If you’ve been diagnosed with hepatitis C, there’s a good chance you’ve already had multiple blood tests. These tests confirm the presence of antibodies and virus particles in your blood. They can also provide specific information about how much of the virus is currently in your bloodstream.
Once you receive the diagnosis, and before you start treatment, you’ll need another blood test to determine the genotype of the virus. There are six known genotypes (strains) of hepatitis C, plus more than 50 subtypes.
This test won’t have to be repeated because the genotype doesn’t change. Although it’s uncommon, it’s possible to be infected with more than one genotype. That’s called a superinfection.
It’s estimated that people born between 1945 and 1965 are five times more likely to have contracted hepatitis C than other adults. Because it can take years or even decades for symptoms to appear, many are unaware they’re infected. If you were born during those years and haven’t been tested, talk to your doctor.
Continue reading to learn why knowing your genotype matters and how it impacts the effectiveness of your treatment.
Why does it matter that I have genotype 2?
Knowing that you have genotype 2 offers limited but important information.
It can’t tell you how quickly the liver disease will progress or how severe your symptoms might get. It can’t tell you if an acute infection will become chronic.
What it can tell you is which treatments are most likely to be effective and how long you should take them. It can prevent you from wasting time on the wrong therapy or taking medications longer than you have to.
For example, genotypes 2 and 3 tend to respond better to drug therapy than genotype 1. In many cases, you won’t have to take them as long as you would if you had genotype 1.
How is hepatitis C genotype 2 treated?
The goal of treatment is to clear your body of the virus and prevent or lessen damage to your liver.
It’s unclear why, but 15 to 25 percent of people clear the infection without any treatment at all. Not knowing if that will be the case with you, your doctor may recommend treating the virus right away.
If you have hepatitis C genotype 2, there’s a good chance you’ll have a sustained virologic response (SVR) to oral drug therapy. In other words, it’s highly curable.
Another option is sofosbuvir plus ribavirin (RibaPak) for 12 weeks. If you have little or no scarring of the liver (fibrosis), this regimen gives you more than a 90 percent chance of SVR. If you have cirrhosis of the liver, you’ll probably have to take this drug combination for 16 weeks.
Ribavirin can also be taken with interferon for 24 weeks.
In choosing the drugs and deciding how long you should take them, your doctor will consider factors such as:
- your overall health, especially other health conditions that could affect your liver
- how much of the virus is present in your system (viral load)
- whether or not you already have damage to your liver
- how well any previous treatment for hepatitis C worked, and how well you tolerated it
Follow-up blood testing will reveal how well you’re responding to treatment.
How other genotypes are treated
Treatment for genotypes 1, 3, 4, 5, and 6 also depend on a variety of factors such as viral load and the extent of liver damage. Genotypes 5 and 6 are rare in the United States.
Antiviral medications may include:
- Harvoni, a combination of ledipasvir and sofosbuvir
- Viekira Pak, a combination of ombitasvir, paritaprevir, and ritonavir
- simeprevir (Olysio)
Treatment for some types may take longer than for genotype 2. If liver damage is serious enough, liver transplant might be an option.
What are the potential complications?
Hepatitis C genotype 2 is often curable. But chronic infection can lead to serious complications.
Most people with hepatitis C experience no symptoms or only mild symptoms, even when the liver is becoming damaged.
The first six months after infection is defined as acute hepatitis C infection. This is true whether you have symptoms or not. With treatment, and sometimes without treatment, many people clear the infection during this time. You’re unlikely to have serious liver damage during the acute phase.
If you still have the virus in your system after six months, you have chronic hepatitis C infection. Even so, the disease generally takes many years to progress. Serious complications can include cirrhosis, liver cancer, and liver failure.
Statistics for complications of genotype 2 in particular are lacking.
For all types of hepatitis C in the United States, the Centers for Disease Control and Prevention (CDC) estimates that:
- 75 to 85 out of 100 infected people will go on to develop chronic infection
- 60 to 70 of those will develop chronic liver disease
- 5 to 20 will develop cirrhosis of the liver within 20 to 30 years
- 1 to 5 will die from complications of chronic infection, including liver cancer or cirrhosis
The earlier you get treatment, the better your chances of preventing serious liver damage. In addition to drug therapy, you’ll need follow-up blood tests to see how well it’s working.
The outlook for hepatitis C genotype 2 is very favorable. That’s especially true if you start treatment early, before the virus has the chance to damage your liver.
If you successfully clear hepatitis C genotype 2 from your system, you’ll have antibodies to help protect you from future attacks. But you can still become infected with a different type of hepatitis or a different genotype of hepatitis C.