Management of hepatitis C infection is difficult. The patients must be excluded from donating blood and should be advised about the known modes of transmission of the virus, particularly by the parenteral route. Alcohol may act synergistically with HCV in causing liver damage, and alcohol intake must be reduced to the absolute minimum, if any. Consideration of life style risks for other viral infections such as hepatitis B and HIV infection is essential.
Treatment with interferon a has been shown to yield good and sustained responses in 25-40% of selected patients. Studies indicate that younger patients without cirrhosis, with genotype 2 and 3 infection, are more likely to respond to treatment for several months than patients with genotype 1, and better response is obtained in patients with a lower viral load. Combination therapy with ribavirin, a synthetic guanosine nucleoside analogue, indicates that up to 50% of patients who have relapsed after treatment with interferon a have a sustained biochemical and virological response to combined treatment.
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