Patient Groups at High Risk for Hepatitis C Treatment-Related Complications

Is there only one good treatment for hepatitis C?

There are many treatment options for hepatitis C with new options becoming available all of the time. This is because treatment options are based both on the specific genotype of the virus that a patient has contracted and because science and technology are ever-changing. In addition to the multiple drug protocols available, which are specifically tied to individual hepatitis C genotypes, there are treatment plans that include multiple drugs and/or dietary alterations, depending on the needs of the patient.

How do I know which to choose?

You won’t be making this choice alone. For some patients, there is only one recommended treatment plan. If you are concerned about the best treatment option, you can take comfort in knowing that your doctor or team of doctors will be discussing your options with you and helping you to understand which option(s) are likely to provide the best results with the lowest number of side effects. These recommendations are based on the genotype of your specific hepatitis C infection, what your health insurance covers, what out of pocket costs (if any) you can afford, and your personal medical history. This history includes everything from your family’s medical history to any illnesses you have had in the past, and it can include any allergies you may have or whether you are generally considered a high risk patient.

My doctor says I am a “high risk” patient; what does that mean?

Some people are high risk patients because of their family’s history of medical problems or because of their own previous medical issues. For example, someone who is considered high risk for an allergic reaction to a specific hepatitis C treatment medication may have that diagnosis because they themselves or their parents have both shown to be allergic to that drug or a similar medication.

However, others are considered high risk because they have had previous medical problems. Someone who was seriously ill as a child or even in previous adult years (with diagnosis such as cancer or leukemia, for example) may always be considered high risk because their bodies have already experienced many medications and may have also endured surgeries, which can permanently alter what an individual’s body can endure. Others are considered high risk because of their advanced age, a blood disorder such as hemophilia, a concurrent illness such as HIV/AIDS, or, in many cases, liver problems including liver damage or cirrhosis of the liver.

When setting up a treatment plan, your doctor will consider all of these aspects by looking at your personal medical history and the way your body is currently working. This may lead the doctor to rule out the option of prescribing certain medications or recommending others. For example, a medication option may be known to be more difficult on the liver. That might be an acceptable risk for someone whose liver is healthy but may not be a safe risk for someone with cirrhosis. Other medications may not work as effectively or may interfere with other necessary medications, especially in the case of elderly patients who may need multiple medications for various medical problems. As the doctor considers all of these concerns, she or he can explain to you both which medication protocol is being recommended and why that specific plan is considered to be the best option for you and your body in order to maximize results and minimize side effects or long-term problems.

Is there anything I can do to become a typical or a low risk patient?

In some cases, no. Some patients are considered high risk because of their family medical history or because of an incurable illness. In either case, there is no way to alter these facts, and the patient simply has to accept that they are considered to be higher risk than other patients. In other cases, however, the risk level is related to the patient’s body mass, high cholesterol, or a current diagnosis of type II diabetes. In these cases, doctors may recommend a healthier diet and an increased exercise regimen. As the patient loses weight, they may also experience a drop in their cholesterol and/or the end of the diabetes, which can lower the patient’s overall risks and possibly make them no longer qualified as being a high risk patient.

If you are considered to be high risk and are interested in finding out whether you can lower your risks now or in the future, you may want to discuss this with your doctor. The doctor will be able to consider your personal medical chart and discuss both the reason for your risk level and anything you may be able to do to lower your risk level.1-6

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