Acupuncture for Adverse Effects of Interferon Therapy for Hepatitis C Infection

Background: Interferon, the recommended treatment for hepatitis C infection, is sometimes poorly tolerated due to its adverse effect profile. Many patients report flu-like symptoms, joint and muscle pains, and intestinal abnormalities often severe enough to cause patients to abandon treatment. Acupuncture has been shown to be an effective treatment for such constitutional symptoms. Objective: To determine if acupuncture could reduce adverse effects in patients receiving interferon therapy for hepatitis C infection. Design, Setting, and Patients: A weekly group acupuncture clinic was created for 6 months (May-October 2009) at the Portland VA Medical Center in Portland, Oregon. All patients receiving interferon therapy for hepatitis C were offered weekly group acupuncture to assess its effect on typical adverse effects associated with interferon. Intervention: Voluntary, anonymous survey packets were distributed to patients before each acupuncture session so they could rate the severity (before vs after acupuncture) of their symptoms of fatigue, muscle aches, irritability, and nausea on a 0-5 Likert scale. Acupuncture consisted of mostly auricular acupuncture points unilaterally (in the style of the Five Needle protocol), and possible scalp or hand command points as indicated by pulse diagnosis. Main Outcome Measure: Fourteen patients completed 39 preacupuncture and postacupuncture session evaluations of their symptoms. Results: Patients described significant reductions in fatigue, muscle aches, irritability, and nausea during their acupuncture treatments. Severity of fatigue decreased 25.7% (P =.01), muscle aches decreased 33.7% (P =.003), irritability decreased 39.5% (P<. 001), and nausea decreased 16.8% (P =.045). Conclusions: Acupuncture appears to offer significant benefits to patients treated with interferon for hepatitis C infection in decreasing adverse effect symptoms of muscle aches, fatigue, irritability, and nausea. Further research is needed to identify the cost-benefit ratio, patient response to treatment, and adherence rates to therapy.