How is Hepatitis C Treated?

Hepatitis C virus (HCV) can cause acute or chronic infection, which causes inflammation of the liver. In approximately 15% to 50% of cases, acute (short-term) HCV may spontaneously resolve on its own and rarely causes complications like liver failure. However, most HCV infections become chronic (long-term). Chronic HCV infection can lead to complications, including cirrhosis (scarring of the liver), hepatocellular carcinoma (liver cancer), or the need for a liver transplant. Fortunately, HCV has largely become a curable disease with the use of antiviral treatment.1

Treatment guidelines

The guidelines for treatment continue to evolve with the development of new medications, and people with HCV are encouraged to talk to their doctor about which treatments are appropriate 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 are different for different groups of patients, such as:

There are six major genotypes, or strains, of HCV and several subtypes. Some treatments work for all the strains while others only work effectively on specific strains. The choice of treatment depends on the genotype of HCV, whether the individual has existing liver damage or other medical conditions, and what other treatments the person has previously received for HCV.2-4

Types of treatment

The goals of treatment are to eliminate the virus in the body and to prevent cirrhosis, liver cancer, and the need for a liver transplant. There are different kinds of medications that are used to treat HCV, including:

DAAs work by targeting specific steps in the HCV viral life cycle. By targeting the virus, DAAs can shorten the length of treatment, provide a sustained virologic response (also called SVR, which means the virus is not detected in the body), and minimize side effects.5

Interferons are proteins called cytokines that are naturally produced by the body as part of the immune response, and the body typically produces more interferon in response to a virus. The interferon medications used in HCV treatment are similar to the cytokines produced by the body and can help the body to eliminate HCV.6

Ribavirin is a type of antiviral medication that is classified as a nucleoside analogue. Ribavirin works by interfering with the virus’ ability to replicate, and it is often used in combination with other medications 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. While a liver transplant can resolve some of the complications, in most cases a transplant does not cure HCV, and those who have had a liver transplant may need additional medication.3

Written by: Emily Downward | Last reviewed: March 2018.
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