects also.

The other side effects of interferon include depression, irritability, sleep disturbances, and anxiety as well as personality changes. Generally these are manageable but take a fair amount of counseling with the patients.

The most significant side effect of ribavirin is hemolytic anemia. Hemolytic anemia is a type of anemia due to destruction of red blood cells. While most patients will be able to continue treatment despite this hemolytic anemia, about 10% of the patients may need to reduce the ribavirin dose to ensure that the anemia does not become more severe.

Other side effects with ribavirin include cough, and some shortness of breath. There also may be some rashes although generally this is very treatable.

There is also the risk of birth defects; thus anybody who is pregnant or considering becoming pregnant cannot be taking ribavirin. Birth control measures MUST be taken during treatments with ribavirin.

Dr. Lee:
I might add that the birth defect risk exists regardless of the sex of the patient undergoing treatment. Thus birth control measures have to be taken even if the male partner is under treatment.

Dr. Edward Block:
I have treated many patients now with Hepatitis C, using combination treatment. It is rare for me to have a patient in whom treatment could not be successfully completed because of these side effects. So, despite side effects people generally do hang in there.

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