Examination of Fiscal Management and the Allocation of Care Act Resources US Department of Health and Human Services: Health REsources and Services Administration
INTRODUCTION
HIV/HCV Coinfection
HCV Treatment
Response to HCV Treatment: Prognostic Factors
Liver Biopsy
Treatment Strategies
Side Effects and Strategies for Managing Them
The Week 12 Early-Stopping Rule
Treating HCV: Long-Term Benefits
Treatment of Acute HCV
Expanding Access to Treatment
Barriers and Key Issues
Conclusion
Resources
References

Side Effects and Strategies for Managing Them

Pegylated and standard interferon and ribavirin may cause numerous side effects, including neuropsychiatric symptoms such as mood swings, anxiety, irritability, insomnia, and depression. Depression may be severe; but in HCV treatment trials, suicide or attempted suicide was reported among less than 1 percent of participants.125,126 Hematologic toxicities (anemia, neutropenia, thrombocytopenia); fatigue; weight loss; and “flulike symptoms” also may occur.127 Although the side effects can be daunting, strategies exist for managing them. Side effects can be alleviated by interventions such as the following:

  • Prophylactic treatment for depression (i.e., before initiation of HCV therapy)
  • Treatment of insomnia and anxiety as needed
  • Dose reductions or use of growth factors to manage anemia and neutropenia
  • Administration of the weekly shot of pegylated interferon on Friday night to mitigate side effects during the work week
  • Tylenol for aches and fever
  • Small, light meals; antiemetics or dronabinol (Marinol) for nausea and loss of appetite
  • Adequate hydration.

 
 
<< Treatment Strategies • The Week 12 Early-Stopping Rule >>