Hepatitis C treatment side effects and forthcoming drugs , hepatitis treatment

Hepatitis C treatment

hepatitis c treatment

Before the introduction of the first doses of antiviral drugs need to donate blood for the general analysis, biochemical analysis, thyroid hormones, coagulation, PCR for HCV-RNA (qualitative, quantitative genotyping, if earlier, these parameters have not been investigated.)In the presence of high hemoglobin levels (above 160 g / l) in patients with chronic hepatitis C is recommended to explore and serum iron.After 2 weeks of therapy performed complete blood count, blood chemistry, can monitor HCV-RNA in serum as early disappearance of HCV-RNA is considered a favorable prognostic factor in the effectiveness of treatment.Further, even after two weeks, and subsequently once per month 1 analyzes are repeated in a given volume. Every 3 months is necessary to control the thyroid hormones. If necessary, your doctor may prescribe additional tests and.Inspection and evaluation of the results of laboratory tests required monthly consultations physician for medication side effects or complications were detected and corrected in time, but rather, to undesirable phenomena threatening not evolved.

Adverse effects of antiviral therapy

Combined therapy with interferon and ribavirin in patients regularly, there are some side effects. Young people, in most cases quite well-tolerated treatment for hepatitis C, quickly adapt to it. Ribavirin is generally well tolerated. But quite often in the overall analysis of the phenomena of light blood hemolytic anemia (destruction of red blood cells). Phenomena can be observed mild dyspepsia, rarely headache, increased levels of uric acid in the blood is very rarely observed drug intolerance. If treatment is indicated interferons, the side effects can not be avoided, but they are predictable. After the first injection of interferon in the majority of patients have flu-like symptoms. After 2-3 hours the temperature rises to 38-39 0 C may be chills, muscle pain, joint pain, severe weakness. The duration of this condition can vary from a few hours to 2-3 days. Within a month the body adapts to the introduction of interferon, so that time disappears flu syndrome. Saved weakness, fatigue, but this has to be reconciled. On the second or third month of treatment may show changes in the blood count. Naturally decreases the number of leukocytes (white blood cells), platelets. It is important to monitor the extent of these changes, it is the task of the doctor. If necessary, reduce the dose of interferon or even cancel them for a certain period of time until the blood counts are restored to a safe value. Marked reduction in the number of leukocytes may facilitate adherence of bacterial infections, and low platelet count can cause hemorrhagic syndrome (bleeding). It is important to prevent these complications, so all patients receiving interferon, one must once a month without fail be to visit a doctor and perform control blood tests (complete blood count and blood chemistry). Rarer with administration of interferon may experience hair loss, depressed mood, depression, dry skin, weight loss, and in predisposed individuals thyroid dysfunction. Therefore medical observation for the treatment of hepatitis C need any medications. How to evaluate the efficacy and safety of treatment? Effectiveness of treatment for hepatitis C is estimated by blood biochemical parameters (reduction of transaminase activity) and the presence of HCV RNA in reducing viral load. Development of side effects is controlled by the results of a general analysis of blood levels of thyroid hormones.

Hepatitis C treatment contraindication

Currently identify several categories of people who combined antiviral treatment for hepatitis C is contraindicated :

•      Patients suffering from severe general diseases, including decompensated diabetes, heart failure, coronary artery disease and pronounced hypertension, chronic obstructive pulmonary disease
•      People who were transplanted kidney, heart, lung
•      Patients in whom administration of interferon exacerbates the autoimmune process in the liver or other organs
•      Patients with untreated hyperthyroidism (thyroid disease)
•      Pregnant women
•      Children under 3 years
•      People with individual intolerance of any drug for the treatment of hepatitis C

Special lifestyle in hepatitis C treatment

Need to give up alcohol.

It is generally recommended diet with reduced fat food and substances that enhance the secretion of digestive juices (salty, spicy, fried, preservatives, etc.). Diet itself in the absence of cirrhosis on liver function is not affected.

A significant change in lifestyle is required. Necessary to discuss use of various drugs on other comorbidities with your doctor. Allowed in the amount of exercise the usual loads.

