Hepatitis C is an infection caused by the hepatitis C virus (HCV). Although some people clear the virus without medical intervention, prompt diagnosis and treatment with antiviral medication can help cure the infection and reduce the risk of long-term complications.

HCV is one of the most serious hepatitis viruses. However, with newer treatments developed over the past few years, chronic hepatitis C is much more manageable now than it was in the past.

Current antiviral drugs that help cure hepatitis C may also help prevent the health complications of chronic liver disease.

Hepatitis C is considered cured or in remission when HCV is undetectable in your blood 12 weeks after treatment is completed. This is otherwise known as a sustained virologic response (SVR).

Medical professionals used to prescribe a combination of ribavirin and pegylated interferon to treat chronic hepatitis C. This approach had a variable cure rate and could have significant side effects.

Rather than directly attacking the virus, the medications would enhance immune system activity. The immune system would then try to kill the virus.

However, since 2011, the Food and Drug Administration (FDA) has approved many medications that attack hepatitis C more directly. These drugs have much better success rates and seem better tolerated than older treatments.

Current antiviral medications

The following drug combinations are direct-acting antivirals (DAAs), which means they aim to attack different aspects of the virus:

  • ledipasvir/sofosbuvir (Harvoni)
  • elbasvir/grazoprevir (Zepatier)
  • ombitasvir/paritaprevir-ritonavir (Technivie)
  • ombitasvir/paritaprevir/ritonavir and dasabuvir (Viekira Pak)
  • daclatasvir/sofosbuvir (Darvoni or Sovodak)
  • glecaprevir/pibrentasvir (Mavyret)
  • sofosbuvir/velpatasvir (Epclusa)
  • sofosbuvir/velpatasvir/voxilapresvir (Vosevi)

Over time, usually 8–24 weeks, this direct-acting approach leads to HCV being reduced and cleared from your system. If you develop SVR after treatment, hepatitis C is considered cured.

Recent research indicates that antiviral drugs may also prevent serious virus complications, such as cirrhosis from chronic liver damage.

Most recent FDA-approved medications

In 2019, the FDA approved glecaprevir/pibrentasvir (Mavyret) for an 8-week treatment period for people with all hepatitis C genotypes.

It’s the first 8-week treatment approved for people 12 years and older or who weigh at least 99 pounds (lb) (45 kilograms [kg]) and have:

  • not previously been treated for hepatitis C
  • no evidence of liver scarring (cirrhosis)
  • mild “compensated” cirrhosis

This treatment is now being used for many people instead of the 12-week treatment that was previously required.

In March 2020, the FDA approved sofosbuvir/velpatasvir (Epclusa) for a 12-week treatment period for people ages 6 years and older or who weigh at least 37.5 lb (17 kg).

It had previously only been approved to treat HCV in adults.

Most FDA-approved treatments take 8–12 weeks to cure the virus, with Mavyret taking the least time for the full treatment. The 8-week course of Mavyret costs approximately $26,056.

Other antivirals such as Harvoni, Zepatier, and Technivie have 12-week treatment courses that cost between $55,000 and $95,000, depending on the antiviral chosen.

Private insurance plans, Medicaid, Medicare, or the Veterans Administration (VA) may help cover the cost of treatment.

Insurance companies usually require prior approval (aka prior authorization) before paying for these medications.

This often depends on whether certain criteria are met involving the severity and progression of the disease, as well as lifestyle factors and coexisting conditions that could contribute to liver damage.

Researchers with the National Institute of Allergy and Infectious Diseases are in the planning stages for future vaccine designs.

Vaccine for hepatitis C treatment

A clinical trial is underway to study the safety and effectiveness of a DNA (deoxyribonucleic acid) vaccine that may boost the immune system’s ability to clear the virus.

The goal of using a DNA vaccine would be to treat chronic hepatitis C in people who already have the condition.

Vaccine for hepatitis C prevention

There’s currently no vaccine available to reduce the risk of developing hepatitis C.

One clinical trial that ended in May 2018 concluded that an experimental vaccine wasn’t effective in preventing HCV infection in adults. However, research continues in hopes of discovering an effective vaccine.

Ongoing research is being conducted that could lead to a vaccine that effectively prevents hepatitis C.

