
What you Should Know About Hepatitis C and Anemia
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Photo Credit: Confidencial Colombia
Hepatitis C is a liver infection. It is caused by a virus. It is characterized by symptoms like:
- Abdominal pain
- Fatigue
- Fever
- Jaundice
- Nausea
- Vomiting
Some medications can treat hepatitis C effectively. However, these medications can cause some side effects, like anemia.
Anemia is caused by a shortage of hemoglobin in the blood. Hemoglobin is a protein that helps with the transport of oxygen by the red blood cells.
Your body cells don’t work well if you are deprived of oxygen. This will result in weakness, tiredness, or an inability to think properly.
Ribavirin and interferon are examples of medications that treat hepatitis C effectively. Studies have shown that these drugs can increase the risk of anemia in people who take them.
Newly developed hepatitis C medications also have this side effect.
How do I know that I am anemic?
When there is a shortage of oxygen in your cells, they won’t work at optimal conditions. This may result in tiredness or cold.
You may experience symptoms such as:
- Pains in your chest
- Chills
- Fainting
- Dizziness
- Chronic fatigue
- Headache
- Pale skin
- Difficulty sleeping
- Shortness of breath
- Weakness
- Foggy thinking
If left untreated, anemia can result in very serious complications, such as jaundice and an enlarged spleen.
Anemia can also worsen pre-existing conditions, such as chronic obstructive pulmonary disease or coronary artery disease.
In some cases, anemic people can develop cardiac arrest. Cardiac arrest is a condition that occurs when the heartbeat ceases.
What causes anemia in hepatitis C?
Ribavirin and interferon can cause anemia. These are drugs used to treat hepatitis C. They cause anemia as a side effect.
Interferon suppresses red blood cell production. On the other hand, ribavirin ruptures red blood cells, thus resulting in their death.
New hepatitis C medications like boceprevir also cause anemia as a side effect. The combined therapy of ribavirin and interferon with boceprevir can cause very drastic drops in hemoglobin levels.
You are also at risk of anemia is you have the following conditions:
- Cirrhosis of the liver
- Sickle cell anemia
- HIV
- Hemorrhage due to injury
- Bleeding in the gastrointestinal tract due to peptic ulcer
- Kidney disease
- Deficiency of iron, folic acid, or vitamin B-12 in your diet
How to control anemia from hepatitis C
While treating your hepatitis C, your healthcare provider will ask you to take some blood tests every few weeks or months. The goal is to check your Hb levels. If your risk for anemia is high, then you may need weekly tests.
After treating for a couple of months, your Hb levels will stabilize. And once you stop taking the drugs, the anemia will resolve.
If the symptoms persist, your doctor will reduce your dose of ribavirin. If it continues to fall, then they may stop the treatment altogether.
You may be given injections of epoetin alfa to help relieve the symptoms. This injection stimulates the production of red blood cells by your bone marrow.
If you have more red blood cells in your body, you will also have more oxygen in your body. Common side effects caused by these medicines include sweating, chills, and muscle aches.
It is a fact that anemia can cause cold and tiredness, it isn’t entirely bad. A drop in hemoglobin level is associated with a sustained virologic response.
A sustained virologic response means that there is no trace of the hepatitis C virus in your blood for at least 6 months after treatment. Frankly, a sustained virologic response means a cure.
Discussing with your doctor
During treatment, your doctor will test you regularly for anemia. If you have anemia with persistent symptoms, inform your healthcare provider, they will know how best to treat it.
Ask your doctor about other alternative treatments that may help you feel better. Take naps and breaks to relieve the fatigue caused by anemia. You can also ask your family and friends to assist you with chores and other activities of daily living. Eat a balanced diet to keep you healthy.

Tonika Bruce, also known as The Network Nurse, is a multi-talented individual with a career spanning over 20 years. She’s a Registered Nurse, speaker, author, and advocate for change, excelling in business building and team development. Tonika holds two Master’s degrees in Nursing and Business Administration, (MSN & MBA) and is currently pursuing her Doctorate of Nursing Practice in Executive Leadership.
Her expertise extends to various fields such as nursing, entrepreneurship, business, basketball coaching, and executive leadership. She is a published author of “Relentless Pursuit: Proven Tips for Unlocking Your Potentials, Limitless Success and Post COVID Syndrome: A Guide to Repositioning the Nursing Profession for A Post COVID Era”. Currently, Tonika is working on Thrudemic, an anthology examining the impact of the coronavirus pandemic on medical professionals and patients.