Study: Healthier Hepatitis C Patients May Want to Pass Up Combo
People with hepatitis C who are otherwise healthy with minimal
evidence of liver damage may be better off passing up combination
therapy with pegylated interferon, which is effective in at most 60
percent of patients and can produce severe side effects, according
to Harvard researchers.
The recommended 48-week combination treatment -- injections of
interferon and oral ingestion of ribavarin -- has been shown to
lengthen the lives of hepatitis C sufferers with existing liver
But a majority of hepatitis C patients do not develop liver
damage before ultimately dying of other causes so the drug
treatment may not be cost-effective or helpful, the researchers
reported in the Journal of the American Medical Association.
The researchers said the probability of patients with chronic
hepatitis C developing cirrhosis over a 30-year period ranged from
13 percent tro 46 for men and from 1 to 29 for women.
"For patients at low risk of progressing, the overall health
gain from treatment may be minimal given the potential for toxic
side effects," said Sue Goldie, author of the report.
"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," Goldie said.
"While newer treatment options for hepatitis C appear to be
reasonably cost-effective on average, these results vary widely
across different patient subgroups and depend critically on
quality-of-life assumptions," the researchers concluded.
"As the pool of persons eligible for treatment for hepatitis C
infection expands to the more general population, it will be
imperative for patients and their physicians to consider these
assumptions in making individual-level treatment decisions," the
Source:Journal of the American Medical Association
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