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Side Effects Of Hepatitis C Treatment With Interferon

What Conditions Do Interferons Treat

Managing Hepatitis C Treatment Side Effects in the Interferon Era

Interferon-alpha treats viral infections, including:

  • Chronic hepatitis C, hairy cell leukemia, Kaposi sarcoma caused by AIDS, chronic myelogenous leukemia
  • Chronic hepatitis, lymphoma, and malignant melanoma

But interferons aren’t used as often to treat these diseases newer drugs have come along that work better and faster.

Interferon-beta treats different types of multiple sclerosis. It eases inflammation in your brain and spinal cord to prevent nerve damage.

Interferon gamma-1b treats chronic granulomatous disease, which affects the way your immune system works, and severe malignant osteopetrosis, which affects your bones.

Certain types of interferon medications have a chemical called polyethylene glycol added to them. PEG makes the medicine last longer in your body, so you don’t need as many shots. These are called peginterferon drugs.

What Are The Names Of The Medications For Treating Hepatitis C

Since 2014, multiple different antiviral treatments for hepatitis C have been developed. With the many options now available, often there is more than one good choice for a patient. Some of the treatments are recommended as first-line options, some are second-line options, and others are used less commonly in light of all the available choices.

  • Elbasvir/Grazoprevir

Second line hepatitis C medications:

  • Sofosbuvir/Velpatasvir/Voxelaprevir

How Do Interferons Work

Interferons work in a few ways. For one, they change the way white blood cells destroy invading cells. This change triggers the bodys built-in immune response to fight viruses such as hepatitis C.

Interferons also help stop the spread of hepatitis C. Hepatitis C spreads by multiplying, or copying, its cells. Interferons would help stop the virus from multiplying, which helped slow the spread of the virus.

Interferons have other broad actions that dont target any virus in particular. This is one reason why these drugs can cause many side effects.

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Talking To Your Healthcare Professional About Treatment

Before visiting your healthcare professional to discuss treatment options, its a good idea to prepare a list of questions so that you make the best use of your time during the appointment. Some questions to ask include:

  • How much Hepatitis C virus do I have in my body?
  • What is my genotype?
  • Has the virus damaged my liver?
  • With treatment, can I be cured of the Hepatitis C virus?
  • What treatment options are available?
  • What are the benefits and risks of each option?
  • Do I have any conditions that affect my options?
  • Which option do you think is best for me and why?
  • How long will treatment last?
  • What side effects will I have? Are the side effects different between the treatment options?
  • Will my past medical history have any impact on how I will react to the different treatments ?
  • How will treatment affect my daily life?
  • Will treatment affect my ability to work?
  • What will the treatment cost and will my insurance cover it?
  • What else can I do to keep healthy and minimize damage to my liver?
  • What is the next step?

How Is Hepatitis C Treated

Secondary Hyperpigmentation During Interferon Alfa Treatment for ...

Hepatitis C virus is treated with all-oral medications. These pills, calledantiviral medications, are usually taken once per day. These antiviral medications are extremely good at attacking the virus and preventing it from multiplying.

Antiviral medications were not the original treatment for hepatitis C. Before 2014, the only treatment for hepatitis C was called interferon and ribavirin, taken as weekly injections under the skin, plus pills. Interferon treatment caused many unpleasant side effects and was not usually successful. Then a new generation of medications became available. These antiviral treatments are extremely successful at curing the virus and have very minimal side effects.

Ribavirin is still sometimes prescribed to be taken along with the new antiviral medicines, but it has become more and more uncommon that ribavirin is needed at all. Ribavirin has some mild-moderate side effects. Ribavirin is a pill taken twice per day, as 2 or 3 pills in the morning plus 2 or 3 pills at night, depending on the patient’s body weight. Most patients do not need ribavirin.

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What About Complementary Therapies

Some people seek out complementary or alternative ways to treat their Hepatitis C. Complementary and alternative medicine, known as CAM, includes a variety of interventions. Some common complementary therapies include the following:

Relaxation techniques, such as meditation and visualization

  • These focus on how a persons mind and imagination can promote overall health and well-being.

Physical techniques, such as massage, yoga, and tai chi

  • These focus on using a persons body and senses to promote healing and well-being.

Herbal medicine

  • These are substances that come from plants. They can be taken from all parts of a plant, including the leaves, roots, flowers and berries.

These therapies, which are based on different traditions and disciplines, are generally considered to be outside the realm of conventional Western medicine. When used with conventional medicine, they are referred to as complementary. When used instead of conventional medicine, they are considered alternative.

