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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.
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.
