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 . 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 . 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 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
- The most common and significant side effects of boceprevir , sofosbuvir , and ledipasvir/sofosbuvir include
- fatigue ,
You Can Have It And Not Know It
What is Hepatitis C?
Hepatitis C is a liver disease caused by the hepatitis C virus . HCV is far more infectious than HIV. Presently, there is no vaccine to prevent HCV infection.
In 2011, it is estimated that over 220,000 people in Canada were infected with HCV. In 2012, 10,180 new cases of hepatitis C were reported in Canada. It has been estimated that over 40% of people living with chronic hepatitis C don’t even know they are infected.
About 15 to 25 percent of adults will recover within 6 months of becoming infected . The remaining 75 to 85 percent are unable to clear the virus and will become chronically infected. Chronic hepatitis C is treatable and in some instances can be cured.
Why is hepatitis C a health concern?
Many people infected with HCV do not know they have the virus because symptoms can take two to six months to appear and the majority of people will not develop symptoms. During this time, they can spread the infection to others. You may not know you have this infection until damage has already been done to your liver. Potential complications from chronic hepatitis C include cirrhosis of the liver, liver failure, liver cancer and premature death.
Why do I need my liver?
How is hepatitis C virus spread?
Organization:
The most common risk factors for HCV infection include:
What are the symptoms of hepatitis C?
How can I find out if I have hepatitis C?
How can I protect myself and others against HCV?
What if I have hepatitis C?
Remember:
Antiviral Medication For Hepatitis B
Doctors may recommend antiviral medication for people with chronic hepatitis B, which occurs when the virus stays in your body for more than six months.
Antiviral medication prevents the virus from replicating, or creating copies of itself, and may prevent progressive liver damage. Currently available medications can treat hepatitis B with a low risk of serious side effects.
NYU Langone hepatologists and infectious disease specialists prescribe medication when they have determined that without treatment, the hepatitis B virus is very likely to damage the liver over time. People with chronic hepatitis B may need to take antiviral medication for the rest of their lives to prevent liver damage.
There are many different types of antiviral medications available, and your doctor recommends the right type for you based on your symptoms, your overall health, and the results of diagnostic tests. A doctor may take a wait-and-see approach with a person who has a healthy liver and whose blood tests indicate a low viral load, the number of copies of the hepatitis B virus in your bloodstream.
Someone with HIV infection or AIDS may have a weakened immune system and is therefore more likely to develop liver damage. The U.S. Centers for Disease Control and Prevention strongly recommends that people with HIV infection who are diagnosed with hepatitis B immediately begin treatment with antiviral medication.
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Medical Treatment For Hepatitis A B & C
Treatment for hepatitis A, B, or C is based on which type of hepatitis is present in the bloodstream and the severity of the resulting liver damage. Depending on the results of diagnostic tests, our specialists at NYU Langone may recommend antiviral medication to stop the virus from replicating and protect your liver from further damage.
What Medications Cure Hepatitis C Infection
Interferons, for example, Roferon-A and Infergen, and pegylated interferons such as Peg-IntronT, Pegasys, were mainstays of treatment for years. Interferons produced sustained viral response of up to 15%. Later, peglatedll forms produced SVR of 50%-80%. These drugs were injected, had many adverse effects, required frequent monitoring, and were often combined with oral ribavirin, which caused anemia. Treatment durations ranged up to 48 weeks.
Direct-acting anti-viral agents are antiviral drugs that act directly on hepatitis C multiplication.
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Cost Of Hepatitis C Medicines
The newer direct-acting antiviral medicines for hepatitis C can be costly. Most government and private health insurance prescription drug plans provide some coverage for these medicines. Talk with your doctor about your health insurance coverage for hepatitis C medicines.
Drug companies, nonprofit organizations, and some states offer programs that can help pay for hepatitis C medicines. If you need help paying for medicines, talk with your doctor. Learn more about financial help for hepatitis C medicines.
Can Hcv Treatment Cure The Joint Pain
According to the American College of Rheumatology, 97% of people that take direct-acting antivirals for HCV fully recover from the virus. In many cases, treating the infection improves or completely cures any joint pain.
For this reason, it is important to seek testing and treatment as soon as possible to prevent any long-lasting damage to the joints. In the meantime, joint and liver specialists should work together to help manage a persons joint pain in a safe and effective way, as certain arthritis drugs may not be suitable for those with HCV.
For example, several RA drugs can damage the liver. If a person already has some liver damage due to advanced HCV, these drugs will not be suitable for them. Anti-tumor necrosis factor drugs appear to be safe for use in people with HCV, and researchers are testing more.
Anyone who suspects they may have HCV should speak with a doctor as soon as they can. This may be because they have new or unexplained symptoms, because they have several risk factors for contracting HCV, or both.
