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.

Hepatitis C genotype 3 is harder to contract than other genotypes, but it’s also harder to treat. Read on to discover what it means to have genotype 3 and how it’s treated.

According to the Centers for Disease Control and Prevention (CDC), at least seven HCV genotypes have been identified. Each genotype has its own subtypes — more than 67.

Because each genotype may be treated with different medications for different durations, it’s important to identify which genotype a person has. Genotypes don’t change. Although in rare cases, someone may be infected with more than one type of the virus at once.

Approximately 22 to 30 percent of people with HCV infections have genotype 3. The clinical research on therapies for this genotype have so far trailed behind research for other genotypes. However, this gap is now believed to be closing.

Research into better treatments is important as there’s evidence to suggest that people with this genotype experience a faster progression of fibrosis. 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 can 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.

With the HCV infection, it’s important to know which genotype a person has. This will allow a healthcare provider to give the best care by creating a treatment plan specific to the 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.

Various nucleic acid amplification tests can differentiate between the following genotypes:

  • 1
  • 1a
  • 1b
  • 2
  • 3
  • 4
  • 5

To do this, your doctor will first obtain a sample of your blood plasma or serum. In the test, genetic material will be pulled out that’s present inside the HCV virus. From there, several identical copies of this extracted material will be produced. 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 for HCV should be tested for the disease.

Diagnosing HCV

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

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

  • 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 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.

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 8 and 24 weeks and includes combinations of antiviral drugs and other medications that attack the virus. These treatments can help minimize or prevent liver damage.

It’s been shown that genotype 3 is less likely to respond to a typical course of the new direct-acting antiviral agents (DAAs) approved by the FDA. Regimens more likely to fail may include:

  • boceprevir
  • telaprevir
  • 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 newer drug combinations, including:

  • glecaprevir-pibrentasvir (Mavyret)
  • sofosbuvir-velpatasvir (Epclusa)
  • daclatasvir-sofosbuvir (Sovaldi)

Genotype 1 is the most common variation of HCV in the United States and worldwide. Approximately 70 percent of U.S. people with HCV have genotype 1.

Worldwide, data suggests that approximately 22 percent of all cases are genotypes 2, 4, and 6. Genotype 5 is the rarest, comprising less than 1 percent of the global population.

Genotype 3 is associated with higher rates of liver cancer, fibrosis, and mortality. Because of this, it’s important to determine which HCV genotype someone has, if they’ve been diagnosed with the HCV infection.

This allows someone with this genotype to kick-start their treatment, potentially limiting the damage done to their liver and other serious side effects. The longer diagnosis and treatment are put off, the more difficult treatment will become and the higher the risk for complications.