Hepatitis - Outlook

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Highlights	Prognosis	Medications
Introduction	Symptoms	Resources
Risk Factors and Transmission	Diagnosis	References
Prevention	Treatment

Drug Complications and Warnings for Nucleoside/Nucleotide Analog Drugs. Patients who discontinue anti-HBV drug therapy are at risk for severe and sudden worsening of hepatitis. These patients should be closely monitored for several months after stopping treatment. If necessary, drug treatment may need to be reinstated.

Lactic acidosis (buildup of acid in the blood) is a serious complication of nucleoside/nucleotide analog drugs. Signs and symptoms of lactic acidosis include feeling extremely tired, unusual muscle pain, difficulty breathing, stomach pain with nausea and vomiting, feeling cold (especially in the arms and legs), feeling dizzy or light-headed, or a fast or irregular heartbeat. Immediately contact your doctor if you experience these symptoms.

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Liver hepatotoxicity (liver damage) is another serious complication. Signs and symptoms include yellowing of skin or white part of eyes (jaundice), dark urine, light-colored stool, or lower stomach pain. Immediately contact your doctor if you experience these symptoms.

These drugs may also cause kidney damage (nephrotoxicity), particularly for people who already have kidney function problems.

Medications for Chronic Hepatitis C

Pegylated interferon combined with the nucleoside analog drug ribavirin (Copegus) is the gold standard treatment for chronic hepatitis C in both adults and children. During a standard 24-week course of treatment, this drug combination achieves response rates of up to 50% for patients infected with hepatitis C genotype 1 (the most common genotype form in the U.S.) and up to 80% for patients infected with genotypes 2 or 3.

Interferon alone is usually reserved for patients who cannot tolerate ribavirin. Pegylated interferon is given as an injection once a week. Ribavirin is taken as a pill.

Two types of pegylated interferon are available for chronic hepatitis C treatment:

Peginterferon alfal-2a (Pegasys)
Peginterferon alfa-2b (Peg-Intron)

Candidates for Treatment. While all patients with chronic hepatitis C are potential candidates for treatment, doctors usually decide whether treatment is appropriate based on many different factors.