Generally, physical and relaxation therapies are safe. However, some complementary medicines can be dangerous, particularly for people who have liver disease. Many people use complementary medicines because they believe that its natural and therefore healthy and harmless. But natural does not equal healthy or safe. Poison ivy is natural, but its certainly not harmless.

For more detailed information about Hepatitis C and complementary therapies, you can visit the NCCIH website.

Paroxetine For The Treatment Of Interferon Related Side Effects For Hepatitis C

The safety and scientific validity of this study is the responsibility of the study sponsor and investigators. Listing a study does not mean it has been evaluated by the U.S. Federal Government. Read our disclaimer for details.
First Posted : September 21, 2005Last Update Posted : April 11, 2016

A.OVERVIEW

This is a 26 week study examining the ability of paroxetine to prevent the development of depression and neurotoxicity in patients receiving either 3 million units of subcutaneous IFN 3 times/week ) or PEG interferon-alpha-2b and ribavirin for chronic hepatitis C . The IFN plasma half life of PEG, a CHC treatment recently approved by the FDA, is significantly prolonged allowing for once a week dosing. Studies indicate that the side effect profile of the two forms of IFN-alpha treatment are very similar. CHC patients will be screened for study eligibility, and a total of 100 CHC patients between the ages of 18 and 65 years old will be enrolled across three sites Two weeks prior to treatment with subcutaneous IFN-alpha-2b, patients who meet inclusion and exclusion criteria will be stratified on the basis of a history of major depression and then randomly assigned to paroxetine or placebo in double blind fashion.

Condition or disease
Hepatitis CDepressionInterferon-alpha Associated Side Effects Drug: paroxetine

Exclusion Criteria:

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Are There Ways To Cure Hepatitis C Other Than With Medications

Patients sometimes ask whether there are ways to treat hepatitis C other than taking medicines. Currently, there are no vaccines to prevent hepatitis C. Once a person is infected, the only way to treat it is with prescribed antiviral medications.

Some patients worry that having hepatitis C means they will need a liver transplant. Only a very small fraction of people with hepatitis C require a liver transplant. By far, most people with hepatitis C never need a liver transplant. A transplant is performedonlywhen damage to the liver is extremely advanced and the liver is unable to perform its basic functions. A transplant provides a new working liver, but a transplant does not get rid of the hepatitis C virus in the patient. Patients with a liver transplant still need antiviral medication to cure their virus.

Interferons And Pegylated Interferons

What You Need to Know About Interferon Beta (Avonex®, Betaseron®, Extavia®, Rebif®)

The two most frequently used recombinant interferon preparations in clinical trials have been IFN alfa-2b and IFN alfa-2a , which differ from each other by only a single amino acid residue. IFN alfacon-1 , or consensus IFN, is a genetically engineered compound synthesized by combining the most common amino acid sequences from all 12 naturally occurring IFNs. Roferon-A was discontinued from the market in 2007 and Infergen was discontinued from the market in 2013.

The addition of propylene glycol molecules to IFN has led to the development of long-lasting IFNs that have better sustained absorption, a slower rate of clearance, and a longer half-life than unmodified IFN, which permits more convenient once-weekly dosing. The FDA has approved PEG-IFNs for the treatment of chronic hepatitis C.

Two PEG-IFN preparations are available for the treatment of chronic hepatitis C. PEG-IFN alfa-2b consists of IFN alfa-2b attached to a single 12-kd PEG chain it is excreted by the kidneys. PEG-IFN alfa-2a consists of IFN alfa-2a attached to a 40-kd branched PEG molecule it is metabolized predominantly by the liver.

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Why Would My Doctor Prescribe Interferons

Until recently, treatments for hepatitis C focused on interferons and ribavirin. These drugs were used in an attempt to cure the hepatitis C infection. However, they were only effective some of the time.

Effective treatment with these medications would prevent liver disease and cirrhosis . In addition, effective treatment would decrease the risk of liver cancer and help prevent liver failure.

But today, interferons arent typically prescribed to treat hepatitis C. In recent years, DAAs have become available, and they have a cure rate of up to 99 percent . These drugs require a shorter treatment time and typically have fewer side effects than interferons. However, theyre very expensive, and most of them only treat certain types of hepatitis C.

