Table of Contents
Hepatitis C Treatment
The main goal of hepatitis c treatment is to cure the patient suffering from the virus (1). This is also referred to as SVR or Sustained Virological Response (2). If the patient is cured, the RNA test will show them to be antibody positive but without any active virus in the body. However, there is no guarantee that a person who was cured will not be re-infected (3). Generally speaking, there is yet no immunity against hepatitis C (4).
Aside from this main goal of hep c treatment, the other goals include:
- Minimizing liver damage
- Preventing progression
- Improving patient’s quality of life
- Reducing the pool of infection
No matter what the state of the liver disease is, everyone should be evaluated for treatment. Sometimes, treatment for hepatitis c is not a possible option, but the decision is usually based on:
- Level of damage to the liver
- Other health problems of the patient
- The amount of hep c in the body
There are many medicines often used to cure this condition, but most of them can cause serious side effects. They are mostly expensive and have not proven to work in every hepatitis c case. This is why many people decide on giving their body a chance to fight off the virus at the beginning stage of hepatitis C, prior to making a decision of choosing a treatment.
Summary: The goal of hepatitis C treatment is to cure the patient suffering from the virus, also known as Sustained Virological Response (SVR). Other goals include reducing liver damage, disease progression, improving quality of life, and minimizing infection. Decision for treatment depends on level of liver damage, existing health issues, and the amount of hep C in the body. Common medications can cause side effects.
Short-Term (Acute) Hepatitis C Treatment
Some people are diagnosed with this hepatitis type when the virus is in the acute phase. This means they are diagnosed in the first six months after the patient is being exposed and infected (5). In these cases, a doctor may recommend a waiting period of a couple of weeks to months, in order to see if the body can fight the virus on its own (6). The chances of this happening are almost non-existing, so in most cases, the patient has to begin with treatment at a later stage (7).
The short-term hepatitis C is generally easier to treat than the chronic one (8). The treatment regimen can be simpler and the duration may be shorter. Additionally, the success rate for acute hepatitis C treatments is much higher than that of chronic hepatitis C (9).
Many patients are concerned about the numerous side effects of treatments and decide to delay the treatment to a later time in their lives.
The length and type of treatment for acute hepatitis C can vary greatly. There are various treatments for acute hepatitis C, such as:
- Peg-interferon and ribavirin
- Other hepatitis C medicines
The length of acute hepatitis C treatment can vary between 12 and 24 weeks (10). You should always consult the doctor for all possible treatment options.
The acute phase of hepatitis c can include no visible symptoms and it is very difficult to discover at the beginning (11). There are many people who suffer from acute hepatitis C but are not treated for the reason of not being aware of the virus. Most people get treated with medicine, which may prevent chronic infection. However, the debate over when treatment should be started and how long should it last is still ongoing.
Summary: Acute hepatitis C is usually diagnosed in the first six months after a patient is exposed and infected. Oftentimes, there are no visible symptoms in the beginning. Some physicians recommend waiting on treatment to see if the body can fight the virus on its own, which is somewhat rare. Many patient opt to wait on treatment because of the side effects. Treatments include peg-interferon, peg-interferon and ribavirin, and other hepatitis C medications.
Long-Term (chronic) Hepatitis C Treatment
As we mentioned, it is a common situation for a person infected with the virus to spend many careless years without being aware of their situation. Most people diagnosed with hepatitis C find out that they are infected when the infection becomes chronic and symptoms start to appear (12, 13).
Treatments may include a combination of antiviral medicines that can be used to fight the viral infection from causing serious liver problems (14). Such liver problems include liver cancer and cirrhosis (15). These medicines are used as a treatment for 12 weeks up to a year and their aim is to help the patient get rid of the virus permanently.
Even if the doctor does not recommend medicines or the patients decide not to go with a treatment, patients should have routine blood tests to check the liver condition.
Summary: Due to the lack of symptoms in the beginning after being infected, a person can live many years without knowing they have hepatitis C. Treatment of long-term (chronic) hep C includes a combination of antiviral medications which aims to get rid of the virus permanently. Routine blood tests should be done to check the liver for damage.
