The most serious of hepatitis strains, the hepatitis C virus (HCV) can lead to significant liver damage and even liver cancer. Not all people, however, will need treatment. Your doctor will look at several factors to determine a course of action. Standard treatment for Hepatitis C is a combination of two particular drugs.
Treatment Guidelines
According to the National Institutes of Health, you should treat your HCV if tests indicate the virus is moving through your blood, if you have biopsy results that indicate serious liver damage and if you have increased levels of the liver enzyme alanine aminotransferase (ALT) in your bloodstream.
If your liver shows only small abnormalities, your chances of developing serious complications are slight. In this case, your doctor might not recommend treatment since it can cause very serious side effects. On the other hand, it is not possible to know for sure how your condition will progress, so some doctors might recommend fighting the virus.
Goal of Treatment
HCV treatment aims to remove the virus from your bloodstream. According to the Mayo Clinic, it gets rid of the virus in 40 to 80 percent of those treated. Success rates are based on genotype, which is the genetic make-up of an individual. The therapy has a success rate of up to 50 percent in people with genotype 1, the most common in the United States, while it works up to 80 percent of the time in those with types 2 and 3. Your doctor will determine your type before starting treatment.
Medication
The standard care for hepatitis C consists of a combination of two treatments.The first treatment, pegylated interferon alfa (Peg-Intron, Pegasys), injected weekly, is an anti-viral treatment that helps the immune system keep the virus from multiplying and attaching to other cells. The broad-spectrum antiviral medication ribavarin (Rebetol), taken twice a day orally, makes up the second half of treatment.
Treatment Timeline
You will require a high dose of medication for 48 weeks if you have genotype 1. If you have genotype 2 or 3, 24 weeks of treatment with a lower dose is usually sufficient. The first round of treatment may not clear the virus from your system, which will require a second course of the same medications.
Side Effects
These medications can cause serious side effects. Interferon medications can cause severe symptoms that mimic the flu, along with irritability, depression, memory loss, skin problems, fatigue and insomnia. Ribavarin can cause anemia (low red blood cell count), itchiness, nasal congestions, skin irritation, fatigue and birth defects.
When combined, these medications can induce psychosis and suicidal behavior in a minority of people; therefore, you are not a good candidate for this treatment if you have or have had in the past, uncontrolled depressive episodes. Other factors precluding treatment are pregnancy, untreated thyroid disease, low blood cell counts and autoimmune diseases. You are also not a good candidate if you drink alcohol or use drugs and are unwilling to stop or seek treatment.
The first few weeks of treatment usually produce the most serious side effects. Pain medications and antidepressants can sometimes mitigate these effects. For some people, interferon causes such severe side effects that they might have to stop treatment.
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