Use of growth factors with antiviral therapy for chronic hepatitis C

Interferon (IFN)-based regimens for the treatment of chronic hepatitis C virus (HCV) infection have become increasingly effective and are able to eradicate virus in more than one half of treated individuals. Treatment strategies are complex and involve self-administration of injectable IFN and oral ribavirin medication, frequent office visits, and laboratory testing. Current therapies have significant side effects that may impair performance and quality of life (QOL), necessitating dose reductions or interruption of therapy. As a consequence of these dose reductions or treatment interruptions, patients may not achieve a sustained virologic response (SVR). Recent data suggest that aggressive management of side effects may improve QOL and therefore patient adherence to therapy. Use of antidepressant and anxiolytic medications and off-label use of hemopoietic stem cell growth factors are increasing in the daily management of HCV therapy. Although these therapies may improve QOL, prevent dose reductions, and increase the number of patients completing therapy, there are no data available to definitively show that such tactics are associated with improvement in SVR rates in individual patients.