But even after you finish taking the medication, you may still need to take a few additional steps to safeguard your health — even if you’ve been cured. Here are seven things to expect.
1. You may still need to have follow-up appointments.
Once you’ve been treated for hepatitis C, your doctor will perform another blood test to see if the virus is still present, says Omar Massoud, MD, chief of hepatology at Cleveland Clinic in Ohio. Then you will be tested after another three months to make sure the virus has not come back. “If all tests are negative, you are cured,” says Dr. Massoud. Since hepatitis C doesn’t always cause any symptoms, you may not feel any different after being cured. If you were experiencing symptoms — fatigue is the common one — you should start to feel stronger and more energetic, which should continue to improve after you finish treatment, says Massoud.
2. You may still have liver damage.
Antiviral medication can clear the body of a hepatitis C infection, but it can’t treat the permanent liver damage that may have occurred in the meantime. To determine if you have liver damage, your doctor will perform a biopsy or a scan either before or after you start treatment. If there’s no scarring, you probably won’t need long-term follow-up. If you have severe liver damage, known as cirrhosis, it can be life threatening, so you will need to continue to see your doctor twice a year to monitor your condition. Currently, there’s no treatment for cirrhosis, which is unfortunate, says Massoud. “This is why we stress the need for patients to continue to see their doctor.” At each visit, your doctor will assess your symptoms and, if you have any, run blood work to check your liver function and order an ultrasound to look for cancer. The hepatitis C virus causes inflammation in the liver, which can cause scarring (cirrhosis) and increase the risk for liver cancer. If you had high levels of liver damage before you started treatment, you may still have an increased risk of liver cancer after the infection has been cured, says Massoud. If at any time your doctor believes these tests point to a decline in liver function, you may be evaluated for a possible liver transplant.
3. You may have to stop drinking.
If you have cirrhosis or liver damage — even if it’s mild — you should abstain from alcohol until your liver is healed. “In this case, there is no safe amount of alcohol to drink, even if the patient is feeling well,” Massoud says. If you don’t have liver damage and are cured of hepatitis C, it may be possible to drink in moderation. Talk to your doctor first, though.
4. You can get hepatitis C again.
Hepatitis C is unlike many other viruses, in the sense that you can be reinfected, even after you’ve been cured. While people who’ve been cured of the virus do have antibodies, they don’t protect against the virus, says Massoud. To avoid being reinfected, it’s important to take steps to avoid the virus. For example, don’t share razors or syringes, and avoid sharing toothbrushes with others. It’s also a good idea to ask your partner to be tested for hepatitis C, even though the risk of sexual transmission is low. People who work in healthcare should take additional steps to protect themselves from accidental needlestick injuries.
5. You might need to get vaccinated against hepatitis A and B.
Hepatitis A, B, and C are three different viruses that all cause inflammation of the liver. If you have hepatitis C and contract one of the other two hepatitis viruses, your symptoms will be even more severe, says Massoud. If you haven’t already been vaccinated against hepatitis A and B and also have cirrhosis, the CDC recommends getting the shots after you’ve finished your hepatitis C treatment, to prevent additional liver damage. (There is currently no vaccine available for hepatitis C.)
6. You may want to avoid supplements.
Some supplements, herbs, and over-the-counter drugs can cause liver damage and potentially even liver failure, particularly herbal remedies and bodybuilding supplements, including green tea extract, according to research published in January 2017 in the journal Hepatology. Massoud adds that there are no supplements that can improve the liver, no matter what the claims are. “Nothing can scientifically support, strengthen, or ‘clean’ the liver,” he says, adding that some of them can even be harmful.
7. It’s more important than ever to keep your weight in check.
The second biggest contributor to liver damage (hepatitis C is the main cause) is fatty liver disease, which can be a result of being overweight, says Massoud. So if hepatitis C has already lead to cirrhosis or damage to your liver, it’s especially important to keep your weight in check. Try to eat healthy whenever possible: Fill up on vegetables, while cutting back on sugar and junk food, says Massoud. Eating a balanced diet will not only keep your weight down but can also improve your overall health. If you need help shoring up your diet, ask your primary care doctor or hepatologist to refer you to a nutritionist who has experience working with people who have liver diseases. Additional reporting by Colleen de Bellefonds
