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Questions When Starting Hep C Treatment

What you and your healthcare provider need to know in order to give you the best chance of successfully treating hep C.

Questions When Starting Hep C Treatment

Hepatitis C is a blood-borne virus that causes inflammation in the liver. In 60 to 80 percent of cases, hep C develops into a chronic infection, meaning that it does not resolve and requires treatment. Left untreated, a chronic hep C infection can lead to serious long term complications, including cirrhosis of the liver, liver cancer, and liver failure.

Although it can be a serious threat to a person’s health, most people with chronic hep C do not have noticeable symptoms, and a person can have hep C for years without knowing it. The only way to know if you have hep C is to get tested—this can be done with a blood test performed by a healthcare provider. The U.S. Preventive Services Task Force recommends hep C screening for every person between 18 and 79 years old.

Fortunately, if a hep C screening comes back positive, the treatments available are very effective—and are able to cure hep C infections in over 90 percent of cases that were not previously treated. With hep C, a person is considered cured if there is no trace of the virus in their blood three months after finishing treatment.

Direct-acting antivirals
The preferred treatment for hep C is a class of drugs called direct-acting antivirals, or DAAs, which work by disrupting the lifecycle of the hep C virus and interfering with the virus’s ability to replicate. There are several different types of DAAs that target the hep C virus in different ways. There are also different strains of the hep C virus, called genotypes. Different DAAs work better for treating different genotypes. Identifying the genotype is done during diagnosis, after confirming that a person has an active hep C infection. A treatment plan will often use a combination of several types of DAAs. This combination is referred to as a regimen.

Starting treatment
It is recommended that a person with hep C begin treatment as soon as possible. There are a number of factors about your medical history and overall health that your healthcare provider will consider when choosing a regimen and deciding how to treat. These include:

  • If you have previously been treated for hep C, and what therapies were used during that treatment.
  • If you have had a liver transplant.
  • If you have a co-infection with another virus, such as HIV (human-immunodeficiency virus) or hepatitis B.
  • The health of your liver and the extent of liver damage.
  • Other illnesses, such as kidney disease or a health condition that causes anemia.
  • What medications you take, including prescriptions, over-the-counter medications, supplements, and herbal remedies. These may interact with hep C therapies and some may cause damage to the liver.
  • If you are pregnant. Treatment should be delayed if you are pregnant. The potential side effects of antiviral therapy during pregnancy are unknown.
  • If you are breastfeeding or planning to breastfeed. It is unknown if medications used to treat hep C are passed through breast milk.

Adhering to treatment
In order to have the best chance of success at being cured of hep C, it is important to follow your treatment plan exactly as prescribed. DAAs are taken as oral medications, and are typically taken daily for a period of three months (though duration of treatment can vary). Skipping doses or stopping treatment early can make DAAs less effective and may lead to the virus becoming resistant to those medications.

Your healthcare provider may also discuss other ways to protect your liver and your overall health from hep C, including changes to diet, seeking treatment for substance abuse, practicing safe sex, and staying up to date on your vaccinations.

Medically reviewed in September 2019.

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