Treatment of Nonresponse or Relapse
If the first round of medicine does not work well, sometimes patients can change to a different combination as a treatment alternative. The decision of changing treatment is based on the tolerance of the first treatment and the results achieved at the moment of deciding.
Treatment of Worsening Condition
Chronic hepatitis C can cause severe liver damage (16, 17). This can take a period of 20 or more years to develop and if hepatitis C continues to worsen, it can cause the liver to stop working completely (18, 19). This is also known as end-stage liver failure (20).
When this happens, the only way to extend the life of the patient is by a liver transplant (21). If the person in need of a liver drinks alcohol, uses drugs or suffers from severe depression or mental illness, chances are that transplant will not be an option (22).
Summary: If the first treatment does not work, a different combination may be recommended. Chronic hep C can cause liver damage, and eventually cause the liver to stop working properly which is known as end-stage liver failure. A liver transplant is then recommended for the person to extend quality of life.
Length of Treatment
A combination of different treatments is usually given for a fixed amount of time in cases of hepatitis C. This amount of time may vary from eight weeks to a year. If a person has an undetectable hepatitis C viral load, there may be chances for a shorter course of treatment in certain points and cases.
Summary: Length of treatment varies from 8 weeks to 1 year. It varies based on how detectable and severe the hepatitis C viral load is.
Stage of Liver Damage in Hepatitis C
The initial parts of diagnosing hepatitis c include assessing the levels of liver damage in the patient (23). The amount of damage to the liver a person has can influence and impact the treatments for the virus.
Medications have more chances of curing people with minimal liver damage compared to those in advanced stages of it (24). Therefore, treating the condition earlier is a much better and open alternative than treating it late.
Rarely, there are cases where people have a liver that gets damaged very slowly. These people may have to wait in order to start the treatment of hepatitis C (25).
There are some recent medications that have shown to work good in clinical trials used to find a cure for people with cirrhosis.
Summary: Treating earlier stages of hepatitis C has much better outcomes and less liver damage. The first part of diagnosing hep C is assessing the level of liver damage, which influences and impacts treatment courses.
Other Health Conditions and Hepatitis C
When a person who suffers from hepatitis c also suffers from other conditions, treatment has to be selected accordingly. Other health conditions can greatly affect the chances of the patient being cured of hep c. Also, a particular hepatitis c medication being used may not have been tested in people with that particular health condition. This is why it is highly important that the doctor who is taking care of the patient knows about all health issues prior to selecting the treatment.
A patient must inform the doctor about any health issues they have or medications they are taking prior to the beginning of the treatment. If the doctor is informed, they may determine if there is a potential for medication interaction between the medications for the other health issue and the hepatitis c.
Summary: It is very important the doctor is notified of any medications and existing health conditions when diagnosed with hepatitis C. Other health issues greatly affect chances of being cured of hep C. Medications for hep C may not be tested and verified safe for individuals with other health conditions. It’s also important to note medications can interact with one another and in some cases cause further damage.
There is a grand variety of treatments and experimental hepatitis treatments that are currently being tested in people who suffer from both this disease and HIV.
Clinical trials have shown that people who co-infected with hepatitis c and HIV have lower cure rates when treated with drug combinations that include peg-interferon, compared to people who were only mono-infected with hepatitis c (26).
Therefore, new clinical trials for the new interferon-free treatments were also introduced. The results of these were equal for people who suffer from both HIV and hepatitis C and those who only have hepatitis C (27, 28).
New treatments are rarely tested on people who also have HIV. These are usually tested in people who are mono-infected with hepatitis C first (29). Therefore, people who are co-infected have much smaller chances of accessing the newest medications when compared to those who do not have HIV (30).
Summary: There are many experimental treatments currently being tested for those who have both HIV and hepatitis C. Peg-interferon drug combinations have shown lower cure rates compared to those mono-infected with hep C. People who are co-infected generally don’t have access to the newest medications because new treatments are rarely tested on people who have both HIV and hep C.
