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Patient care — conditions, diseases

photo Hepatitis C: Hepatitis C is a virus-caused liver inflammation which may cause jaundice, fever and cirrhosis. Persons who are most at risk for contracting and spreading hepatitis C are those who engage in unprotected sex with multiple partners and those who share needles for injecting drugs.

Symptoms: Many people who are infected with the hepatitis C do not have symptoms. Hepatitis C is often detected during blood tests for a routine physical or other medical procedure. The following symptoms could occur:

  • jaundice
  • abdominal pain (right upper abdomen)
  • fatigue
  • loss of appetite
  • nausea and vomiting
  • low-grade fever
  • pale or clay-colored stools
  • dark urine
  • generalized itching

Treatment: Some patients with hepatitis C benefit from treatment with interferon alpha or a combination of interferon alpha and ribavirin.

Interferon alpha is given by injection just under the skin and has a number of side effects, including flu-like symptoms, headaches, fever, fatigue, loss of appetite, nausea, vomiting, depression, and thinning of hair. Treatment with interferon alpha may also interfere with the production of white blood cells and platelets.

Ribavirin is a capsule taken twice daily, and the major side effects are severe anemia (low red blood cells) and birth defects. Women should therefore avoid pregnancy during and for 6 months following treatment.

Recently, a version of interferon alpha with a longer half-life (pegylated interferon alpha) was introduced, and the longer half-life means the injections are taken weekly instead of the three times a week with standard interferon alpha. Pegylated interferon alpha and ribavirin lead to a sustained response in approximately 50% of patients.

A sustained response means that the patient remains free of hepatitis C virus 6 months after stopping therapy. Approximately 40% of patients with genotype 1 infection will respond.

Rest may be recommended during the acute phase of the disease when the symptoms are most severe. People with hepatitis C should avoid any substances toxic to the liver (hepatotoxic). All patients with hepatitis C should be immunized against hepatitis A and B.

People with hepatitis C should also be careful not to take vitamins, nutritional supplements, or new over-the-counter medications without first discussing it with their doctor. Patients with hepatitis C should avoid alcohol. Even moderate amounts of alcohol speed up the progression of hepatitis C, and alcohol reduces the effectiveness of the treatment.

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