After-Effects of DAA Treatment

There has been some discussion recently in online peer groups about the after-effects of treatment with direct-acting antiviral (DAA) therapies for hep C.

Fears are becoming more apparent in a population of people (us) who have had several years of doubt and fear over the toxicity of drugs like interferon and ribavirin. Not to mention the two even more toxic, triple drug therapies with Peg/Riba and Telaprevir or Boceprevir.

The after-effects of interferon are well studied now and there are many of us who were treated with it either alone or in combination with other drugs. I won’t belabor the long-term effects of interferon that can cause permanent health issues. I have some myself as I have disclosed before.

So what do we know about the new drugs, and what possible after-effects can people expect?

I am not trying to cause alarm or frighten anyone who has treated with or planning to treat with these drugs. The regulators who approved these drugs had data from clinical trials and there has been years since the earlier trials so there is some data to support their safety.

I treated with this class of drug 7 years ago and as far as I know there are no lasting affects I can attribute to the trial I was in. My after-effects are related to interferon because there is lots of data and anecdotal evidence to support that conclusion.

As presented at European Association for the Study of the Liver (EASLD) earlier this year, there is some evidence that people with a history of liver cancer also know as hepatocellular carcinoma (HCC) may have a higher rate of recurrence after treating with DAA’s as opposed to people who have not used the treatment. The recommendation by some researchers is that these people be monitored more closely after the end of treatment because there is evidence that the recurrence of lesions may occur in a very short time after treating with DAA’s.

I would suggest that all people who have advanced liver disease and hep C be monitored closely both before and after treatment with cure or not. For people with prior liver cancer (HCC), who are at much greater risk, it is even more important.

Most of us do not fit into this group, but for those who do you need to aware of the risks and make sure your treating physician is aware both of your status and the research, so that you can make an informed decision on what is the best course of action.

In my own view, it is better to be hep C free than not, but it does present some questions that hopefully we can get answers for.

There are always possible risks associated with treatment, which I addressed in the opening of this piece. Like I have said before, I think everyone should weigh the risks and benefits of treatment before embarking on any regimen. This is not meant to discourage or deter anyone from treating with DAA’s.

It is difficult at times for us to use reasoning like this I know, and when we are faced with an illness like hepatitis C we want to be rid of it, and we want to be rid of it as soon as possible. We all deserve to be hep C free and free of fear.

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