Hepatitis C is a virus that can cause damage to the liver, an organ that plays a major role in your health and performs more than 500 unique functions in the body, according to Johns Hopkins Medicine. “People don’t recognize how important the liver is until it’s not working anymore,” says Lanla Conteh, MD, MPH, a transplant hepatologist specializing in the treatment of end-stage liver disease and liver cancer at The Ohio State University Wexner Medical Center in Columbus. Liver problems can include internal bleeding, confusion, fluid retention, and liver cancer, she says. The good news is that timely treatment can prevent cirrhosis (permanent scarring of the liver), a deterioration of liver function, liver cancer, liver transplant, and death, according to a May 2019 clinical update in JAMA Insights. Here are some questions you may have about hepatitis C medication.
1. How soon should I get treated for hepatitis C?
If you have chronic hepatitis C, you should be treated right away. “Over time, hepatitis C can cause chronic inflammation in the liver that leads to cirrhosis or end-stage liver disease [also known as liver failure],” says Dr. Conteh. By treating the infection as soon as possible, you might be able to stave off some of the permanent damage that can occur to the liver.
2. Can hepatitis C be cured?
Yes. The current antiviral medications can cure hepatitis C in more than 90 percent of people after 8 to 12 weeks of treatment, according to the Centers for Disease Control and Prevention (CDC). “Other viruses, including HIV and hepatitis B, can only be suppressed, but hepatitis C is one we can actually cure,” says Conteh. That said, people who’ve been cured of hepatitis C aren’t immune to the virus, meaning they can be reinfected in the future. You’re at higher risk for catching hepatitis C if you’re injecting drugs, are receiving hemodialysis, have HIV, or get a body piercing or tattoo with nonsterile instruments, according to the CDC.
3. What type of hepatitis C treatment will I start?
Hepatitis C is treated with antiviral medications. Your doctor will determine what “type” of hepatitis C you have — i.e., its genotype — and, depending on those results, will recommend one or more medications to take. (About 70 percent of people in the United States have genotype 1.) Some meds can treat all hepatitis C genotypes, whereas others treat one specific genotype, according to the American Liver Foundation. There are several drugs/drug combinations that have been approved by the Food and Drug Administration. You can find more information on them here.
4. What are the side effects of the treatment?
Whenever you begin a medication, there are always risks of side effects. But unlike the older treatments for hepatitis C, the newer antivirals “tend to be very well tolerated,” says Conteh. These side effects, according to the American Liver Foundation, include fatigue, insomnia, and nausea. Some medications can also reactivate a hepatitis B infection, which can cause serious liver complications. For that reason, you will also be monitored for hep B, she says.
5. What types of follow-up care will I need during the weeks I’m being treated?
Before treatment, your doctor will likely check your blood work. Then, they will check it again one month after treatment has started, explains Conteh. At the three-month mark, when most people have been cured and will stop taking the medication, your doctor will look at your lab work again.
6. Is there anything I shouldn’t do while taking hepatitis C medication?
You shouldn’t drink, but not because alcohol will interfere with the medication specifically. Rather, alcohol can lead to cirrhosis and advanced liver disease, according to the American Liver Foundation. “If people have cirrhosis, we recommend that they don’t consume alcohol,” says Conteh.
7. Can I give hepatitis C to the people I live with?
It’s possible but not likely. “Hepatitis C is usually transmitted by blood,” says Conteh, so you won’t give it to your friends and family through everyday contact. People usually get the virus via injection drug use or needlestick injuries in a healthcare environment. In the past, they could have received infected blood during a blood transfusion before blood screening for hepatitis C became available in the early 1990s, according to the CDC. The CDC points out that sex is a possible route of transmission, as is sharing items such as razors and toothbrushes, which could contain contaminated blood, but both are unlikely ways to pass along the infection.
8. What can I expect after my treatment is complete?
If you have developed cirrhosis, you will be screened regularly for liver cancer with an abdominal ultrasound every six months, says Conteh. “This scan is very reasonable price-wise and is easily accessible,” she says. You will also likely get an alpha fetoprotein (AFP) tumor marker test, she says, which is a blood test that can detect liver cancer and is used to monitor the health of people with cirrhosis or liver cancer, according to the U.S. National Library of Medicine. Keep in mind, too, that even if you’ve been cured of the infection, you can still catch it again.
9. Should I be embarrassed that I have hep C?
No. There’s an unfortunate stigma associated with hepatitis C, and that can make people shy away from being tested or treated for the virus. Currently, the CDC recommends that all adults over 18 be screened for hepatitis C, and that women get tested during each pregnancy. “As clinicians, we know that people can become infected many ways,” says Conteh. “We are not here to judge. We want to diagnose, treat, and cure the virus.”
