Doctors typically treat hepatitis C with antiviral medications. They may recommend additional or alternate treatments for some people, depending on kidney function and other factors.

Chronic hepatitis C infection is caused by a virus that’s transmitted from person to person through contact with blood containing the virus. If left untreated, hepatitis C can cause liver damage.

Keep reading to learn about the different types of treatments and the latest ones to hit the market.

Hepatitis C is treated with drugs designed to help rid your body of the hepatitis C virus (HCV).

There are several treatment options for hepatitis C. The drug regimen a doctor recommends may vary depending on the type of virus you have.

Medications and recommendations for hepatitis C treatment are changing constantly.

New medications may help people who previously did not have success with treatment. They’re also helping people who may have been unable to receive HCV treatment due to other medical problems. These new medications are more effective and have fewer side effects.

For many years, a combination of two antiviral drugs was used to treat hepatitis C. Antiviral drugs are medications designed to rid the body of viruses.

The two medications include:

  • pegylated interferon (PEG-INF), taken as a weekly injection
  • ribavirin (RBV), taken twice daily

It typically takes between 6 months and a year to complete a round of the combination therapy, sometimes called PEG/RBV.

PEG/RBV therapy alone works for less than half of people with genotype 1, the most common type of hepatitis C virus in the United States. Roughly 60–70% of the U.S. population with hepatitis C have genotype 1.

Side effects from PEG/RBV treatment can be severe and may include:

  • fatigue
  • headache
  • nausea
  • insomnia
  • depression
  • anemia
  • low neutrophil count (neutropenia)
  • low platelet count (thrombocytopenia)

Doctors may sometimes prescribe these medications in combination with other treatments.

Despite having more side effects, this treatment tends to be more affordable than other medication options for hepatitis C.

Treatment options began to get better in 2011 with the introduction of a new class of drugs called direct-acting antivirals (DAAs). These medications help destroy the virus directly by interfering with its ability to reproduce and stay in the body.

DAAs are more effective against most types of hepatitis C than interferon and ribavirin alone with a cure rate of over 90%. They also have fewer side effects.

DAAs have become the standard of treatment for people with chronic hepatitis C. PEG/RBV therapy is no longer recommended for managing hepatitis C.

DAAs may include:

  • daclatasvir (Daklinza)
  • elbasvir/grazoprevir (Zepatier)
  • glecaprevir and pibrentasvir (Mavyret)
  • ledipasvir/sofosbuvir (Harvoni)
  • ombitasvir/paritaprevir/ritonavir (Technivie)
  • ombitasvir/paritaprevir/ritonavir/dasabuvir (Viekira Pak, Viekira XR)
  • simeprevir (Olysio)
  • sofosbuvir (Sovaldi)
  • sofosbuvir/velpatasvir (Epclusa)
  • sofosbuvir/velpatasvir/voxilaprevir (Vosevi)

Some DAAs can interact with other medications, such as cholesterol-lowering statin drugs or certain medications for erectile dysfunction.

These medications, though effective, tend to be expensive. Their cost may be restrictive for some people and may not be covered for Medicaid beneficiaries. In some cases, DAAs may be available through a subscription model.

Protease inhibitors are a new type of DAA medication used to treat HCV infection.

There are four protease inhibitors available in the United States:

  • simeprevir (Olysio)
  • paritaprevir (Viekira, Technivie)
  • grazoprevir (protease inhibitor) with elbasvir (Zepatier)
  • glecaprevir (protease inhibitor) with pibrentasvir (Mavyret)

All are typically used in combination with other drugs depending on the type of hepatitis C. The different classes of drugs used with protease inhibitors each inhibit certain proteins to target different parts of the virus. These can include:

  • NS5A protein inhibitors
  • NS5B nucleoside (NPIs)
  • nonnucleoside (NNPIs) polymerase inhibitors

Protease inhibitors are more effective at treating all genotypes than previous therapies for hepatitis C infections. These drugs may cause fewer and less severe side effects, though this may depend on the other medications prescribed.

In 2014, two oral interferon-free therapies became available in the United States for people with genotype 1.

Two interferon-free therapies became available in the United States for people with genotype 1 in 2014. The medications included:

  • ledipasvir/sofosbuvir (Harvoni), taken once daily for 12–24 weeks
  • ombitasvir/paritaprevir/ritonavir (Viekira Pak), taken daily for 12 weeks

Harvoni is a single tablet that contains a combination of two medications.

Viekira Pak is a combination of three medications and requires taking four to six pills per day.

Both drugs have been shown to have a 95–100% efficacy in people with HCV genotype 1, depending on the duration of treatment.

Side effects of the new medications are generally mild and may include headaches and fatigue.

Before starting any treatment, it’s important to discuss all medications you’re taking with a doctor. That includes prescription and over-the-counter medications.

Treatment for hepatitis C has advanced in the past decade. Newer drugs can cure hepatitis C in most people.

The specific therapy a doctor recommends can depend on other health conditions you may have, your hepatitis C genotype, the amount of liver damage you have, and whether you have undergone treatment in the past.

It’s also important to note that newer medications typically cause fewer side effects.