Management of hepatitis C: evaluating suitability for drug therapy
- Am Fam Physician. 2004 Mar 15;69(6):1429-36.
Management of hepatitis C: evaluating suitability for drug therapy.
Ward RP, Kugelmas M, Libsch KD.
St. Mary's Family Practice Residency, Grand Junction, Colorado 81506,
Chronic hepatitis C virus infection is a common and serious disease.
Although an estimated 2.7 million persons in the United States have
this disease, most have not yet been diagnosed. Recent advances in
treatment provide successful cure in 50 to 80 percent of cases.
Current drug therapy consists of a combination of pegylated
interferon and ribavirin. Although all patients with chronic
hepatitis C virus infection are potential candidates for treatment,
pharmacologic therapy has a number of contraindications. Evaluation
of suitability for treatment includes a thorough search for comorbid
medical and psychiatric conditions that can be contraindications.
Initial testing involves anti-hepatitis C virus antibodies, but
definitive diagnosis of active disease requires detection of viral
RNA. Most patients require a liver biopsy to determine the amount of
hepatic fibrosis and ongoing hepatocellular inflammation. Viral
genotype also should be determined: type 1 requires 12 months of
treatment and does not respond as well as types 2 and 3, which
require only six months of treatment. Common side effects of drug
therapy include anemia, anorexia, depression, fatigue, fever,
headache, myalgia, nausea, and erythema at the injection site.
PMID: 15053407 [PubMed - in process]
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