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Caring People Of Hepatitis C Carriers Living With Adverse Effects During Antiviral Treatment: A Longitudinal Study

Author(s): Wen-Nan Chiu, Tung-Jung Huang, Jiung-Wei Lin, Mei-Yen Chen


Aim: To examine the distribution of adverse effects during receiving antiviral treatment (AVT) and neuropsychiatric symptoms and effects of a referral program for hepatitis C virus (HCV) carriers after 5 years.

Background: Although antiviral treatment (AVT) is successful for hepatitis C virus (HCV) infection, there is limited information regarding AVT in liver cancer endemic rural areas. In addition, many patients discontinue treatment because of intolerable adverse effects, including headache, poor appetite, and neuropsychiatric symptoms.

Design: A community-based, prospective cohort study is used.

Methods: This study was a nurse-led health promotion program combined with a multidisciplinary approach for community adults with HCV carriers in southern Taiwan. Six hundred and forty two community adults with HCV carriers participated in this study between August 2011 and July 2016 in collaboration with a local hospital. Assessed parameters included distribution of adverse effects, healthrelated behaviors, number of treatment completion and decrease in HCV prevalence rate.

Results: The treatment completion and success rates were 76.2% and 75.5%, respectively, although 19% of the participants discontinued treatment because of adverse effects, especially for neuropsychiatric symptoms. During the 5-year follow-up, the prevalence of HCV infection significantly decreased from 20.8% to 11%. Many participants experienced adverse effects, involving six systems, such as influenzalike (80%), and neuropsychiatric symptoms (60.7%), including depressive mood, insomnia, instable emotions, memory degradation, anxiety, and suicide ideation.

Conclusion: The findings highlight the value of a nurse-led referral program for HCV carriers to receive AVT. Thus, healthcare providers should help rural adults overcome the adverse effects, especially for neuropsychiatric symptoms.

Relevance to clinical practice: The findings suggest that early detection of HCV infection and education of HCV carriers should be a routine part of all general health assessments in endemic areas.

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