Alternative hepatitis C treatments

Currently, treatment with interferon alone or in combination with ribavirin - the only possibility for long-term removal of hepatitis C virus from the body. Along with this constantly meet descriptions achieved success with the help of so-called alternative substances. However, controlled trials in which was tested to the effectiveness of such drugs do not exist. Therefore, all the information about these drugs is based on unverified reports about the experience. Substances, which are used for treatment of diseases (Silymarin), artichoke preparations and glycyrrhizin, which primarily are used in Southeast Asia. Certain preparations of silymarin (silibinin) can reduce the viral load, if their day in a large dose of intravenously injected into the patient. However, until now not yet clear whether the substance in such a high dose of a safe and whether it is able to not only reduce viral load but also improve the frequency index cures achieved in the treatment of peginterferon / ribavirin. In the commonly used doses in the form of tablets, silymarin has no effect on virus replication. All herbal and other alternative drugs may produce dangerous side effects, liver damage or undesirable mutual influence exercised when receiving other medications. Patients should always inform their treating physicians or home medical specialists for further preparations taken for the fact that they were able to express their opinion about the tolerability of these drugs and the possible risks associated with their reception.

Hepatitis C treatment side effects

In the beginning of the course of treatment side effects are common, but in the course of treatment they pretty least weakened. Most often arise such flu-like symptoms such as: fever, headaches, pain in joints and muscles, fatigue and drowsiness, lack of appetite, weight loss. Sometimes also found thyroid dysfunction. In some patients, therapy for having severe complaints of skin dryness and / or temporary hair loss. In addition, patients may experience mood changes, up to depression. In addition, important changes in the blood picture are related, primarily, WBCs. Allergic reaction may be caused by either alpha-interferon and ribavirin. The most common side effects while taking the drug ribavirin is known temporary anemia (anemia). Therefore certainly should regularly monitor the blood picture of the patient. During the time of the current course of treatment, patients should regularly talk with your doctor and accurately describe him everything they encountered side effects. On the many side effects of combination therapy with interferon alpha / ribavirin can positively influence by adapting doses of these drugs or by a (temporary) assignment of additional of medicines. Before completely discontinue therapy due to intolerance or same because of side effects should always be first exhausted all possibilities, smiling. In any case we can not exclude the fact that because of the drug ribavirin risk children malformations increases. Therefore, patients undergoing treatment with ribavirin, throughout the course of treatment, as well as and in within six months after its closure should use a reliable contraceptive method. Women who have been pregnant before the start of therapy, this method can not be treated.

What should you pay attention to the treatment of alpha-interferon and ribavirin?

During the time of treatment with interferon alpha and ribavirin should regularly monitor the performance of the liver (ALT, AST), blood count and thyroid indices. Furthermore, at four and twelve weeks of treatment (in the case of need also after 24 weeks) that establish the viral load in the blood (RNA viral hepatitis C). Experts say a rapid virological response (RVR ") in the case when a sensitive method of testing at the beginning of the 4th week of treatment is not possible to establish the presence of RNA viruses of hepatitis C in the blood. At the beginning of the 12th week of treatment make the difference between complete response and partial response (CHVO). At full response (defense) 12 nd week of treatment in the patient's blood is no longer possible to identify RNA viral hepatitis C, in that time, as in patients with a partial response (CHVO) on viral load compared to the viral load to the top of treatment decreased approximately by a factor of 100, but the patient's blood is still not detect HCV RNA Based on the results of studies in the blood levels of HCV RNA, held at the beginning of the 4th and 12th week, we can conclude that crowned whether the treatment success and how long it should be carried out.

Hepatitis C treatment options in the future

In the present time are carried out clinical tests of various therapeutic options, including specific inhibitors of hepatitis C viral enzymes which are responsible for virus replication (protease inhibitors, helicase, NS5A protein and polymerase). The greatest progress in clinical development has been achieved with the two protease inhibitors of hepatitis C virus (boceprevir and telaprevir), which respectively in combination with peginterferon alfa and with ribavirin to be able to improve long term virological response rates for patients infected with genotype 1 by approximately 20% up to 70-75%. Registration of these substances should be expected in Europe in 2011-2012 Other so-called development comprise immunomodulators and drugs that suppress their own cell structure involved in the process of multiplication of the virus, as well as therapeutic vaccines, ie serum, which should help his own immune system to beat hepatitis C virus or slow the flow of the disease. In the long term it is hoped that in the future with the hepatitis C virus can be successfully addressed without interferon injections. However, this will require a combination of at least two or three inhibitors. For all new substances important is that they do not allow for the possibility of so-called variants of hepatitis C virus resistance
 In general, it should be strongly emphasized that none of the new substances will not be registered, if it will not be collected extensive data obtained in safety of these substances. Patients Currently, should apply to the major centers for the treatment of liver diseases and there to get information about current trials of therapeutic methods.