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How Direct-Acting Antivirals Treat Hep C

Learn how direct-acting antivirals can clear hep C infections.

How Direct-Acting Antivirals Treat Hep C

Often called hep C, hepatitis C is a viral infection that causes liver inflammation. This infection is often asymptomatic, meaning it does not cause any noticeable symptoms, which makes it possible for a person to have hep C and not know it. Over many years, the persistent inflammation caused by the virus can result in serious complications, increasing a person’s risk of cirrhosis (scarring of the liver) as well as liver cancer and liver failure. It is estimated that more than 3 million people in the United States have hep C.

The good news is that there are effective treatments for hep C.

Direct-acting antivirals (abbreviated as DAAs) are the preferred treatment, and can cure hep C infections in most patients. When discussing hep C, “cured” means that blood tests are unable to detect the virus at least 12 weeks after treatment has been completed.

How DAAs work
To understand how DAAs work, it helps to understand how the hep C virus replicates. In very simplified terms, hep C attaches to liver cells and inserts its own genetic material (called RNA) into those liver cells. Once inside a cell, the virus takes over the cell’s systems and begins to make copies of itself. These copies are then released to infect other liver cells.

While this is a very simplified explanation, the process is complex. It occurs over numerous different stages, and involves the interaction between numerous proteins and enzymes.

DAAs work by blocking the different enzymes, proteins, and processes that hep C needs to replicate. There are a number of different DAAs available, which are named and categorized based on what they target and how they work.

Choosing a treatment
A person being treated for hep C may take one DAA medication, or a combination of several medications. Medications are typically taken for a duration of 8 to 12 weeks (though longer durations may be necessary for some patients).

There are a number of factors your healthcare provider will take into account when deciding what treatment plan will be most effective. Among these factors is the hep C genotype. Genotypes are different forms of the hep C virus, and certain medications are used to treat certain genotypes.

Other factors that healthcare providers will consider when deciding on a treatment:

  • The extent of liver damage, and if you have cirrhosis.
  • If you’ve been treated for hep C before.
  • If you’ve had a liver transplant.
  • Other health conditions (such as diabetes, other forms of hepatitis, kidney disease, or other chronic viral infections such as HIV).
  • Other medications you are taking.
  • Your overall health.

The only way to know what hep C treatment is right for you—and to get treated—is to work with a healthcare provider.

Medically reviewed in June 2019.

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