Tell a doctor about any:
- joint pain or stiffness
- tiredness that is causing difficulty with daily activities
- low-grade fever
These symptoms do not necessarily mean a person has HCV, but a doctor can investigate the cause and find out.
It is also important to tell a doctor about any risk factors that make contracting HCV more likely. These include:
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Side Effects Of Treatment
Treatments with direct acting antivirals have very few side effects. Most people find DAA tablets very easy to take.
You may feel a little sick and have trouble sleeping to begin with, but this should soon settle down.
Your nurse or doctor should be able to suggest things to help ease any discomfort.
You need to complete the full course of treatment to ensure you clear the hepatitis C virus from your body.
If you have any problems with your medicines, speak to your doctor or nurse straight away.
Side effects for each type of treatment can vary from person to person.
For a very small number of people, more severe side effects from hepatitis C treatments may include:
Contagious And Incubation Periods
The incubation periodthe time it takes for symptoms to appear after the hepatitis C virus has entered your bodyis from 2 weeks to 6 months. But not all people have symptoms when they are first infected.
You can spread the virus to someone else at any time after you are infected, even if you don’t have symptoms.
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You May Not Need Treatment
Not everyone with hepatitis C will need to receive these expensive treatments. In up to of people with hepatitis C, the virus clears on its own within a few months without any need for medication. Your doctor will monitor you closely to see if your condition persists, and then decide if you need treatment.
How Can I Prevent Spreading Hepatitis C To Others
If you have hepatitis C, follow the steps above to avoid spreading the infection. Tell your sex partner you have hepatitis C, and talk with your doctor about safe sex practices. In addition, you can protect others from infection by telling your doctor, dentist, and other health care providers that you have hepatitis C. Dont donate blood or blood products, semen, organs, or tissue.
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Getting Tested For Hepatitis C
Seek medical advice if you have persistent symptoms of hepatitis C or there’s a risk you’re infected, even if you do not have any symptoms.
A blood test can be carried out to see if you have the infection.
GPs, sexual health clinics, genitourinary medicine clinics or drug treatment services all offer testing for hepatitis C.
Early diagnosis and treatment can help prevent or limit any damage to your liver, as well as help ensure the infection is not passed on to other people.
What Causes Hepatitis C
The hepatitis C virus causes hepatitis C. The hepatitis C virus spreads through contact with an infected persons blood. Contact can occur by
- sharing drug needles or other drug materials with an infected person
- getting an accidental stick with a needle that was used on an infected person
- being tattooed or pierced with tools or inks that were not kept sterilefree from all viruses and other microorganismsand were used on an infected person before they were used on you
- having contact with the blood or open sores of an infected person
- using an infected persons razor, toothbrush, or nail clippers
- being born to a mother with hepatitis C
- having unprotected sex with an infected person
You cant get hepatitis C from
- being coughed or sneezed on by an infected person
- drinking water or eating food
- hugging an infected person
- shaking hands or holding hands with an infected person
- sharing spoons, forks, and other eating utensils
- sitting next to an infected person
A baby cant get hepatitis C from breast milk.18
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A Cure For Hepatitis C
It kills more Canadians than any other virus. Now theres a cure, but few can afford it.
John Woods/Macleans
Linda Zimmerman was at the end of her rope when she went into a health food store in 2008 searching for something to soothe her strange symptoms. Her doctor said her blood platelets were low. She bruised easily. Leg cramps and an unscratchable itch kept her up every night. Then a store employee suggested something might be amiss with her liver. The retired nurse from Winkler, Man., turned to Dr. Google for help. I put in allergies and low platelets and liver, I think it was, the 66-year-old says. Things started to come together.
Her family doctor found Zimmermans liver enzymes had been out of whack since 2004, and a test revealed she had hepatitis C, a blood-borne viral disease that attacks the liver. It affects an estimated 300,000 Canadians and kills around 500 every year, more than any other single virus, including HIV/AIDS and seasonal flu.
Snorting or injecting drugs even once, patronizing a less-than-sanitary tattoo joint, receiving immunizations during military service or getting a blood transfusion or a transplant before July 1990 are just a few of the ways people get it. Zimmerman had been walking around with the virus since July 31, 1976, the day her youngest son was born and she received tainted blood.
Hepatitis C Drugs Are Pricey
Antiviral drugs for hepatitis C are very effective, but they come at a steep cost. Just one Sovaldi pill costs $1,000. A full 12-week course of treatment with this drug costs $84,000.
