Dưới sự giám hộ của họ, bệnh nhân có thể học cách kiểm soát cơn sốt kết hợp với IFN bằng cách acetaminophen dự phòng. Ho khó chịu và da khô kết hợp với ribavirin điều trị có thể được giảm đáng kể bằng cách khuyến khích các bệnh nhân để duy trì một lượng chất lỏng cao. | 532 Chapter 33 to be closely monitored by an individual who has the time to interact and support them throughout treatment. Physicians are rarely able to achieve this and this role is best performed by a specially trained nurse. Under their tutelage the patient can learn to control the fevers associated with IFN by taking prophylactic acetaminophen. The irritating cough and dry skin associated with ribavirin therapy can be considerably reduced by encouraging the patient to maintain a high fluid intake. The troublesome depression that particularly affects individuals whose pretreatment history indicates past depressive illness can be greatly helped by prophylactic use of antidepressant medications. Appropriate dose reduction of IFN and or ribavirin Dose reduction is most often required because of adverse laboratory events particularly a fall in haemoglobin and or absolute neutrophil count. Sometimes symptoms particularly overwhelming fatigue and shortness of breath may occur when the haemoglobin is not very low but the haemolysis caused by ribavirin has been particularly rapid. Under these circumstances it may be necessary to reduce ribavirin dosage for a short period of time. Addiction medicine counselling A recent study of antiviral therapy given to patients with hepatitis C who fell into various psychiatric risk groups indicated that adherence rates could be easily maintained in individuals with well controlled psychiatric illnesses or in those with prior addiction habits that were controlled on methadone. But in those who were former injecting drug users IDUs but not on methadone the drop-out rate was higher and hence SVR rates were much Unfortunately methadone is only useful in injecting drug users who are addicted to opioids and at present there is no medication which helps curb addiction to other compounds such as cocaine. In some centres antiviral treatment given to current IDUs is said to be successful 45 although few current IDUs are motivated to
