Side Effects and Treatment Labs continued:
Uncommon but serious side effects associated with either ribavirin or interferon:
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Bacterial infections. |
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Exacerbation or initiation of autoimmune diseases. |
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Seizures. |
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Depression and psychosis. |
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Suicide. |
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Heart failure and renal failure. |
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Induction of fetal abnormalities or loss of fetus in pregnant patients. |
Although the above complications are rare they are severe and should be reported to your physician as soon as possible. A primary concern is depression. You should tell your physician if you feel you have problems with depression or suicidal thoughts. Interferon based regimens can exacerbate depression particularly in the second three month period of treatment. A simple depression score can be obtained to your physician's office that will help you and your physician assess your degree of depression more objectively.
Oftentimes abdominal pain occurs with treatment of hepatitis C with interferon base to regimens. This is usually mild and can be treated with small amount of acetaminophen (Tylenol). This is safe medication when used in small doses (about 2 to 3 grams per day) for patients without cirrhosis. However, you should always inform your physician to ensure that this is an appropriate drug for your particular case. Alternatives, which are available in over-the-counter preparations, include ibuprofen. This is a mild nonsteroidal anti-inflammatory drug that can be used in small amounts to ameliorate side effects of interferon. Since these drugs can cause other gastrointestinal problems, such as ulcers, is important for you to discuss this with your physician.
Nausea and fatigue are very commonly associated with both Hepatitis C and interferon regimens. It is important to understand that other causes of nausea and fatigue are present as well. Nausea and decreased appetite can be partially ameliorated by eating small frequent meals, avoiding acidic foods, adequate hydration, and use of higher protein based products such as yogurt and soy-based supplements. In some cases, and evaluation by nutritionist can be of significant help.
Overall, hepatitis C and its treatment should not preclude patients from pursuing their normal daily activities. Certainly companies may need to be restricted or limited during interferon based treatment regimens.
Summary of Terminology
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Viral Load: The amount of virus detected in the bloodstream of the individual patient. This is usually accomplished through a special test named polymerase chain reaction (PCR). Many times, a PCR is used interchangeably with a viral load. |
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Polymerase Chain Reaction (PCR): Also known by the abbreviation PCR, this is the most commonly used test to confirm the presence of virus in an individual patient. A PCR can be used in several situations:
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As a quantitative test in which the amount of virus (viral load) can be determined |
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As a qualitative test in which a simple positive or negative answer is reported. That is either there is virus or there is no virus in the patient's serum. |
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End Treatment Response (ETR): This term describes the response of a patient at the end of therapy. If the PCR is negative (no viral load) at the end of treatment, the patient is termed a responder. If the patient has virus present within the blood (viral load is positive), the patient is termed a non-responder. |
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Sustained Viral Response (SVR): Sustained viral response is the terminology used to describe a patient who has a negative viral load at the end of a predetermined follow-up period. The follow-up period may be 6, 12 or 24 months depending upon the situation. Most commonly, a sustained viral response is determined at 24 months after completion of therapy. |
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Endpoints: Endpoints are those goals of the particular study or treatment program for an individual patient or group of patients. The primary endpoints described in HCV studies are 1) liver histology, 2) quantitative PCR (viral load), and 3) liver function tests. |
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Nonresponder: Nonresponders are patients who have not responded to a particular medical therapy. |
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Responders: Responders are characterized by improvement in the PCR and/or liver function tests while on treatment. They remain PCR negative and have normal liver function tests, as well as improved histology, in follow-up. When a patient has completed 24 months or being a responder, the patient then has a sustained viral response (SVR). |
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Naive Patient: This refers to a patient who is not yet been treated with any form of medical therapy. |
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Relapse patients ("Relapsers"): Patient who initially responds to medical therapy but who have a relapse of their viremia after the medical regimen has been discontinued. Thus, these patients respond to medical therapy at end of treatment (ETR) but have a recurrence of their viremia or they "relapse". |
Globetrotter's Pocket Doc - the only English international medical communication book for travelers to foreign countries
Other Liver Pages:
- Acute Acalculus Cholecystitis |
Acute Calculus Cholecystitis |
Albumin |
Alcoholic Cirrhosis |
Alcoholic Liver Disease |
Alpha 1 Antitrysin Deficiency |
Autoimmune Hepatitis |
Bilirubin |
Common Bile Duct Stones |
Esophageal Varices |
Gallstones |
Hemochromatosis |
Hepatitis G Virus |
Hepatitis - General |
Hepatitis A |
Hepatitis B |
Hepatitis C |
Hepatitis D |
Hepatitis E |
Iron Overload Diseases |
Primary Biliary Cholangitis |
Primary Sclerosing Cholangitis |
Wilson's Disease
Related Links
- Definitions |
Liver Function Tests
Patient Education:
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