Report questions early treatment of hepatitis C

Last Updated: 2003-07-08 17:02:18 -0400 (Reuters Health)

CHICAGO (Reuters) - 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 on 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 cancer.

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.