Hepatitis C 101: Can Hepatitis C be Cured?

Hepatitis C (HCV) is one of the more serious viral infections that attacks and can damage the liver. Naturally, then, when you or someone you care about contracts HCV, you’ll want to know if it’s a curable infection.

According to the Centers for Disease Control and Prevention (CDC), an acute hepatitis C infection occurs within the first 6 months after someone is exposed to the hepatitis C virus. For most people, an acute infection leads to a chronic infection, but between 15 – 25% of patients in the acute phase will clear the infection without treatment. The other 75 – 85% will progress to chronic hepatitis C.

What is the Goal of Treatment?

The goal of chronic hepatitis C treatment is to cure the infection by reducing the virus to an undetectable level. This is usually done using a couple of different drugs at a time.

Which drugs are used depends on a myriad of factors, such as genotype (the genetic structure of the virus), current viral load, past treatment experience (if any), detectable liver damage, tolerance to prescribed treatment, and whether someone has had or is waiting for a liver transplant.

When someone has an undetectable viral load 6 months after completing a full course of treatment, HCV treatment is considered to have been successful.  Successful HCV treatment is called a sustained virological response (SVR).

Does Successful Treatment Mean HCV is Cured?

A decrease in viral load during treatment can link to successfully achieving SVR. Achieving rapid virologic response (4 weeks after treatment begins), extended RVR (between 4 to 12 weeks after treatment begins), and early virologic response (12 weeks after treatment begins) can provide guidance to the possibility of SVR. Sustained virologic response (SVR) is defined as having undetectable virus for at least 6 months after completion of therapy.

Someone who has an SVR is considered virologically cured. Patients with cirrhosis may still be at risk for liver cancer. This is especially true if the patient was diagnosed and treated for HCV after they already had cirrhosis. However, treatment can help reduce the chance of the development of liver cancer.

Which Treatments Cure Hepatitis C?

Peginterferon alpha once per week through injection and ribavirin pills taken daily for anywhere from 6 to 11 months was the standard treatment for nearly a decade, but within the last few years, several new drugs have been approved by the FDA. These new drugs include the protease inhibitors: Boceprevir (Victrelis) and Simeprevir (Olysio), the polymerase inhibitor: Sofosbuvir (Sovaldi), and most recently, the multi-class combination drugs: Harvoni and Viekira Pak - all of which have greatly improved the cure rates for HCV patients. Previously, cure rates were around 40-50%, in most cases, but now cure rates have increased to over 90% in anyone who hasn’t previously been treated for chronic HCV.

These new drugs are not only improving cure rates, but they’re also reducing the duration of treatment and the number of adverse side effects associated with older treatment regimens. What’s more, there are upwards of 20 other HCV treatments currently being evaluated in clinical trials which are expected to continue improving cure rates, side effects, and treatment duration.

Does Treatment Work for African Americans and Latinos?

Previously, HCV treatment was less effective for African Americans than for those from other racial groups because of genetics. Specifically, researchers identified a gene that links a less successful response to treatment with pegintereferon alpha. However, clinical trials done with newer generation drugs have not found the same results, and there was no difference in the cure rates among Black study participants to that of non-Black participants.

While HCV has been found to progress more rapidly in Latinos than for people from other racial groups, clinical trials of newer generation treatments have also no longer found a difference in success rates among Latinos.

Can Vaccines Cure Hepatitis C?

Currently, there are vaccines to prevent both hepatitis A and B, but there are no vaccines available for the hepatitis C virus. Nevertheless, researchers are working to develop a vaccine for hepatitis C as well.

Those who are diagnosed with HCV may be advised to get a vaccine against hepatitis A and B to help reduce any additional exposure and potential complications or damage to the liver as a result of contracting a new hepatitis infection.

Can a Liver Transplant Cure Hepatitis C?

Following a liver transplant, it’s important to continue all prescribed medications and to have frequent check‐ups with a healthcare provider. Even though a liver transplant removes the damaged part of the liver and replaces it with healthy liver tissue, this is not necessarily a cure for hepatitis C. If the hepatitis C virus is still present in the bloodstream, it can re-infect the new liver.

Can Alternative Medicines Cure Hepatitis C?

Some people believe alternative medicines can cure an HCV infection, however, the Mayo Clinic asserts that there is no research confirming alternative methods will be complimentary to one’s treatment regimen.

Of the alternative therapies commonly mentioned, milk thistle tends to appear most often, but a study published by the Journal of the American Medical Association (JAMA) debunked this claim and found that milk thistle had the same effect as the placebo did in treating patients with HCV.

The National Institute of Health (NIH) urges those who have been diagnosed with hepatitis C to follow their doctor’s instructions and any recommended treatment regimens prescribed by their healthcare team.^1,2,3,4,5