Hepatitis Management in Arizona

At present, the most effective drug therapy for hepatitis C in Phoenix, AZ involves the use of two medications called Pegylated Interferon and Ribavirin, given together for a 24 to 48-week period. The length of therapy and response to treatment vary depending on several factors like the genotype of the hepatitis C infection.

Common side effects of Interferon include fever, chills, headache, tiredness, loss of appetite, joint pain, and muscle aches. Side effects may improve as the body adjusts to the medication, and Tylenol or Advil and rest are helpful. Interferon can aggravate depression and you should inform your doctor if you have suffered from depression in the past or develop symptoms while in therapy.

Over the course of the drug therapy, follow-up visits and blood tests to monitor the effectiveness of treatment and potential toxicity are required. Interferon is associated with bone marrow suppression that causes lowered levels of white blood cells (leukopenia) and platelets (thrombocytopenia). Sometimes the dose of the Interferon must be lowered to avoid infections caused by leukopenia. Lowering the dose of Interferon typically results in an improvement in the white blood cell count, but may also reduce its effectiveness against the hepatitis C virus. Another alternative would be treating leukopenia with another injectable drug called Neupogen, which stimulates the bone marrow to produce more white blood cells. This strategy can allow the patient to continue the full prescribed dose of Interferon.

Ribavirin commonly causes anemia or a reduction in red blood cell mass. Anemic patients will usually experience fatigue. Some patients require a dose reduction or discontinuation of Ribavirin if the anemia progresses in severity. Another alternative to treat the anemia would be to prescribe Procrit, another injectable drug that stimulates the bone marrow to produce more red blood cells. Cardiac patients and some women of childbearing age may not be candidates for this drug and your provider at Arizona Digestive Health will help you decide if Ribavirin is right for you.

New drugs called protease inhibitors have recently become available for the treatment of hepatitis C and are used in addition to Interferon and Ribavirin. Please talk to your provider at Arizona Digestive Health about the drug treatment that will be ideal for your condition.

Genotype refers to the genetic makeup of a virus. HCV can mutate and change its genetic makeup. By varying its structure, it has evolved into six known genotypes. Identifying the genotype of HCV can help your provider at Arizona Digestive Heath determine the duration of therapy and projected response. The most common genotypes in the U.S. are 1a and 1b, accounting for more than 75 percent of all infections. These genotypes are considered the hardest to treat and the recommended length of treatment is 48 weeks. For patients with genotype 1a or 1b, the Sustained Virologic Response (SVR) for combination therapy with Pegylated Interferon and Ribavirin is 40 to 50 percent. Genotypes 2 and 3 account for approximately 20 percent of patients. These genotypes are easier to treat and respond to a recommended treatment period of 24 weeks, with an anticipated SVR of 80 percent with combined Pegylated Interferon and Ribavirin. The addition of protease inhibitors to standard hepatitis C therapy in Phoenix, AZ has resulted in significant improvements in treatment response.