US report questions early treatment of hepatitis C CHICAGO,
July 8 2003 - People with hepatitis C whose livers remain healthy
may be better off not undergoing drug treatment, which can produce
severe side effects such as nausea and depression and does not
always work, researchers said Tuesday.
The recommended 48-week course of treatment for the blood-borne
virus -- injections of interferon and oral ingestion of ribavarin
-- is effective in, at most, 60 percent of patients. It also has
potentially severe side effects such as nausea, fatigue, depression
and, in some cases, suicidal impulses.
The treatment, which costs in excess of $20,000, has been shown
to lengthen the lives of hepatitis C sufferers with existing liver
damage, a condition which can lead to deadly cirrhosis or
But a majority of hepatitis C patients do not develop liver
damage before dying of other causes, so the drug treatment may not
be cost-effective or helpful for them, the report from the Harvard
School of Public Health's Center for Risk Analysis said.
In the United States, 2.7 million people have chronic cases of
hepatitis C and there are about 25,000 new cases each year, most
infected through needle sharing or from receiving blood from an
infected donor. But four out of five have no signs or symptoms and
many of them are unaware they have it.
The disease's progression varies considerably and milder cases,
especially among women, may never progress to cirrhosis. The
report's analysis of U.S. health data showed that the probability
of infected men developing cirrhosis over a 30-year period was
between 13 percent and 46 percent, and among women the probability
was between 1 percent and 29 percent.
''There has been a huge effort over the last few years to
identify people infected with (hepatitis C), but this wider group
of patients will likely include those who are least likely to
develop advanced liver disease,'' Sue Goldie, author of the report
published in this week's issue of the Journal of the American
Medical Association, said in a statement.
''For patients at low risk of progressing, the overall health
gain from treatment may be minimal given the potential for toxic
side effects,'' she said.
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