tailieunhanh - Short Guide to Hepatitis C_4

Đếm tiểu cầu. Điều này giới hạn việc sử dụng IFN trên bệnh nhân xơ gan là gan nâng cao Ai cũng dễ bị nhiễm. Các thrombopoietin miệng eltrombopag chủ vận thụ thể đã được thử nghiệm trên bệnh nhân viêm gan C mãn tính và xơ gan gan (McHutchinson 2007). | 40 Hepatitis C Guide platelet counts. This limits the use of IFN in patients with advanced liver cirrhosis who are also more vulnerable to infections. The oral thrombopoietin receptor agonist eltrombopag has been tested in patients with chronic hepatitis C and liver cirrhosis McHutchinson 2007 . Eltrombopag increased platelet levels in 75-95 of patients depending on the dose and antiviral therapy was then initiated. It remains unapproved for this indication. Neutropenia is another common reason for dose modification. Granulocyte macrophage colony-stimulating factor and granulocyte colony-stimulating factor could be used to stabilize neutrophil counts during IFN therapy Shiftman 1998 Van Thiel 1997 Younossi 2008 . However cost-benefit analyses and further trials are required to establish routine use of these agents. Flu-like symptoms usually occur during the first weeks of treatment and severity declines over time. These symptoms include fever chills headache arthralgia and myalgia Chapter 6 Table 7 . Antipyretic drugs such as paracetamol can help to prevent or reduce these side effects. Neuropsychiatric side effects such as irritability severe fatigue and apathy are also frequent and pose a great problem for many patients and their family members. When severe side effects may reduce adherence to therapy and may result in dose modifications resulting in suboptimal responses. Severe depression can occur and suicide has been reported Manns 2006 . Psychiatric care and the use of antidepressants especially selective serotonin reuptake inhibitors SSRIs are highly effective in HCV patients during IFN-based therapies when starting early after the onset of clinically relevant depression Schaefer 2005 Krauss 2008 . IFN has immunomodulatory properties and treatment can induce autoimmune phenomena Wesche 2001 . This may not be rev Thiis p isth trialr- version 4. Hepatitis C Standard of Care 41 autoimmune diseases can be aggravated by IFN therapy . diabetes

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