Hepatitis C is a disease that affects the liver. Living with hepatitis C for a long time can damage your liver to the point where it doesn’t work very well. Early treatment can help protect your liver and preserve your quality of life.
Doctors divide hepatitis C into two types based on how long you’ve had the condition:
- Acute hepatitis C is the early stage when you’ve had hepatitis for less than six months.
- Chronic hepatitis C is the long-term type, which means you’ve had the condition for at least six months. Up to 85 percent of people who have hepatitis C will eventually develop the chronic form of the disease.
Your doctor will recommend a treatment based on the type of hepatitis C you have. Understanding your treatment options will help you make informed decisions.
Treatments for acute hepatitis C
If you have acute hepatitis C, you don’t need to treat it right away. In 15 to 25 percent of people with this disease, it will clear on its own without any treatment.
You will need to be monitored, however. Your doctor will give you an HCV RNA blood test every four to eight weeks for about six months. This test shows how much hepatitis C virus (HCV) is in your bloodstream.
During this time, you can still transmit the virus to others through blood-to-blood contact. Avoid sharing or reusing needles. For example, this includes when getting a tattoo or piercing in an unregulated setting, or injecting drugs. During sexual intercourse, use a condom or another barrier birth control method to avoid transmitting the virus to others.
If the virus clears by six months, you won’t need to be treated. But it’s important to take precautions to avoid contracting the virus again in the future.
Treatments for chronic hepatitis C
A positive HCV RNA blood test after six months means that you have a chronic hepatitis C infection. You’ll need treatment to prevent the virus from damaging your liver.
The main treatment uses antiviral drugs to clear the virus from your bloodstream. New antiviral drugs can cure more than 90 percent of people with chronic hepatitis C.
Your doctor will choose an antiviral drug or combination of drugs based on the amount of liver damage you have, what treatments you’ve had in the past, and what hepatitis C genotype you have. There are six genotypes. Each genotype responds to certain medications.
Antiviral drugs that are FDA-approved to treat chronic hepatitis C include:
- daclatasvir/sofosbuvir (Daklinza) – genotypes 1 and 3
- elbasvir/grazoprevir (Zepatier) – genotypes 1 and 4
- glecaprevir/pibrentasvir (Mavyret) – genotypes 1, 2, 5, 6
- ledipasvir/sofosburir (Harvoni) – genotypes 1, 4, 5, 6
- ombitasvir/paritaprevir/ritonavir (Technivie) – genotype 4
- ombitasvir/paritaprevir/ritonavir and dasabuvir (Viekira Pak) – genotypes 1a, 1b
- simeprevir (Olysio) – genotype 1
- sofosbuvir/velpatasvir (Epclusa) – all genotypes
- sofosbuvir (Sovaldi) – all genotypes
- sofosbuvir/velpatasvir/voxilaprevir (Vosevi) – all genotypes
Peginterferon alfa-2a (Pegasys), peginterferon alfa-2b (Pegintron), and ribavirin (Copegus, Rebetol, Ribasphere) used to be the standard treatments for chronic hepatitis C. However, they took a long time to work and often didn’t cure the virus. They also caused side effects like fever, chills, appetite loss, and sore throat.
Today, peginterferon alfa and ribavirin are used less often because new antiviral drugs are more effective and cause fewer side effects. But the combination of peginterferon alfa, ribavirin, and sofosbuvir is still the standard treatment for people with hepatitis C genotypes 1 and 4.
You’ll take hepatitis medications for 8 to 12 weeks. During treatment, your doctor will give you periodic blood tests to measure the amount of hepatitis C virus left in your bloodstream.
The goal is to have no trace of the virus in your blood at least 12 weeks after you finish treatment. This is called a sustained virologic response, or SVR. It means that your treatment was successful.
If the first treatment you try doesn’t work, your doctor can prescribe you a different drug that may have better results.
Hepatitis C damages and scars the liver. If you’ve lived with the disease for many years, your liver could be damaged to the point where it no longer works. At that point, your doctor might recommend a liver transplant.
A liver transplant removes your old liver and replaces it with a new, healthy one. Often the liver comes from a donor who has died, but living donor transplants are also possible.
Getting a new liver will help you feel better, but it won’t cure your hepatitis C. To work towards curing the virus and achieving SVR, you’ll still need to take the antiviral drug that matches your disease genotype.
Talk with your doctor
Today, new antiviral treatments are helping to cure many more people with hepatitis C than in past years. If you have hepatitis C or may be at risk for it, be sure to see your doctor. They can test you for the virus and determine which type of hepatitis C you may have. If you need treatment, your doctor can help you create a treatment plan for managing hepatitis C and working toward a cure.