Treating hepatitis C
Hepatitis C can often be treated successfully by taking a combination of medicines for several months.
If the infection is diagnosed in the early stages, known as acute hepatitis, treatment may not need to begin straight away. Instead, you may have another blood test after a few months to see if your body fights off the virus.
If the infection continues for several months, known as chronic hepatitis, treatment will usually be recommended.
Your treatment plan
Treatment for hepatitis C involves:
- making lifestyle changes to help prevent further damage to your liver and reduce the risk of spreading the infection
- taking a combination of two or three medications to fight the virus – this is known as combination therapy
You'll normally need to take medication for 12 to 48 weeks. This length of time will depend on the exact medicines you're taking and which version (strain) of the hepatitis C virus you have. Your doctor will advise you about this.
There are six main strains of the virus. In the UK, the most common strains are known as "genotype 1" and "genotype 3".
During treatment, you should have blood tests to check if your medication is working. If the test shows treatment is having little effect, it may be stopped as further treatment may be of little use.
There are some things you can do to help limit any damage to your liver and prevent the infection spreading to others. These can include:
- eating a healthy and balanced diet
- exercising regularly
- cutting out alcohol or limiting your intake
- stopping smoking
- keeping personal items, such as toothbrushes or razors, for your own use
- not sharing any needles or syringes with others
Read some FAQs about living with hepatitis C for more information.
Hepatitis C medications
Currently, treatment for chronic hepatitis C usually involves taking two main medicines:
- pegylated interferon – a medication that encourages the immune system to attack the virus
- ribavirin – an antiviral medication that stops the virus reproducing
These medications may just be taken together, although they're often combined with a third medication, such as simeprevir or sofosbuvir.
These are newer hepatitis C medications that have been shown to make treatment more effective. Read more about all these medications below.
Pegylated interferon and ribavirin
Pegylated interferon is usually taken as a weekly injection. You can be trained to inject yourself at home. It usually needs to be taken for up to 48 weeks, depending on your circumstances.
Ribavirin is available as capsules, tablets or an oral solution. It's normally taken twice a day with food. It needs to be taken alongside pegylated interferon for up to 48 weeks.
For more information see the National Institute for Health and Care Excellence (NICE) guidelines on peginterferon alfa and ribavirin for the treatment of chronic hepatitis C.
Simeprevir and sofosbuvir
Simeprevir and sofosbuvir are two of the newest hepatitis C medications recommended by NICE in 2015. They also work by stopping the hepatitis C virus from reproducing.
Simeprevir may be recommended if you have genotype 1 or genotype 4 hepatitis C. Sofosbuvir is usually given to people with genotype 1 hepatitis C, although it can be used to treat the other genotypes in some cases.
Both medications come as a tablet that's taken with food once a day. They're usually taken for either 12, 24 or 48 weeks, depending on your circumstances.
For more information see the NICE guidelines on simeprevir for treating genotypes 1 and 4 chronic hepatitis C and sofosbuvir for treating chronic hepatitis C.
A number of other medications are also available to treat hepatitis C – such as daclatasvir, ombitasvir and paritaprevir – although these haven't yet been recommended by NICE.
You can read about the draft NICE recommendations on the treatment of hepatitis C with daclatasvir, ledipasvir, ombitasvir, paritaprevir, ritonavir and dasabuvir on the NICE website. These recommendations haven’t been finalised yet, but are unlikely to change.
Research into even more effective medications is ongoing.
How effective is treatment?
The effectiveness of treatment for hepatitis C can depend on the strain of the virus you have.
Genotype 1 used to be more challenging to treat and, until quite recently, less than half of people treated would be cured.
However, with the newer medications now available, the chances of a cure can be much higher. Combinations of tablets can now have a cure rate of more than 90%.
This is higher than the chances of curing most other hepatitis C genotypes.
Treatment for genotype 3 will usually involve the standard treatments of pegylated interferon and ribavirin. About 70-80% of those treated will be cured.
If the virus is successfully cleared with treatment, it's important to be aware that you're not immune to the infection. This means, for example, that you could become infected again if you continue to inject drugs after treatment.
If treatment doesn't work, it may be repeated, extended or tried using a different combination of medicines.
Side effects of treatment
Side effects of combination therapy involving interferon are quite common. The new tablet treatments have far fewer side effects and most people feel unaffected by them.
If your treatment involves interferon, side effects can include:
- flu-like symptoms, such as a headache, fatigue (extreme tiredness) and a high temperature (fever)
- a reduced number of red blood cells (anaemia), which can make you feel tired and out of breath
- a rash
- itchy skin
- feeling and being sick
- constipation or diarrhoea
- problems sleeping (insomnia)
- loss of appetite and weight loss
Hepatitis C medications can have unpredictable reactions when taken with other medicines or remedies. Always check with your specialist, GP or pharmacist before taking other types of medication.
Any side effects may improve with time as your body gets used to the medications. Tell your care team if any side effect is becoming particularly troublesome.
Coping with side effects can be challenging, but you should continue to take your medication as instructed. Missing doses may reduce the chances of you being cured.
Treatment during pregnancy
The medications used to treat hepatitis C, particularly ribavirin, can be harmful to unborn babies and aren't normally used during pregnancy.
If you're pregnant when diagnosed with the infection, treatment will usually be delayed until you have given birth. Otherwise, you'll be advised to use contraception throughout your treatment and you may need to have regular pregnancy tests.
If you're a man taking ribavirin, you shouldn't have sex with a pregnant women unless you use a condom. If your partner isn't pregnant, you should ensure contraception is used during the course of your treatment and your partner may need to have regular pregnancy tests.
Deciding against treatment
Some people with chronic hepatitis C decide against treatment. This may be because they:
- don't have any symptoms
- are willing to live with the risk of cirrhosis at a later date
- don't feel the potential benefits of treatment outweigh the side effects treatment can cause
Your care team can give you advice about this, but the final decision about treatment will be yours.
If you decide not to have treatment but then change your mind, you can ask to be treated at any point.
Page last reviewed: 10/07/2015
Next review due: 10/07/2017