UNDESIRABLE EFFECTS DURING HEPATITIS C TREATMENT AND THEIR REMEDIES

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Abstract

ABSTRACT
Background: Hepatitis C virus (HCV) infection is one of the most important health issues. It is estimated that 130-170
million people are affected with this virus worldwide. HCV infection is associated with development of chronic liver
disease and hepatocellular carcinoma. Due to its serious nature and associated morbidity, a lot of research is being
done and newer antiviral agents have been introduced for its management. Adverse effect profile varies among dif-
ferent antivirals and is more pronounced with triple therapy including PEGylated interferon as compared to dual oral
antivirals (Sofosbuvir + Ribavirin).
Methodology: The study enrolled 84 patients who were infected with hepatitis C virus confirmed by PCR. 48 patients
received triple therapy i.e. PEGylated Interferon (PEG-IFN) along with oral antivirals (sofosbuvir + ribavirin) and 36
patients received oral antivirals. These patients were selected from the KRL hospital liver clinic, medicine department.
They were given treatment for 03 months and 06 months respectively. Before starting treatment thorough physical
examination, systemic review, psychological assessment and baseline labs (Complete Blood Count, Liver Function
Tests (LFT’s), Renal Function Tests (RFTs), Prothrombin Time (PT), Thyroid Function Tests (TFTs) and serum Albumin)
and Ultrasound abdomen were done. During treatment course their constitutional, respiratory, Gastrointestinal, Hema-
tological, Psychiatric and dermatologic adverse effects were noted and appropriate remedies initiated. SPSS version
20 was used for data analysis.
Results: The overall side effects with Chronic Hepatitis C treatment are flu-like symptoms (i.e. low grade fever, muscle
aches and headache), neuropsychiatric symptoms, gastrointestinal and dermatological complaints. In general flu-like
symptoms (i.e. low grade fever, muscle aches and headache) were most common in both treatment groups (50%).
Flu-like symptoms were followed by fatigue (47.6%), fever (45.2%), insomnia (33.3%) and Gastrointestinal symptoms
i.e. nausea (30.9%), vomiting (29.7%) and abdominal pain (22.6%). Dose modification was done where required be-
cause of adverse effects and only 01 patient discontinued the treatment due to severe rash which occurred after 1st
 
injection of PEG-IFN. In addition, Interferon therapy was associated with neutropenia (8.3%) and thrombocytopenia
(2.4%). Anemia was found in 19% of patients and was found in both groups, 10.7% vs 8.3% (triple vs double regimen).
Sofosbuvir is not associated with hematological abnormalities. Remedial measures were taken in order to prevent
and treat adverse effects as they occurred. This played a vital role in treatment adherence which helped in achieving

Authors: 
Azmat Ali
Javaria Ilyas Shaikh
Awais Saeed Abbasi
Journal Issue: 

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