Coverage and Cost of Medications for Hepatitis C
The medications for hepatitis c treatments are usually expensive. People who do not have the funds to pay treatment often get the medication costs covered through the many programs available for financial assistance.
Some cover their medication costs by private health insurance, while others are covered by territorial or provincial drug formularies. Of course, there are certain conditions for accessing the latter programs.
If you are in need of information about programs that can cover the costs of the medications fully or partially, the best thing to do is discuss this issue with a doctor or another medical professional. Also, there is much information about medical coverage available online.
Summary: Hepatitis C medications are usually expensive. Financial assistance and programs are often available for those who cannot afford the treatment. Discuss with a doctor or medical professional concerns for coverage and potential financial assistance.
Vaccines for Hepatitis C
Prevention of Hepatitis C
Even though there is no vaccine to prevent the virus from entering the body, you could always reduce the risk of being infected with it. You will achieve this if:
- You don’t share needles, cotton, water, and spoons if you are injecting drugs. There are cities that have needle exchange programs that will provide you with sterile needles so that you don’t share the ones you use with people who may suffer from hepatitis c.
- If you work in health care, make sure to strictly follow the safety guidelines. These include wearing protective clothing and gloves, disposing of sharp objects and needles that can be contaminated.
- If you decide on getting a tattoo, make sure that you choose a practitioner that sterilizes the instruments and the supplies they use on you. The same applies to acupuncture and body piercing.
Summary: If you work in health care, be sure to wear protective clothing and gloves, and properly dispose of contaminated needles. If you take injectable medications, make sure to not share needles, cotton, water, and spoons. If you decide to get a tattoo, make sure the practitioner is using safe sterilizing practices.
If you are diagnosed with hepatitis c, the human thing to do is try not to spread it to others. You could do this by:
- Not sharing needles and equipment that you use for injecting drugs
- Keep scrapes, cuts, and blisters covered at all times to prevent others from infecting themselves when in contact with your body fluids.
- Dispose properly of blood-soaked items, including used band-aids
- Do not donate blood
- Do not donate sperm
- Wash the hands or any object that comes in contact with your blood
- Do not share razor, nail clippers, toothbrush, diabetes supplies or anything that may be infected with your blood.
Summary: If you have been diagnosed with hepatitis C, avoid sharing needles, cover scrapes, cuts, and blisters, dispose properly of bandages, do not donate blood or sperm, wash hands after touching your blood or bodily fluids, and do not share anything that comes in contact with blood or fluids.
Managing the treatment of hepatitis C is easier when the life of the patient is stable and they have the necessary support at home and in life (33). There are many things that can help a person fight this condition and accept treatment as a part of a daily routine.
Hepatitis C treatment often includes peg-interferon and this can cause depression in some cases (34, 35). If the person suffering from hepatitis C has suffered from depression in the past or has a family member with a history of mental health problems, there are chances depression will occur while treating this virus.
You should discuss treatment options with your doctor in cases when you are currently suffering or have been diagnosed with depression before. After the treatment ends, the doctor is the one to determine when and whether the patient should stop taking antidepressants. This, of course, applies in cases where patients use antidepressants as a part of their treatment.
People diagnosed with hepatitis C suffer through an enormous life change, so they need all help they can get. Luckily, with the advancement in medicine, there are now numerous hep c treatments available and the chances of surviving this virus are much higher than before. However, hepatitis C is not something to be taken as something irrelevant, especially because complications may even lead to death. After all, this condition affects one highly important organ in the body, the liver, and this may cause additional health issues even if hepatitis C has been treated.
Summary: It is overwhelming for patients diagnosed with hepatitis C. This big change means they need all the support they can get. In some cases, the treatment peg-interferon can cause depression. If a hep C patient has a history of mental health issues, risk of developing depression is high. Consult with a physician if this is the case, and seek support services for the condition.
People should check for hepatitis C infections often since something as simple as a blood contact can make you the next patient (36, 37). After all, treating hepatitis c in the acute phase is a much easier thing to do. When it reaches the chronic phase, treatment and chances are both more difficult for the patient.