Many people live with the hepatitis C virus (HCV) without even knowing they have it. Hepatitis C, caused by HCV, damages the liver. About 15 to 25 percent of people with the virus clear it without treatment. This is called acute HCV and is rarely associated with life-threatening conditions.
The other 75 to 85 percent of people will develop chronic HCV infection. Chronic hepatitis C is long-term and can lead to permanent liver scarring (cirrhosis) or liver cancer. Anywhere from 5 to 20 percent of the people who develop chronic hepatitis will develop cirrhosis within 20 years. Chronic HCV usually has no symptoms. People with chronic HCV may not even know they have it. But once symptoms appear, it means that damage to the liver has already begun.
The outlook and life expectancy for people with chronic HCV depends on how much of their liver is damaged. It also depends on how well a person responds to treatment.
Read on to learn about the latest treatments and how you or someone you know can improve their outlook.
Chronic HCV is often treatable. It usually involves taking a combination of medicines until the virus clears from your body. These drugs work to keep the virus from multiplying and eventually kill off the virus. Drug regimens for hepatitis C are always changing and getting better. Talk to your doctor about the latest treatment to see if it might work for you.
After treatment, your doctor will make sure the virus is gone. Being clear of the virus, also called SVR (sustained virologic response), means that it will likely not come back. But you can still get reinfected.
In the United States, older drug regimens included interferon injection and Ribavirin, an oral medication. Now, newer oral medications called direct antiviral agents (DAAs) may be more effective and better tolerated. The percentage of patients clearing the virus to undetectable levels can range from 60 to 95 percent, depending on the:
- DAA used
- HCV genotype
- viral count
- severity of liver damage prior to treatment
Treatment time may also be shortened (between 8 and 12 weeks depending on the medication used).
The Centers for Disease Control and Prevention (CDC) reports that HCV causes more deaths than any other infectious disease. This is because HCV screening isn’t as routine and people who have the virus aren’t aware of the infection.
It’s important to include routine HCV screening for certain populations to identify the condition before severe damage occurs. A late diagnosis can affect the treatment’s effectiveness.
Treatment success for chronic hepatitis C also depends on the genotype of the virus. Genotypes are variations of the virus that have evolved over the years. Some genotypes may be more difficult to treat than others. Currently in the United States, the most common genotypes are types 1A and 1B, which account for about 70 percent of all cases of hepatitis C.
Cases of hepatitis C in the United States
The CDC reports that deaths associated with hepatitis C reached an all-time high in 2014. This may be due to the fact that many people born between 1945 and 1965 unknowingly have HCV.
Studies show that baby boomers are five times more likely than other groups to have been exposed to hepatitis C. This is most likely due to receiving blood, blood products, or transplants prior to universal screening procedures. And since people with HCV might not show symptoms, they may unknowingly transmit the virus to others.
Today, the most common risk factor for hepatitis C in the United States is intravenous drug use.
Since an HCV infection can show no symptoms, the number of new cases is likely higher than reported, according to the CDC.
Cirrhosis and liver cancer cause about 1 to 5 percent of HCV-related deaths as treatment options are limited for these conditions. It normally takes 20 to 30 years for people with chronic hepatitis C to develop cirrhosis. And about 5 to 20 percent of people with chronic HCV will develop cirrhosis. Without treatment, cirrhosis can lead to liver failure.
Treating cirrhosis and liver cancer typically requires a liver transplant. A transplant can cure both cancer and liver function impairment. But a transplant is only available for a small number of people.
In June 2016, the U.S. Food and Drug Administration (FDA) approved the combination medication Epclusa (sofosbuvir and velpatasvir). This is the first drug approved to treat all six genotypes of hepatitis C. Treatment options and new drug regimens for hepatitis C are rapidly evolving.
Read more about the latest drug regimens.
As of 2016, there’s no vaccination for hepatitis C. The virus is unique because it has at least six distinct forms and 50 subtypes. But researchers are working on a vaccine that has promising results. In phase I of the safety trial, 15 healthy volunteers showed high T-cell immune response. T cells are important to naturally clearing the virus.
Your outlook for HCV depends on the type of virus you have. In fact, you may not even know you have acute HCV, which in about 15 to 30 percent of cases clears on its own. But for chronic HCV, the outlook depends on your overall health, the degree of liver damage, how soon you get treatment, and how you respond to treatment.
Drug therapies for chronic HCV can clear the virus and newer therapies are frequently improving the success rates of these treatments.
Learn more about recent advances for hepatitis C medication.
Untreated chronic HCV can lead to cirrhosis and liver cancer. About 1 to 5 percent of chronic HCV cases with cirrhosis or liver cancer lead to death. At advanced stages of cirrhosis, your doctor may recommend a liver transplant and medication. Overall, your outlook improves with early diagnosis.