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Hepatitis C Treatment May Cause Death

Considered the drug of choice for hepatitis C and chronic liver disease, interferon may cause side effects and even death when used a second time, according to a new review.
By Alysha Reid, Everyday Health Staff Writer

WEDNESDAY, Jan. 30, 2013 — Those who have failed to respond to initial treatment for hepatitis C or chronic liver disease may not benefit from a second round of interferon therapy. Instead, they could experience a variety of side effects — including an increased risk of dying sooner, according to an updated review published in The Cochrane Library.

After analyzing results of two trials involving a total of 1,676 patients, researchers found that those who received a second infusion of interferon therapy had a 9.4 percent risk of dying compared to those who received a placebo or no treatment, whose risk of death was 6.7 percent. Patients in the treatment group were also more likely to experience complications such as cirrhosis and fluid in the belly.

"It was troubling to see that in those trials providing the most reliable estimates of treatment effects, interferon seemed to increase the risk of death," said lead researcher Ronald Koretz, MD, an emeritus professor of clinical medicine at the UCLA School of Medicine,  in a press release. "Based on these results, interferon monotherapy cannot be recommended for chronic hepatitis C patients who have already failed one course of treatment and are being retreated.”

Interferon is a powerful medication used to treat chronic forms of viral hepatitis B, C, and D. When the body detects a virus like hepatitis C, certain cells naturally create interferon proteins to alert nearby cells of the imminent threat. This triggers a mass production of additional anti-virus proteins that keep the virus from replicating and spreading. Interferon also stops the body from producing proteins that the virus needs to thrive. With interferon therapy, doctors inject genetically engineered interferon to boost that produced by the immune system and help stop the replication of the hepatitis virus quickly. While interferon is often used to prevent potentially fatal liver damage, it can come with serious side effects, such as damage to the heart and psychological changes.

Interferon therapy is usually administered in combination with other anti-viral medication, such as Ribavirin. When the initial treatment fails to eradicate the hepatitis C virus, doctors usually increase the frequency or dosage of the interferon.

Generally, interferon therapy is considered to have been successful when the hepatitis C virus is no longer detectable through blood tests. But according to Dr. Koretz, his analysis of past clinical trials, which included rates of liver failure and death rates, proved that this isn’t enough. “We looked at whether patients got better,” he said. “The blood tests did not predict the outcome.” And while other studies have examined the drawbacks of interferon therapy, Koretz believes that doctors need to do a better job at informing patients of the risks.

“People in the future who are going to be offered a combination therapy that includes interferon need to be told that there may be an increased risk of death,” he said.