A hepatitis C diagnosis can come as a shock. After all, many people who test positive for the virus have been living with it for years — even decades — without knowing it. But, it’s important not to underestimate a hepatitis C infection.
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 vital bodily functions, 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 cure hepatitis C and significantly lower its complications, including cirrhosis (permanent scarring of the liver), deterioration of liver function, liver cancer, the need for a liver transplant, and death, according to a review published in June 2023 in Gastroenterology Insights and a study published in December 2022 in JAMA Internal Medicine. 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 liver damage that can occur.
2. Can Hepatitis C Be Cured?
Yes. 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 reinfection in the future is possible. You’re at higher risk of catching hepatitis C if you inject drugs, are receiving hemodialysis, have HIV, or get a body piercing or tattoo with unsterile instruments, according to the CDC.
3. What Type of Hepatitis C Treatment Will I Start?
Hepatitis C is treated with direct-acting antiviral (DAA) medications. Your doctor will determine what genotype of hepatitis C you have and, depending on those results, recommend one or more medications to take. (About 75 percent of Americans with hepatitis C have genotype 1a or 1b, according to the American Liver Foundation.) Some meds can treat all hepatitis C genotypes, whereas others treat only one specific genotype.
There are several drugs and drug combinations that have been approved by the U.S. Food and Drug Administration. You can find more information on them here.
4. What Are the Side Effects of Treatment?
Whenever you begin a medication, there’s always a risk of side effects. But, unlike older treatments for hepatitis C, the newer DAAs “tend to be very well tolerated,” says Conteh. Possible side effects include headaches, fatigue, insomnia, and nausea, according to the American Liver Foundation.
Some medications can also reactivate a hepatitis B infection, which can cause serious liver complications. For that reason, you will also be tested for hepatitis B before you start treatment, she says.
5. What Types of Follow-Up Care Will I Need During the Weeks I’m Being Treated?
Your doctor will likely check your blood work before treatment and then 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 do anything to further damage your liver, such as smoke or drink. While these substances won’t affect your treatment specifically, 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 a needlestick injury in a healthcare environment. Before blood screening for hepatitis C became available in the early 1990s, the virus could be acquired through infected blood during a blood transfusion, according to the CDC.
The CDC points out that sex is a possible route of transmission, as is sharing items that could contain contaminated blood, such as razors and toothbrushes, but both are unlikely to pass along the infection.
8. What Can I Expect After My Treatment Is Complete?
If you have developed cirrhosis, you will be screened 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 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 City of Hope.
People with mild to moderate liver damage shouldn’t require any special aftercare. Keep in mind, though, that even if you’ve been cured of the infection, you can still catch it again.
9. Should I Be Embarrassed That I Have Hepatitis 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 in many ways,” says Conteh. “We are not here to judge. We want to diagnose, treat, and cure the virus.”