The type of DAA your doctor might prescribe would depend on your insurance coverage and the type of hepatitis C you have. Some examples of DAAs include:

Potential Outcomes Of Treatment

In order to adequately monitor your response to treatment, youll need to visit your healthcare provider so he or she can examine you in person and discuss how youre feeling. The level of Hepatitis C virus in your bloodstream will be checked to monitor your response to treatment. The potential outcomes of treatment are the following:

  • Sustained virologic response : You are considered cured if the Hepatitis C virus is not detected when measured with a blood test three months after youve completed treatment. This is called a sustained virologic response and data suggest that you will stay virus free indefinitely.
  • Nonresponse: The Hepatitis C virus does not become undetectable as a result of treatment. This can be further categorized as partial response, when the viral levels become lower but not undetectable, or null-response which is when the viral level never drops significantly.
  • Relapse: The Hepatitis C virus becomes undetectable on treatment, but then is detectable again, either during treatment or after treatment is stopped.
  • Incomplete treatment: Treatment ended earlier that the prescribed duration.

The goal of treatment is to have an SVR. This is when you are considered cured. Taking your medication as prescribed will increase your chance of being cured and decrease the long-term complications of Hepatitis C.

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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:

Depression Anxiety And Other Psychiatric Side Effects With Old Hcv Treatment

HCV New Drugs: Treatment of chronic hepatitis C: The new standard of ...

However, depression and anxiety are common side effects of old HCV drugs: peg interferon and ribavirin.

In rare cares, this includes feeling suicidal, and a few people have committed suicide during their HCV treatment.

A history of depression may increase this risk, although these side effects are also common in people without this history. Peginterferon can also cause mood swings, irritability, difficulty sleeping and psychosis.

Access to mental health care before, during and sometimes after HCV treatment is important. This will help treat psychiatric side effects promptly and appropriately.

Some people start an antidepressant before going on peginterferon. You may need to try more than one antidepressant to find one that is effective. Because antidepressants and other psychiatric drugs have their own side effects, other people only use these drugs only if and when they get symptoms.

An antidepressant can make a big difference. Depression causes some people to stop HCV treatment too early, when it was otherwise working well.

Your own history and how you feel about this are also important.

If you have not had depression or mental illness you will need to know about the symptoms. This makes it important to talk to your doctor about this before starting treatment.

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What Are The Possible Side Effects Of Interferon Alfa

Get emergency medical help if you have any of these signs of an allergic reaction: hives chest tightness, wheezing, feeling like you might pass out swelling of your face, lips, tongue, or throat.

Call your doctor at once if you have flu symptoms such as fever, chills, and body aches.

Less serious side effects may include:

This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

Anaemia Neutropenia And Thrombocytopenia Old Hcv Drugs

Modern HCV drugs are easy to take with few side effects.

However, a low CD4 cell count sometimes causes low white and/or red blood cell counts or a low platelet count .

Regular blood tests during old HCV treatment with pegylated interferon and ribavirin are especially important for people with coinfection.

Anaemia is a side effect of ribavirin, peginterferon and two old HCV protease inhibitors . In 2017, these drugs are not longer recommended also sometimes ribavirin might still be used.

The most common symptom of anaemia is fatigue. Anaemia can also be caused by AZT although this is rarely used in the UK, especially during HCV treatment.

Frequent monitoring is important when using any HCV treatment because anaemia can develop quickly. With both telaprevir and boceprevir, monitoring is recommended with any symptoms and at weeks 2, 4, 8 and 12. Anaemia may be less common with simeprevir*.

People with coinfection may need more aggressive management of anaemia, especially if they have cirrhosis.

Three main ways to treat anaemia are:

  • With boceprevir- and telaprevir-based treatment, it is best to lower the dose of ribavirin. This will not make treatment less effective. When just using peginterferon and ribavirin, the impact of dose reduction is less clear.
  • Another strategy is to use epoetin-alpha . This is a red blood cell growth factor, given by injection, which reduces fatigue and helps people to stay on ribavirin.
  • Severe anaemia is treated by blood transfusions.
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    Who Treats Hepatitis C

    If you think you are at risk of having Hepatitis C, talk to your current healthcare provider about getting tested. Once youve been diagnosed with Hepatitis C infection, you may want to see a specialist. Specialists who work with people with Hepatitis C include the following healthcare providers:

    • Doctors who specialize in liver diseases
    • Doctors who specialize in stomach and intestinal diseases
    • Doctors who specialize in infectious disease
    • Nurse practitioners whose practice concentrates on people with liver diseases

    Nurse practitioners are registered nurses who are prepared through advanced education and clinical training to assume some of the duties formerly assumed only by physicians. They work in a medical care team, and can provide a wide range of health care services, including the diagnosis and management of common, as well as complex medial conditions.

    Hepatitis C: Interferon/ribavarin Side Effects

    Efficacy of an Interferon- and Ribavirin-Free Regimen of Daclatasvir…
    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 . 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.

    Please remember, information can be subject to interpretation and can become obsolete.

    Back to Doctors’ Dialogue Index

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