Treating Hepatitis C: Medicine

Hepatitis C is a virus that harms the liver. It’s treated with antiviral medicines. In many cases, the medicines can cure hepatitis C. Even if the medicines don’t cure the virus, they can prevent or slow the scarring of your liver (cirrhosis). And they may lower your risk for liver cancer.

During treatment, follow your doctor’s instructions exactly.

How antiviral medicine works

Antiviral medicine stops a virus from reproducing in the body. You need to take the medicines for weeks or months for them to work. If the hepatitis C virus can’t be found in a blood test 12 weeks after treatment, the infection is considered to be cured. This is called sustained virologic response (SVR). At that point, you can also no longer transmit the virus to other people.

In some cases, the hepatitis C virus is still found in the blood after treatment. Staying on a strict medicine schedule can help prevent this.

There are different kinds of antiviral medicines for hepatitis C. And there are different types of the hepatitis C virus. The types of virus are called genotypes, and numbered 1 through 6. Your genotype is found with a blood test. Genotypes 1, 2, and 3 are the most common. Most genotypes can be treated with the same antiviral medicines, but occasionally a different medicine is needed.

Creating your treatment plan

You will likely take one medicine daily by mouth for 8 weeks to 6 months. Occasionally multiple medicines are needed. Your healthcare provider will decide the best types of medicines and schedule for you.

Your treatment plan will depend on:

• How much hepatitis C virus is in your body

• Your hepatitis C genotype

• How much liver damage you have (such as if you have cirrhosis and how severe it is)

• If you have any thyroid or kidney problems

• If you were treated for hepatitis C in the past, and with what medicines

• If you had a liver transplant

• What medicines you take, including supplements and over-the-counter medicines

• What other health conditions you have

During treatment, you’ll have visits with your healthcare provider every few weeks or months. You’ll have blood tests to check the amount of virus in your body. You’ll also have blood tests to see how well your liver is working. The medicine will likely help your liver work better. Make sure to tell your healthcare provider about any side effects you have from the medicines.

Staying on track with your medicine

While you’re taking medicine, it’s important not to miss any doses. Missing doses may cause the medicine not to work as well. To remind yourself of your daily dose:

• Set reminders. Put reminders in a digital calendar, or use alarms or timers. Put a sticky note next to the coffee maker or on the bathroom mirror. Figure out what will work best for you.

• Use a pill organizer. You can buy a pill organizer at most drugstores. They have small compartments labeled by day of week or time of day.

• Tell family and friends. They can help you stay on track with your medicine schedule.

• Join a support group. Hepatitis C support group members may have other ideas for staying on schedule.

• Ask about company support programs. Ask your healthcare provider about a support program from the company that makes your medicine. Some companies have resources to help people stay on top of their medicine schedule.

After treatment

After treatment, you’ll have follow-up visits with your healthcare provider every few weeks or months. You’ll have tests such as:

• Blood tests. These are to see if the virus is being cleared from your body. You’ll also have tests to check how your liver is working.

• Imaging tests. If you have liver scarring, you may have a test every 6 months to check for signs of liver cancer. You may have an ultrasound, CT scan, or MRI test.

• Upper endoscopy. If you have cirrhosis, this is done to look for swollen blood vessels in the stomach or esophagus. These can bleed and cause serious health problems.

In some cases, you may still have the virus in your blood after treatment. You may have another course of medicine in the future. Your healthcare provider will talk with you about your options.

Women and birth control

If you’re a woman who hasn’t gone through menopause, take special care in these cases:

• Treatment with ribavirin. You’ll need to prevent pregnancy with at least 2 types of birth control during and 6 months after treatment.

• Treatment with a protease inhibitor. Don’t use hormonal birth control during treatment. These medicines cause hormonal birth control not to work well. This includes birth control pills, injections, patches, implants, and hormone ring.

Protecting your health after treatment

To help prevent damage to your liver after treatment:

• Don’t drink alcohol

• Don’t use drugs

• Use condoms during sex

• Talk with your healthcare provider before taking any new medicine

• Talk with your provider about vaccines for hepatitis A and B. There is no vaccine for hepatitis C.

It’s important to know that if you’re cured of hepatitis C, you’re not protected from being infected again. You can get the virus again through contact with blood from someone who has the virus. Talk with your healthcare provider about the best ways to protect yourself from another infection.