- Treatment of hepatitis C - not an easy task
Methods of treatment of hepatitis C with its chronic course
The goal of treatment of such patients is the maximum suppression of viral replication and restore liver function. To suppress the active virus replication is assigned to combined antiviral therapy. The indication for its purpose is to detect in the blood of a patient with hepatitis C virus RNA (RNA HCV). This takes into account the general condition of the patient, condition of the liver and its potential risk of side effects of antiviral drugs, which can be considerable. Therefore, to determine the strict indications for antiviral treatment used today results of histological examination of liver tissue taken by biopsy. With minimal risk of developing cirrhosis of the liver antiviral therapy can be postponed.
The latest treatments for hepatitis C - a combination antiviral therapy: a combination of alpha - interferon ribaverinom. The effectiveness of antiviral treatment depends on the correct selection of the dose and duration of treatment of these drugs.
Most modern drugs for hepatitis C is a pegylated interferon (peg-IFN), which in contrast to conventional (short, they are administered every other day) of interferons significantly longer maintains the desired drug concentration in the human body - just one injection per week.
Currently produces two types of Peg-IFN: peginterferon alfa-2a (Pegasys - pharmaceutical company Hoffmann - La Roche, Switzerland), peginterferon alfa-2b (PegIntron - the pharmaceutical company Merck, Germany). As ITP-pegylated delayed in humans and its longer effect due to special additives increases, its efficiency is higher than with short interferons without increasing side effects.
Another cure for hepatitis C - ribaverin, it is usually administered at the same time as the second interferon antiviral drug. Ribaverin refers to a group of synthetic nucleoside analogues having an antiviral effect and the treatment of hepatitis
Treatment of hepatitis - a difficult task
Since only in combination with interferons. The mechanism of the antiviral effect of ribavirin in this case is unknown. Nevertheless, the use of combination antiviral therapy allows to achieve sustained suppression of the replication of hepatitis C virus in 60% of patients with type 1 virus and up to 85% in patients with viruses types 2 and 3. HCV treatment protocol typically involves these two antiviral drug.
Nevertheless, the combination of interferon with ribaverinom not always effective. In such cases a part of complex treatment of injected drugs of protease inhibitors (enzyme required for viral replication), resulting in the percentage of cured patients is significantly increased. These drugs are also recommended to assign patients with liver cirrhosis. For drugs in this series are INSIVEK (telaprevir, INCIVO) and boceprevir (VICTRELIS).
They are used as drugs for the treatment of hepatitis C with hepatoprotective action. Effective hepatoprotectors group of essential phospholipids, which have the ability to reduce fatty changes in the liver and neutralize free radicals (and Essliver Essentiale forte). They promote sufficiently rapid restoration of liver cells, slowing down growth therein connective and adipose tissue. Hepatoprotectors Heptral
Geptral - protection and support to the liver and not only
It has detoxifying, regenerating, antioxidant effects, inhibits the growth of connective tissue in the liver (ie, fibrosis and cirrhosis). Scheme geptralom treat hepatitis C: 800 mg per day for one - two weeks, intravenously, with a transition to reception of the drug inside at 400-800 mg (1-2 tablets) for two weeks.
It is also effective to use hepatoprotector Ursosan choleretic action. It is administered in the form of a continuous course over time - from several months to several years, 2-5 capsules per day. After active treatment is often prescribed hepatoprotectors vegetable origin, such as Kars.
Methods of treatment of hepatitis C is constantly being improved. However, a new treatment for hepatitis C appear less frequently - an obstacle is constant mutating virus.
Side effects in the treatment of hepatitis C.
The side effects of antiviral treatment for hepatitis C can be considerable, they add up mainly of the side effects of interferon and ribaverina. Approximately 10% of patients with antiviral treatment was discontinued because of side effects that occur in each of the third through fifth-patient.
Side effects of pegylated alpha-ITF-2a - Pegasys: fever, chills, weakness, irritability
Irritability - you try to control my temper
, Chest pain, flu-like symptoms, lethargy, thirst, weight loss. When receiving Pegasys may develop benign and malignant liver tumors, thrombocytopenia (associated with increased bleeding), anemia, changes in the thyroid gland, lupus, rheumatoid arthritis, allergies, diabetes, a complete lack of appetite, dehydration, disorders of the central nervous system (headaches, dizziness, depression, insomnia, seizures, hallucinations), visual and hearing impairment, heart rate, increased blood pressure, angina attacks, hemorrhagic strokes, nosebleeds, nausea, vomiting, abdominal pain, unstable stool, bleeding gums
How to prevent bleeding gums: important rules
, Flatulence, dry mouth, abnormal liver function, alopecia, dermatitis, pain in muscles and joints, muscle weakness, renal dysfunction, impotence.
Acceptance of Pegasys is contraindicated in children under three years, pregnant women, nursing mothers and in case of hypersensitivity to alpha interferons, autoimmune diseases, severe violations of the liver, decompensated liver disease, severe cardiovascular diseases.
The side effects of hepatitis C treatment can be enhanced also by ribaverina. Ribaverin has the following side effects: a decrease in hemoglobin due to the destruction of red blood cells, anemia, reduction of blood leukocytes, including granular (low immunity) and platelets (increased bleeding), thyroid dysfunction, allergic reactions, reduction in blood pressure, changes in laboratory indicators.
Application ribaverina contraindicated in severe diseases of the cardiovascular system, the thyroid gland, certain blood disorders, kidney function and liver, severe depression, autoimmune diseases, as well as during pregnancy (ribaverin teratogenic, so the pregnancy can be planned only six months after the course treatment), breast-feeding and the presence of hypersensitivity to the drug.
Combined treatment for hepatitis C may appoint a doctor with all the indications and contraindications. When the independent use of antiviral drugs for hepatitis C treatment effects can be disastrous.
Currently, new methods of treatment of hepatitis C, including regimens without interferon. But doctors hepatologists believe that these techniques will be fully worked out and introduced into clinical practice only after several years.
Treatment of hepatitis C - this is a serious problem that only by doctors with special training in hepatology.