What Can You Expect From Treatment For A Hepatitis C Infection?

Hepatitis C is a serious global health problem — over 70 million people live with the chronic form of this viral liver disease globally, and over two million of those are US residents. If the year 2017 was anything to go by, around three thousand people in the United States are newly diagnosed with hepatitis C, though the CDC estimates that the disease is seriously underreported and underdiagnosed, and the true number may of new annual infections may be in the tens of thousands. 

Part of that is due to the fact that hepatitis C doesn't announce itself with very distinctive symptoms that will cause most people to know there's something seriously wrong, prompting them to see a doctor. Yes, around a third of newly infected people develop symptoms — which may include a fever, upset stomach, fatigue, nausea and vomiting, and a loss of appetite. They may also include signs of liver trouble, like pale bowel movements and yellow eyes and skin (jaundice). 

Consider getting tested for hepatitis C, which spreads through contact with infected blood, if:

• You have ever injected drugs. Even if it was a long time ago, and even if it happened only once. Intranasal drug use may also raise the risk of hepatitis C, if equipment is shared. 
• You have ever had unsafe sex — that is, unprotected sex with a person whose health status you weren't fully aware of (as you might when you, for instance, both get tested for STDs at the same time). Sexual activity isn't a primary way through which hepatitis C spreads, but since it can potentially expose you to traces of blood, it's far from impossible. 
• You have shared personal care products like razors and toothbrushes with someone who had hepatitis C or may have had hepatitis C. 
• You have otherwise been exposed to blood of unknown status — maybe you suffered a needlestick injury, or maybe you administered first aid to someone when you also had a cut. 
• You received a blood transfusion or organ transplant before 1992, or in a developing country that doesn't routinely test these products for hepatitis C. Also if you have liver disease, HIV, or are on hemodialysis. 

How is acute hepatitis C treated?

Acute hepatitis C is the first stage of the disease, which occurs right after infection. Depending on which data you look at, somewhere between 15 and 25 percent of people who have acute hepatitis will go on to spontaneously clear the infection from their bodies — without any treatment. 

How is chronic hepatitis C treated?

Treatment for chronic hepatitis C consists of three parts:

• Liver tests to see if your liver has been damaged. 
• Oral medications to treat the infection. 
• Lifestyle changes that seek to reduce the risk of permanent liver damage. 

Hepatitis C comes in six main genotypes (strains), with types 1, 2, and 3 being the most common in developed countries. It is possible to be infected with more than one strain at a time. Treatment will vary slightly depending on the strain(s) you have, but some of the most frequently used medications include:

• Simeprevir (Olysio), mainly used to treat genotypes 1 and 4. 
• Sofosbuvir (Sovaldi), used for all strains, often in combination with other medications.
• Ledipasvir, mainly used for genotype 1, often in combination with sofosbuvir. 
• Ombitasvir​, used for different strains in combination with other medications.
• Velpatasvir, used for all genotypes in varying combinations.
• Voxilaprevir.
• Glecaprevir.
• Ribavirin (tribavirin)

These medications may be marketed under different trade names, including as combinations manufactured as one tablet. The combination that is prescribed depends on the strain of hepatitis C, and patients generally take these tablets for eight to 16 weeks, with the average treatment duration being 12 weeks. The cure rate is high — generally over 90 percent. 

What are the side effects of hepatitis C treatment?

This will vary from patient to patient, as well as from drug to drug. On the whole, however, these medications are quite well tolerated. Some people will feel a bit nauseous, while others will have trouble sleeping or feel tired. Let your doctor know if, after starting your treatment, you begin to experience skin problems, weight loss, or hair loss. If you feel irritable, depressed, aggressive, or anxious, also inform your healthcare provider. 

What can you do to help the treatment succeed and be healthier?

You will be tested to see if the virus can still be detected in your body at the end of treatment. Most of the time, the virus will be gone if the test shows you — but because that is not always true, make sure to attend follow-up tests. 

Remember that successful treatment for hepatitis C does not mean you can't be infected again, with the same strain or a different one. After treatment is complete, make sure to take preventative steps to reduce your risk of hepatitis C and other diseases transmitted in the same way.