The price of other hepatitis C drugs is also high:
- Harvoni costs $94,500 for a 12-week treatment
- Mavyret costs $39,600 for a 12-week treatment
- Zepatier costs $54,600 for a 12-week treatment
- Technivie costs $76,653 for a 12-week treatment
Hepatitis C drugs are expensive due to the large demand for them, and the high cost of bringing them to market. Developing a new drug, testing it in clinical trials, and marketing it can run pharmaceutical companies nearly $900 million.
Another factor adding to the high cost is the lack of a national health care system to negotiate medication costs on behalf of consumers. Theres also little competition from other drug companies. As a result, hepatitis C drug manufacturers can essentially charge whatever they want.
Prices could drop in the future as more pharmaceutical companies get into the hepatitis C drug market. The introduction of generic versions of these drugs should help drive costs down.
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What Are The Complications Of Undiagnosed Hepatitis C
- Hepatitis C is known to be associated with two skin conditions, lichen planus and porphyria cutanea tarda.
- Diabetes, heart disease, and arterial blockage are more common among patients with chronic hepatitis C infection than in the general population. It may be that liver damage and chronic inflammation caused by hepatitis C may affect the levels of blood fats and blood sugar.
- Low platelet counts may occur as a result of the destruction of platelets by antibodies.
Hepatitis C And Health
How can health-care personnel avoid exposure to HCV?
Avoiding occupational exposure to blood is the primary way to prevent transmission of bloodborne illnesses among health-care personnel. To promote blood safety in the workplace, health-care personnel should consult infectious-disease control guidance from the National Institute for Occupational Safety and Health and from CDC. Depending on the medical procedure involved, Standard Precautions may include the appropriate use of personal protective equipment .
What is the risk of acquiring hepatitis C after being accidentally exposed to HCV-contaminated blood or body fluids in the workplace?
Although sharps injuries have decreased in recent decades due to improved prevention measures, they continue to occur, placing health-care personnel at risk for several bloodborne pathogens like hepatitis C. A recent analysis of several studies revealed an overall 0.2% risk for infection among those exposed to HCV-antibody-positive blood through needlestick or sharps injuries . Updated guidelines for management and treatment of hepatitis Cexternal icon are available to provide guidance for health-care personnel who become infected via exposure to contaminated blood at the workplace.
Other than needlesticks, do other exposures place health-care personnel at risk for hepatitis C?
Should HCV-infected health-care personnel be restricted in their work?
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Appropriate Uses Of The Hcv Rna Test
There are 4 major reasons that HCV RNA tests are used:
More rarely, HCV RNA is used when either very acute HCV infection is suspected or a false HCV Ab is suspected.
It would not be appropriate to repeatedly order HCV RNA viral load screening for a patient who is not on or was recently on HCV treatment, or to use the HCV viral load to determine the severity of the patient’s infection or the patient’s risk of developing significant liver disease.
Who Is Most At Risk Of Contracting Hepatitis C
You have a high risk of contracting hepatitis C if you:
- use or have used injection drugs even if it was just once or many years ago
- have received blood or blood products or an organ transplant before July 1990 in Canada
- have been in jail or
- have been injected or scratched during vaccination, surgery, blood transfusion or a religious/ceremonial ritual in regions where hepatitis C is common.
You have a high moderate risk of contracting hepatitis C if you:
- have tattoos or body piercing
- have multiple sexual partners
- have a sexually transmitted infection , including HIV or lymphogranuloma venereum
- have experienced traumatic sex or rough sex or have used sex toys or fisting that can tear body tissue
- have vaginal sex during menstruation
- have received a kidney treatment
- have received an accidental injury from a needle or syringe
- have another infectious disease
- were born to a hepatitis C infected mother or
- have a sexual partner infected with hepatitis C.
Hepatitis C is NOT passed from person to person by:
- coughing, sneezing
- breastfeeding unless your nipples are cracked and bleeding or
- oral sex, unless blood is present.
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Antiviral Medication For Hepatitis C
For people with hepatitis C, the goal of treatment with antiviral medication is to prevent the virus from replicating, or copying itself, and to eliminate the virus from the bloodstream. If the hepatitis C virus has been in the body for more than six months, the infection is considered chronic. Without treatment, most people with acute hepatitis C develop the chronic form of the disease.
Your doctor decides which antiviral medicationor combination of medicationsto prescribe based on the results of a blood test called a genotype test. There are six genotypes, or strains, of the hepatitis C virus, and people with certain genotypes respond more quickly to medical treatment.
For many years, the standard treatment for chronic hepatitis C consisted of the antiviral medications pegylated interferon and ribavirin. Ribavirin is taken by mouth every day, and interferon is an injection that you or a caregiver can administer once a week at home.
In 2013 and 2014, the U.S. Food and Drug Administration approved a group of new medications for the treatment of hepatitis C. These medications, which include sofosbuvir, are very effective and have fewer side effects than older medications, particularly interferon.