Understanding hepatitis C

Hepatitis C is a contagious viral disease that may damage your liver. It’s caused by the hepatitis C virus (HCV). This disease has several genotypes, or genetic variations. Some genotypes are easier to manage than others. Genotype 3 is harder to contract than other genotypes, but it’s also harder to treat.

What does it mean to have hepatitis C genotype 3?

According to the Centers for Disease Control (CDC), at least six HCV genotypes have been identified. Each genotype has its own subtypes. Because each genotype may be treated with different medications for different durations, it’s important to identify which genotype you have. Genotypes don’t change. In rare cases, you may be infected with more than one type of the virus at once.

Approximately 10 percent of people in the United Sates who have HCV have genotype 3. Less clinical research has been done on this genotype, likely because it is less common.

That said, there’s evidence to suggest that people with this genotype experience a faster rate of fibrosis progression. This means that your liver tissue may thicken and scar faster than that of someone with a different genotype.

People with genotype 3 may also have a higher risk of severe steatosis, or fat accumulation in the liver. This may cause your liver to swell and worsen scarring. This may also contribute to your risk of liver failure.

This genotype can also increase your risk for hepatocellular carcinoma. Hepatocellular carcinoma is the most common form of liver cancer, often occurring in people with chronic hepatitis B or C.

How can you identify what genotype you have?

If you’re infected with HCV, it’s important to know which genotype you have. This will allow your doctor to provide better care by creating a treatment plan specific to your type of HCV.

Overall, this is a relatively new component of HCV treatment. Before 2013, there wasn’t a reliable way to distinguish between the different HCV genotypes that may be present in a person with the infection. In 2013, the U.S. Food and Drug Administration (FDA) approved the first genotyping test for people with HCV.

The Abbott RealTime HCV Genotype ll can differentiate between the following genotypes: 1, 1a, 1b, 2, 3, 4, and 5. To do this, your doctor will first obtain a sample of your blood plasma or serum. The test will pull out the genetic material present inside the HCV virus. From there, the test will produce several identical copies of this extracted material. This amplification can help identify the unique genotype or genotypes present.

This test shouldn't be used as a diagnostic tool for determining HCV infection. Anyone who’s at risk of contracting HCV should be tested for the disease.

Diagnosing HCV

HCV is diagnosed through a blood test. This test is usually performed at your local diagnostic lab or health facility.

You’re considered to be at risk if any of the following apply to you:

  • you were born between 1945 and 1965
  • you took illegal injected drugs at least once at any time in your life
  • you had a blood transfusion or organ transplant before 1992
  • you’re a healthcare worker with a needlestick injury that may have exposed you to HCV
  • you have HIV
  • you were born to a mother who was HCV-positive and you’ve never been tested for HCV

The initial test looks for HCV antibodies in your blood. If antibodies are present, it indicates that you’ve been exposed to the virus at some point. But it’s worth noting that this doesn’t necessarily mean you have HCV.

If you test positive for HCV antibodies, your doctor will order additional blood tests to determine if the virus is active and what your viral load is. Your viral load refers to the amount of the virus that’s in your blood. Some people may fight off HCV without treatment, while others may develop the chronic form of the disease.

How is hepatitis C genotype 3 treated? 

Although there are treatment guidelines for each genotype, there’s not a one-size-fits-all option. Treatment is individualized. Successful treatment plans are based on:

  • how your body responds to medications
  • your viral load
  • your overall health
  • any other health conditions you may have

HCV usually isn’t treated with prescription medications unless it’s chronic. Treatment typically lasts between 24 and 48 weeks and includes combinations of anti-viral drugs and other medications that attack the virus. These treatments can help minimize or prevent liver damage.

It’s been shown that genotype 3 isn’t responding well to the new direct-acting anti-viral agents (DAAs) approved by the FDA. These include boceprevir, telaprevir, and simeprevir. Telaprevir has since been discontinued. It’s unclear exactly why genotype 3 is so resistant to these treatments.

Genotype 3 has been found to respond better to daclatasvir and sofosbuvir (Sovaldi).

Learn more: Hepatitis C medications: Protease inhibitors vs. antiviral drugs »

The bottom line

Genotype 3 is associated with higher rates of liver cancer, fibrosis, and mortality. Because of this, it’s important that you determine which HCV variation you have as soon as possible. This allows you to kick-start your treatment, potentially limiting the damage done to your liver and other serious side effects. The longer you put off diagnosis and treatment, the more difficult your treatment and the poorer your overall outlook may be.

Keep reading: Hepatitis C genotype: Your questions answered »