Vaccine after hepatitis C diagnosis

If you receive a hepatitis C diagnosis, your healthcare professional may advise you to get vaccinated against hepatitis A and B.

Contracting another hepatitis virus can increase your risk of complications, especially if you have preexisting liver disease. Vaccinating against hepatitis A and B can help reduce your risk of infection.

According to a 2019 study, hepatitis C could be diagnosed more effectively by using reflex testing. This involves automatically performing the second evaluation step if the first test results are positive.

First, your healthcare professional will perform the HCV antibody test. This is also known as an anti-HCV test. The presence of antibodies in your bloodstream means you’ve been exposed to HCV.

If HCV antibodies are detected, your healthcare professional will perform a second blood test to assess how much of the virus is in your bloodstream. This is known as the viral load.

It’s thought that this “one-step diagnosis” practice could help reduce the overall level of underdiagnosis, as well as reduce the time it takes to begin treatment.

Noninvasive ways to test for liver damage caused by hepatitis C can also aid in diagnosis and treatment.

A liver biopsy is often performed to assess the extent of the viral infection. Magnetic resonance elastography (MRE) and transient elastography (TE) can measure the stiffness of the liver.

Liver stiffness measurement (LSM) can be a useful metric for assessing overall damage.

Can a liver transplant cure hepatitis C?

HCV lives in your bloodstream, not just your liver. Removing your liver will not cure the disease.

If you develop chronic hepatitis C and it leads to liver cancer or liver failure, you may need a liver transplant. Hepatitis C is one of the most common reasons for a liver transplant.

But if you have active hepatitis C at the time of your transplant, damage to your new liver is likely, especially if the condition remains untreated.

Can complementary and alternative medicine treat or cure hepatitis C?

Silymarin, or milk thistle, is commonly suggested to help cure hepatitis C. However, an older, rigorous multicenter study found no beneficial effects from this supplement.

According to the National Center for Complementary and Integrative Health, there are no effective, research-proven forms of alternative treatment or complementary therapy for hepatitis C.

What are the symptoms of hepatitis C?

Every case of hepatitis C begins as an acute infection. It occurs within the first 6 months after exposure. For many people, this stage of the virus has no symptoms.

If you experience symptoms, they can begin weeks or months after exposure to the virus.

Possible symptoms include:

  • fever
  • fatigue
  • nausea
  • vomiting
  • dark urine
  • clay-colored bowel movements
  • joint pain
  • yellow skin or eyes

Most cases of acute hepatitis C will develop into a chronic infection. Chronic hepatitis C usually has no symptoms until it causes a large amount of liver scarring (cirrhosis) and other liver damage.

Over many years, the virus attacks the liver and causes damage. This can lead to liver failure or even death.

How do you prevent hepatitis C?

The only way to prevent hepatitis C is to reduce your risk of exposure to HCV, which is a bloodborne pathogen. To minimize exposure, consider the following actions.

  • Avoid sharing razors, nail clippers, toothbrushes, and other personal care items.
  • Avoid sharing needles, syringes, and other sharps whenever possible.
  • Disinfect wounds and surfaces that blood and other bodily fluids have come in contact with.
  • Patronize reputable tattoo and body piercing studios that practice proper sterilization practices.

HCV usually isn’t transmitted through sexual contact, but it’s possible. Using condoms, gloves, and other barrier methods during sexual activity can help reduce your risk of HCV and sexually transmitted infections (STIs).

How often should you get screened for hepatitis C?

The Centers for Disease Control and Prevention (CDC) recommends getting screened for hepatitis C at least once in your adult lifetime, as well as during each pregnancy.

Additional or more frequent screening for hepatitis C depends on your overall risk of infection. Consult with a healthcare professional to learn more about the risk factors for hepatitis C and to develop an appropriate screening schedule.

Hepatitis C typically doesn’t produce symptoms until after more significant liver damage occurs, so it’s important to get tested as soon as possible if you think you may have been exposed to HCV.

Antiviral medications can cure over 95% of HCV infections, according to the World Health Organization (WHO).

People who develop SVR after treatment are less likely to experience a late relapse in the disease, although further research is needed to understand the potential for reinfection.

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