Hepatitis C: Get Tested and Treated Now to Prevent Problems Later

BY MICHAEL R. PAGE, PHARMD, RPH
Long-term damage from the hepatitis C virus is avoidable if you are proactive in seeking help.
PUBLISHED WEDNESDAY, JUNE 10, 2015
What is Hepatitis C?

Hepatitis C is a contagious virus that can cause serious liver problems. About 170 to 200 million people worldwide have a chronic hepatitis C virus (HCV) infection. Of those people, 3 to 5 million live in the United States—and many have unknowingly had the condition for years. Every year, about 17,000 people develop hepatitis C in the United States, and 12,000 people die of the liver damage that results from the virus.1,2

When a person is first exposed to HCV, they might develop a mild illness that may or may not have any symptoms. This early portion of the illness is known as acute hepatitis C and may last up to six months. In people who develop acute hepatitis C, about 75 percent to 85 percent develop a long-term infection, known as chronic hepatitis C, that gradually damages the liver without causing other symptoms. The remaining 15 percent to 25 percent of patients will fight off the virus and will not develop chronic hepatitis C.1

People who develop chronic hepatitis C may have no symptoms for decades—up to 30 years. When symptoms finally do occur, they are often signs of advanced liver disease. These symptoms may include fever, fatigue, loss of appetite, nausea, vomiting, abdominal pain or dark urine. In addition to causing liver damage, cirrhosis and liver failure, chronic hepatitis C can also lead to liver cancer. Getting tested and getting treatment may prevent liver damage, cirrhosis and even liver cancer in many people with a chronic infection.1,3

How Do I Get Tested?

HCV can be detected by a special blood test that is not performed during regular physical exams. This blood test can detect antibodies, products of the immune system that stay in the body after a person has been infected with HCV. If antibodies are present, another blood test will be needed to find out if the antibodies are from an acute HCV infection that the body fought off in the past or if the acute infection developed into chronic hepatitis C.1,3,4

Chronic HCV infection is five times more common in members of the baby boomer generation than it is in the general population. In fact, three out of every four people in the United States who have a chronic HCV infection are baby boomers. Because of this, the Centers for Disease Control and Prevention recommends that all people who were born between the years 1945 and 1965 get tested for HCV at least once.1,3,5

Others especially at risk for hepatitis C and who should be tested include people who1,3,4:
  • Have HIV
  • Have liver disease or high levels of liver enzymes in the blood
  • Received donated blood or organs before 1992
  • Are undergoing regular hemodialysis
  • Have used injected drugs in the past (even if it was only once, many years ago)
  • Have been exposed to blood through an accidental needle stick
  • Have gotten a tattoo or body piercing in an informal setting or with nonsterile equipment
What Has Changed?

Until 2011, the only drugs available for treatment of HCV infection were peginterferon, an injectable medication, and ribavirin, an oral medication. After 2011, a new generation of treatments became available. These treatments are known as direct-acting antiviral drugs because they act in a very specific way that target parts of the HCV. At first, these treatments were used in combination with the older treatments, such as injectable peginterferon, but two of the most recent treatment regimens only require patients to take oral medication.2

Older treatments for HCV were associated with common side effects that made treatment difficult to use. For instance, patients taking interferons may develop flu-like symptoms, depression, malaise and even lung problems. The other medication, ribavirin, may cause a severe form of anemia and may lead to birth defects if a pregnant woman is exposed to the drug.6,7

Newer medications like Harvoni, Viekira Pak and the combination of Olysio and Sovaldi make up three different oral regimens that the FDA has approved as treatments for HCV. These medications may be easier to use than older medications because no injections are required and they are taken for 12 to 24 weeks, depending on the type of HCV infection and what other illnesses and complications a patient has. Common side effects are listed in the table. In many cases, these new treatments can cure the infection and prevent it from coming back.8-11

How well do these treatments work compared with older medications? Currently, there is no vaccine for hepatitis C, but there are treatments that can help patients cure the chronic infection. In the past, treatment with peginterferon regimens lasted six months to one year and were successful in treating only 40 percent to 50 percent of patients. In addition, people who found out they had advanced liver disease could not use the treatments.

Current treatments offer cure rates ranging from 90 percent to 100 percent with 12 to 24 weeks of treatment and do not require injections. It is important to note that the cure rate will vary depending on how sick patients are to begin with, as well as the type of HCV infection the patient has. The duration of treatment and the type of treatment also may vary depending on these factors.8-12

Recommended Articles
Study finds a common assortment of reasons for non-initiation of HCV therapy, regardless of patient race or ethnicity.
Managing the risk of hepatitis C and liver disease among infants born to mothers with chronic HCV is a challenge.
HCV patients with cirrhosis and severe sepsis face elevated risk of organ failure.
Anti-retroviral drug therapy may effectively treat hepatitis C-HIV coinfection.
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