We’re Here to Help
At Alegria, compassion, understanding and education are the keys to ensuring optimal treatment outcomes. Our patient outreach programs help patients understand how and why different therapies work, and our clinical initiatives help providers monitor and improve therapy adherence. This, combined with our close management of each patient’s individual circumstances, means more support and better quality of care.
What is Hepatitis C?
Hepatitis is defined as inflammation of the liver. Hepatitis C is an infection caused by a virus that attacks the liver and leads to inflammation. Chronic hepatitis C virus (HCV) infection is one of the most common chronic liver diseases, accounting for 8000 to 13,000 deaths annually. Most liver transplants performed in the U.S. are as a result of chronic HCV.
Causes
Hepatitis C is one of several hepatitis viruses and is generally considered to be among the most serious of these viruses. Hepatitis C is passed through contact with contaminated blood. The virus invades the liver cell and takes over its reproductive machinery, damaging the liver cells and causing cell death in most instances. The disease may be acute or chronic in nature.
If the acute form does not resolve on its own or get treated properly with medication, it may lead to the chronic form. Chronic HCV is characterized by the presence of symptoms and disease lasting six months or longer. Seventy to eighty percent of acute cases transition to chronic.
Possible causes:
- Alcohol abuse
- Large doses of specific medications
- Poisonous mushrooms
- Viruses
The following are risk factors of HCV:
- Unsafe use of injection drugs
- Unsafe blood transfusion
- Being born to an HCV-infected mother
- Having a needle-stick accident from a person with hepatitis C
- Having sex with someone with hepatitis C
- Having multiple sex partners
Symptoms
Most people infected with the hepatitis C virus (HCV) have no symptoms.The following are some signs and symptoms of HCV:
- Fatigue
- Mild right-upper-quadrant abdominal discomfort or tenderness (“liver pain”)
- Nausea
- Poor appetite
- Muscle/ joint pains
Signs and symptoms may be more prominent in severe cases and include:
- Muscle weakness
- Poor appetite
- Nausea
- Weight loss
- Itching
- Dark urine
- Fluid retention
- Abdominal swelling
Treatments
Antiviral treatment is the mainstay of HCV medication therapy. The agents commonly used are pegylated interferon (given as a subcutaneous injection), which is a host protein with antiviral activity and ribavirin, an oral antiviral agent. These two agents are usually used in combination. Pegylated interferon may be given by itself when there are compelling reasons not to give ribavirin. Combination therapy improves ALT levels and eradicates detectable levels of HCV RNA in seventy percent of patients. Relapse rates are lower in patients treated with combination therapy as compared to those on monotherapy. Treatment duration of combination therapy can be either twenty four or forty eight weeks, depending on patient specific factors.
Some of the side effects of Pegylated interferon are:
- Fatigue
- Fever
- Chills
- Depression
- Dizziness
- Anxiety
- Insomnia
- Dry skin
- Hair loss (reversible)
- Weight loss
- Nausea
- Diarrhea
- Injection site inflammation
- Muscle pain and/or weakness
The common side effects of ribavirin are:
- Anemia
- Fatigue and irritability
- Itching
- Skin rash
- Nasal stuffiness
- Sinusitis
- Cough
If anemia does occur, it may need to be treated with medication. Procrit and Epogen are two medications used to treat anemia. They both stimulate the production of red blood cells.
Monitoring of blood cells, liver enzymes, thyroid function should be performed by a health care professional periodically throughout the course of antiviral therapy. Adjustments to dosing should be made as needed based upon the results of monitoring and patient tolerance of the medications. After the completion of treatment, liver enzymes should be measured every two months for six months. Additionally, a test for HCV RNA should be performed six months after the stoppage of therapy.