Treatment for Hepatitis C
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How to best treat hepatitis C will be different for everyone. Depending on the specifics of your condition and virus, you and your provider will be able to determine the most appropriate treatment for you. The best care for you may involve taking additional medications or it may simply be avoiding those things that may damage your liver.
By far the most important thing you can do to take care of your liver is to avoid alcohol. Excessive alcohol use combined with hepatitis C increases the risk of cirrhosis, which is extensive scarring of the liver. For example, after about 25 years of infection, heavy drinkers with hepatitis C, those who drink 5 or more drinks per day, will develop twice the scarring of light or non-drinkers. After 40 years of infection, most heavy drinkers will develop cirrhosis. On average even after up to 40 years of infection, light drinkers or non-drinkers only progress to moderate liver scarring. Stopping drinking or at least limiting the amount you drink can have a direct affect on keeping your liver healthy in the long-run.
Treatment for hepatitis C is a process that attempts to slow or stop liver damage by eliminating hepatitis C virus from the blood. It is not right for everyone. The medications used are interferon, which is taken through an injection, and ribavirin, taken in pill form.
The original type of interferon, or standard interferon, was taken three times per week. A newer and more efficient interferon called pegylated interferon is now the preferred type for hepatitis C treatment. Pegylated interferon lasts longer, requiring only one shot per week, and is proven to be a more effective treatment than standard interferon. If you are prescribed interferon, your provider will show you how to take the injections yourself.
The other type of medication used to treat hepatitis C is called ribavirin. This is taken in pill form twice a day, every day, for the full length of treatment. Ribavirin is usually given with interferon in what is called "combination therapy." Studies have shown that the combination of pegylated interferon and ribavirin used together is the most successful treatment for hepatitis C.
How a person responds to treatment can vary depending on how much damage that has been done to the liver as well as the genotype or strain of hepatitis C virus that they have. During the treatment process, medications are taken for either six or twelve months. Your provider will want to monitor this process by using blood tests to watch for potential side effects of the medications. It is important that your provider has a reliable way to stay in contact with you during treatment and will arrange regular visits with you during this process.
Treatment for hepatitis C using interferon and ribavirin does have side effects. The most common of these are flu-like symptoms. Many people describe interferon treatment as feeling like they have a bad flu. These symptoms tend to be worse for the first two days after an injection but then get better as the week goes on. In particular common side-effects include tiredness, headache, muscle and joint aches, fever and the chills. Other side-effects include difficulty sleeping and concentrating, irritability and depression. In some people, interferon can trigger diabetes or thyroid disease so your provider will need to check for these during treatment. If you are already having difficulty with your daily life because of depression, bipolar illness, post traumatic stress disorder or other psychological problems you will need mental health treatment before you can attempt combination treatment for hepatitis C. Typically your mental health provider will also help monitor your symptoms during combination treatment.
Ribavirin can worsen heart problems in people with heart disease or a history of bypass surgery or heart attack. The ribavirin pills can also cause birth defects if either parent is taking the medication. Patients taking ribavirin need to use two forms of birth control if there is any chance of getting pregnant. No attempts to conceive should be made during treatment or for six months afterwards. Combination treatment for hepatitis C is a process that involves many aspects of your life. Only you and your providers working together can determine if treatment is right for your individual case and life situation. Even with hepatitis C, your liver may be so healthy you don't need combination treatment. In any case, you and your provider should focus on hepatitis C care, meaning an overall plan to keep your liver, mind, and body as healthy as possible.