The purpose of hepatitis C virus (HCV) care is to prevent the development of cirrhosis (scarring of the liver), complications from cirrhosis, need for liver transplantation, liver cancer and early death. Right now, there is no vaccine to prevent HCV.
Lately, though, many new drugs have been approved for hepatitis C infection and there are many more drugs that are coming in the next few years. This will lead to cure many patients who have HCV.
- About 15–20 percent of people with HCV will clear the virus from their bodies without treatment and will not get a chronic (lifelong) infection. Experts are not sure why this happens for some patients.
- Most patients will have chronic HCV infection.
A variety of drugs that work in different ways are used together to treat HCV so that the virus can be attacked in different ways to increase your chance of a cure. Your gastroenterologist or liver specialist, called a hepatologist
, will help guide you through complex treatment options.
Injected pegylated interferon and oral medication (Ribavirin):
- In the past, this was the widely used treatment for HCV.
- Patients stay on these drugs for 24–48 weeks.
- It only cures 20–40 percent of patients and is associated with significant side effects.
Protease inhibitors, NS5A inhibitors, polymerase inhibitors:
Examples of HCV drugs:
- These are newer option to care for HCV. They are sometimes called direct-acting antivirals (DAA).
- These treatments do not use interferon.
- Patients stay on these for 12–14 weeks.
- Most cases on these treatments have a greater than 90 percent chance of cure.
- Patients on these have fewer side effects, are better tolerated and have much better success rates than earlier treatments.
- These drugs are very high priced and not all health plans cover them.
No two patients with HCV infection are exactly the same, so each will need an individualized care plan based on certain things, such as:
Note: Active drug abuse or participation in a methadone treatment program does not limit a patient’s chance to be treated for HCV infection.
- The type of HCV.
- There are six genotypes of HCV infection. Most HCV patients in the U.S. have genotype 1 (1a or 1b).
- A lab test can be ordered to find out a patient’s genotype.
- Treatment with other drugs that did not work.
- Scar tissue in the liver (called fibrosis) or cirrhosis (full-blown fibrosis). This can sometimes be found with a liver biopsy (taking a small piece of tissue to look at under a microscope), or other noninvasive studies, such as labs or special ultrasound.
- Complications from cirrhosis that can lead to higher risk of liver failure and early death without liver transplantation.
- Prior liver transplantation for HCV infection.
- Potential for drug allergy or drug-drug interaction.
- Other conditions, such as liver disease, renal disease, HIV, diabetes, psychiatric history or pregnancy.