Hepatitis C is a serious viral infection that can lead to liver damage. You may not even know you have the virus that causes hepatitis C because the condition often has no symptoms.
Early treatment can make a difference. Read on to find out about your treatment options for infection with the hepatitis C virus (HCV).
To determine if you have hepatitis C, your doctor will do a blood test. The one most often used is called an HCV antibody test. It checks for antibodies for HCV. Antibodies are proteins that help your body fight disease.
If you test positive for HCV antibodies, this means you’ve been exposed to the virus. However, you may not have an active infection.
The next step is to have an HCV RNA qualitative test. This test will tell your doctor how much of the virus you have in your body, which will indicate whether you have an active infection.
If these tests show that you have an active HCV infection, your doctor will likely do another test called viral genotyping. This test can tell your doctor what type of HCV you have. The treatment you receive will depend on the type of HCV that’s in your system.
There are two main categories of hepatitis C infection: acute and chronic. Chronic HCV infection is a long-term condition, while the acute form is a short-term infection. Acute HCV infection occurs within the first six months of exposure to the hepatitis C virus.
According to the Centers for Disease Control and Prevention, about 75 percent of people with acute HCV will progress to chronic HCV. That means that up to 25 percent of people with acute hepatitis C will recover from it without treatment.
For this reason, and because treatment for HCV can be expensive, doctors typically don’t treat acute HCV. They’ll often monitor an acute infection to see if it progresses to the chronic form. If the chronic form does develop, treatment can be introduced at that time.
Without treatment, chronic hepatitis C can lead to liver damage and other serious complications. Treatment consists of HCV medications or surgery.
Today, the primary medications used to treat hepatitis C infection are called direct-acting antivirals (DAAs). These drugs may sometimes be used in combination with the drug ribavirin.
Direct-acting antivirals (DAAs)
DAAs are the standard of care for chronic HCV infection. These oral drugs have come onto the market since 2011 and have been found to cure up to 99 percent of people treated with them. In addition, compared to older treatments such as interferons, they can cause far fewer side effects.
Some DAAs are available as individual drugs, and most are available as combination medications. These combination treatments allow you to take fewer pills each day. The combination treatments currently available are:
- Epclusa (sofosbuvir/velpatasvir)
- Harvoni (ledipasvir/sofosbuvir)
- Mavyret (glecaprevir/pibrentasvir)
- Technivie (ombitasvir/paritaprevir/ritonavir)
- Viekira Pak (dasabuvir + ombitasvir/paritaprevir/ritonavir)
- Vosevi (sofosbuvir/velpatasvir/voxilaprevir)
- Zepatier (elbasvir/grazoprevir)
These drugs treat various types of hepatitis C. Your doctor will advise you on the best medications for your type of HCV.
Ribavirin is an older drug that’s still sometimes used. Before DAAs became available, ribavirin was typically prescribed for use with interferons. Today, it’s most often used in combination with certain DAAs to treat resistant HCV infection (infection that’s hard to treat). These DAAs are Zepatier, Viekira Pak, Harvoni, and Technivie.
Ribavirin comes as a capsule, tablet, or solution. Brand-name versions of ribavirin include:
- Ribasphere RibaPak
In more severe cases of chronic hepatitis C and in later stages of the condition, a liver transplant may be needed. This form of treatment is only used if the virus has caused serious liver damage that may lead to liver failure.
During a transplant, surgeons will remove your injured liver and replace it with a healthy organ from a donor. After a transplant, you’ll be prescribed long-term medications to help ensure the success of the transplant.
Having hepatitis C puts you at greater risk for liver cancer. Therefore, as part of your treatment for hepatitis C, you may need to be tested for liver cancer.
By performing an ultrasound test on your liver each year, or sometimes as often as every six months, your doctor will be better able to detect liver cancer.
While some people believe that certain herbs can aid liver health, the National Institutes of Health states that there are no proven alternative supplements or therapies for treating hepatitis C.
Milk thistle (silymarin) is sometimes recommended for treating liver problems. However, studies have confirmed that milk thistle has not been shown to be any more effective than placebo for treatment of hepatitis C. This is true whether the herb is taken as capsules or extracts.
The Mayo Clinic has identified some lifestyle changes you can make to help improve your health during your treatment for hepatitis C. They suggest that you:
- Be careful with your medications. Some drugs, even those prescribed by your doctor, may have the side effect of causing liver damage. This is a bigger risk for people with hepatitis C. Talk to your doctor about whether you should avoid certain prescription or over-the-counter drugs.
- Avoid alcohol. Drinking alcoholic beverages can make liver disease progress more quickly. Therefore, it’s best to avoid alcohol if you have hepatitis C.
Treatments and outlook for hepatitis C are very different today than they were in past years. Many more people are getting cured thanks to the new DAAs available.
If you have hepatitis C or may be at risk for it, the best thing to do is to see your doctor. To start, they can test you for the virus. If you need treatment, they can tell you about the new medications available that have excellent rates for curing hepatitis C.
Working with your doctor, you can build a treatment plan that can help you manage, or even cure, your hepatitis C.