Combination treatment for Hepatitis C

  I was diagnosed with Hepatitis C 3 years ago, with no idea when exactly I contracted the virus.  I have taken interferon alpha-2b for 6 months with excellent results; however, I experienced a relapse within 3 months of cessation of therapy.  I was then prescribed a second course with initial excellent response, but became non-responsive and therapy was discontinued after 5 months.  Now my hepatologist wants me to try a course of interferon with ribavirin when it is approved, which he says may be as early as July.  
  I experienced flu-like symptoms and headaches as well as muscle and joint pain on interferon alone.  How do the side-effects differ with combination therapy, if at all?  How great is the risk of becoming anemic from the addition of ribavirin to my regimen?
  Also, since being treated before, I have become a lacto-ovo vegetarian with 10% or less total dietary fat intake.  Will my current dietary regimen increase or decrease my risk for becoming anemic?  What effect might my dietary habits have on the side effects from my treatment regimen?
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Dear Wonda,
Side effects of combination Interferon and Ribavarin are very similar to those associated with Interferon alone.  The major side effect of Ribavirin is anemia.  The average hemaglobin fall is about 2.5 gm.  So if you start with a normal hemaglobin, chances are you will do fine even if your hemaglobin falls a bit.  In our practice we monitor blood counts closely.  This necessary because rarely the anemia becomes very severe requiring dose reductionof Ribavirin or even stopping the drug.  Blood transfusions may be needed.  
An important feature of your new diet is to maintain adequate protein intake (1.5 gm per kg weight) and iron.  In this way you can decrease the risk of iron deficiency anemia.  Low fat diets for the most part are healthy for the liver and should not interfere with your Hepatitis C therapy.
This information is presented for educational purposes only.  Always consult your physician for specific medical issues.
HFHSM.D.-kb
*keywords: hepatitis, treatment
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