How is Hepatitis C Treated?

Hepatitis C virus (HCV) can cause acute or chronic infection, which causes inflammation of the liver. In about 15 to 50 percent of cases, acute (short-term) HCV may spontaneously resolve on its own. It rarely causes complications like liver failure. However, most HCV infections become chronic (long-term). Chronic HCV infection can lead to complications like:1

Fortunately, HCV is often a curable disease with the use of antiviral treatment.1

Treatment guidelines

The guidelines for treatment continue to evolve with the development of new medicines. People with HCV should talk to their doctor about which treatments are right for them.

General guidelines for HCV treatment come from the American Association for the Study of Liver Diseases (AASLD) and Infectious Diseases Society of America (ISDA). Recommended treatments vary for different groups of people, such as:2

  • Those who have not had any prior treatment for HCV
  • Those who have had other treatments for HCV
  • Those who also have human immunodeficiency virus (HIV)
  • Those who have had a liver transplant
  • Those who have developed cirrhosis (scarring of the liver)
  • Those with kidney problems
  • Those who are pregnant
  • Children with HCV

There are 6 major genotypes (strains) of HCV and several subtypes. Some treatments work for all the strains. Others only work on specific strains. The choice of treatment depends on:2-4

  • The genotype of HCV
  • Whether the person has existing liver damage or other medical conditions
  • What other treatments the person has previously received for HCV

Types of treatment

The goals of treatment are to eliminate the virus in the body, as well as prevent cirrhosis, liver cancer, and the need for a liver transplant. Different kinds of medicines are used to treat HCV, including:1

DAAs work by targeting specific steps in the HCV viral life cycle. By targeting the virus, DAAs can:5

  • Shorten the length of treatment
  • Provide a sustained virologic response (SVR), which means the virus is not detected in the body
  • Reduce side effects

Interferon are proteins called cytokines. They are naturally made by the body as part of the immune response. The body makes more interferons in response to a virus. The interferon drugs used in HCV treatment are similar to the cytokines made by the body and can help the body eliminate HCV.6

Ribavirin is a type of antiviral drug that is known as a nucleoside analogue. Ribavirin works by interfering with the virus’ ability to replicate. It is often used along with other medicines to treat HCV.7

Liver transplant

For people with chronic HCV who have developed complications, a liver transplant may be an option. In a liver transplant, the damaged liver is removed and replaced with a healthy liver from a donor. The donor may be deceased, or a living donor can give a portion of their liver. A liver transplant can resolve some of the complications, but in most cases, it does not cure HCV. People who have had a liver transplant may need additional medicines.3

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Written by: Emily Downward | Last reviewed: September 2021