Hepatitis C is a disease that infects the liver and is caused by a virus. The virus, referred to as HCV, in short, is the lesser known one among other hepatitis viruses; A and B are the more common ones. Most people are not aware of this disease, but the statistics are alarming.
HCV is said to infect an estimated 170 million persons worldwide. What is startling is the fact that it is five times more prevalent than the human immunodeficiency virus type 1 (HIV-1) infection. This virus accounts for approximately 20 percent of cases of acute hepatitis, 70 percent of chronic hepatitis cases, and 30 percent of end-stage liver disease in the United States. The disease is mostly asymptomatic, due to which it fails to get diagnosed early.1
Common Symptoms Of Hep C
The most commonly
- Fatigue or malaise
- Right upper quadrant pain
- Dark urine
- Muscle aches
- Weight loss
In these, fatigue is the most common symptom and the others may or may not occur. At times, you may find more than one symptom occurring in tandem.2
Treatment Of Hep C
A large number of people infected with hepatitis C can be treated and cured. The standard treatment used for HCV is pegylated interferon alpha and ribavirin therapy. Research suggests that these drugs have their side effects and limitations. As in the case of many other viral infections, an early diagnosis can improve the chances of optimal disease management.3
The most common side effects of HCV treatment are fatigue, influenza-like symptoms, hematologic abnormalities like anemia and neutropenia, and neuropsychiatric symptoms. In this, hemolytic anemia is a universally acknowledged side effect associated with ribavirin combination therapy.
Hemoglobin levels decrease within the first 2-4 weeks of standard interferon and ribavirin treatment. This can cause an increase in fatigue and affect the quality of life, necessitating reducing the dosages. It is advisable to counsel patients before starting treatment, so they are aware of the side effects and the symptoms to watch out for.
How Do You Manage Anemia?
Anemia can occur, especially in HCV patients with comorbid renal or cardiovascular disorders. Severe anemia is said to occur in only about 10 percent of the patients. Anemia mostly occurs due to the extensive ribavirin accumulation. Anemia can increase the risk of morbidity and mortality, and may also have negative
Recombinant human erythropoietin has been used to manage anemia caused by ribavirin therapy, but it also has other potential disadvantages. Viramidine, a liver-targeting prodrug of ribavirin, has the potential to maintain the virologic efficacy of ribavirin while also bringing down the hemolytic anemia risk in chronic hepatitis C patients.4
Patients under HCV treatment should watch out for symptoms like increased fatigue and seek medical attention immediately. A study conducted on this topic concludes that hemoglobin levels must be monitored closely among the patient population which falls into the category of old, females and those who have low body weight and platelet counts.5
Any form of Hepatitis necessitates treatment and HCV is no
|↑1||Lauer, Georg M., and Bruce D. Walker. “Hepatitis C virus infection.” New England journal of medicine 345, no. 1 (2001): 41-52.|
|↑2||Hoofnagle, Jay H. “Hepatitis C: the clinical spectrum of disease.” Hepatology 26, no. S3 (1997).|
|↑3||Manns, M. P., H. Wedemeyer, and M. Cornberg. “Treating viral hepatitis C: efficacy, side effects, and complications.” Gut 55, no. 9 (2006): 1350-1359.|
|↑4||McHutchison, John G., Michael P. Manns, and Dan L. Longo. “Definition and management of anemia in patients infected with hepatitis C virus.” Liver international 26, no. 4 (2006): 389-398.|
|↑5||Hung, Chao‐Hung, Chuan‐Mo Lee, Sheng‐Nan Lu, Jing‐Houng Wang, Chien‐Hung Chen, Tsung‐Hui Hu, Kwong‐Ming Kee et al. “Anemia associated with antiviral therapy in chronic hepatitis C: incidence, risk factors, and impact on treatment response.” Liver International 26, no. 9 (2006): 1079-1086.|