After receiving a hepatitis C diagnosis, it’s common to have many questions about your treatment options. Perhaps you’ve heard about long, exhaustive medication protocols that were used in the past and fear that you’ll be treating the condition for years. Hepatitis C treatments have come a long way in the last several years in terms of efficacy and shortened treatment durations. At Batash Medical in Rego Park, NY, we specialize in personalized HCV treatments that identify your specific health needs to deliver the fastest recovery times.
What Is Hepatitis C (HCV)?
The term hepatitis means liver inflammation. Hepatitis types are categorized based on their cause. Some forms of hepatitis are caused by substance abuse, environmental toxins, and certain medications. Other types of hepatitis are caused by viruses. Hepatitis A, hepatitis B, and hepatitis C are all viral infections.
All three of the viral types of hepatitis have similar symptoms but are contracted and spread differently. Hepatitis A is caused by the ingestion of food or drinks contaminated with fecal matter, and hepatitis B is transmitted through contact with infected blood and sexual fluids. Hepatitis C is contracted through contact with infected blood. We have vaccines for hepatitis A and B, but there isn’t a vaccine for hepatitis C.
Acute and Chronic HCV
Often, viral hepatitis C begins as an acute infection that, when left untreated, becomes a severe and chronic condition. Acute hepatitis infections happen within the first six months after exposure to the virus. Without treatment, hepatitis C becomes a chronic infection that can last a lifetime and wreak havoc on the liver.
According to the CDC, approximately 2.4 million people in the U.S. have hepatitis C. Many people aren’t aware that they have the infection because symptoms aren’t always present. Some signs of hepatitis C include:
- Achy muscles
- Appetite loss
- Clay-colored bowel movements
- Dark urine
- Itchy skin
- Joint pain
- Stomach pain
- Yellowing of the eyes or skin (jaundice)
Risk for Baby Boomers
Individuals born between 1945 and 1965 (baby boomers) are five times more likely to have hepatitis C. The CDC recommends that all people born within this time get tested for HCV. Although it’s not completely clear why this group of people has a much higher incidence of the infection, many theories exist. Some point to the lack of universal sterilization practices in hospitals as the culprit for the widespread prevalence of the virus in baby boomers.
Other High-Risk Individuals
Anyone who has ever injected drugs is at an increased risk for HCV, as are those who received clotting factor concentrates before 1987. Any recipient of a blood transfusion or organ donation before July 1992 should get tested for the infection. We also recommend that hemodialysis and HIV patients get tested. If you have ever received a tattoo or a piercing with a questionable needle, it’s a good idea to contact us for the antibody test.
How Do I Find Out If I Have Hepatitis C?
The only way to know if you have HCV is to visit your doctor for blood testing. You can have normal liver enzyme levels with chronic hepatitis C, so it’s not reliable to use a liver function test to gauge whether you have the virus. We’ll run a hepatitis C antibody test to look for HCV. These tests determine if you have or have ever had the hepatitis C virus. There are two results from this test: non-reactive or negative and reactive or positive.
Non-Reactive or Negative
A non-reactive result shows that you have never been infected with the HCV virus. It takes between three and 12 weeks for the virus to show up on an antibody test. If you have been exposed to the virus only recently, you’ll need to be re-tested in the future.
Reactive or Positive
You will receive a reactive or positive result if you have ever been infected with the hepatitis C virus. However, this result doesn’t automatically suggest that you have HCV. Anyone who has ever been infected with the virus will have lingering antibodies in their blood. If you have a reactive test result, we will give you a follow-up test to determine if you are currently infected with hepatitis C.
If you have hepatitis C, we will get to work to find the right treatment plan for you. Fortunately, you now have access to advanced treatments. In the last decade, treatment times have sped up, become more effective, and eliminated much of the side effects that previously plagued those being treated for hep C. Only a gastroenterologist or hepatologist is specialized in treating hepatitis C. This condition requires advanced training that not all physicians have. Your treatment options and plan will depend on:
- Your viral load (how much of the virus is in your system)
- The genotype of the HCV
- Any other health problems you have
- Whether you’ve been treated for HCV previously
- Whether you have liver damage or cirrhosis
How Long Will It Take to Treat Hepatitis C?
The precise time it will take to treat your hepatitis C depends on a variety of factors specific to you as an individual. The good news is that modern medicine has finally developed hepatitis C treatments that work and work quickly.
Before we explore the new treatment options, we’d like to clear the air about hep C treatments of the past. This information can help you understand the differences between the old and new treatment options and ease your mind regarding what to expect.
Old Hep C Treatments
If you are like many patients, you’ve heard stories about HCV treatment that sound unbearable. For decades, treating this virus was a long, experimental process with unpleasant consequences.
Treating HCV the Hard Way
For many years, patients diagnosed with the hepatitis C virus had to take medication daily and visit their doctor every week for an injection of interferon or pegylated interferon. These old-school drugs functioned by mitigating the immune response to the virus indirectly instead of targeting the virus itself. The strategy with these drugs is to boost the immune system hoping it would clear the infection on its own. Sometimes this worked, sometimes it didn’t.
Patients could expect to continue this treatment routine for at least one year, and often much longer. Before the latest advancements in hep C medications hit the market, only about 50% to 70% of patients would clear the virus after one treatment. When the treatment didn’t work in one cycle, patients would need to go through the entire cycle process again. Some patients required three or even four cycles—each at least one year—to get rid of the virus.
Interferon therapies are infamous for causing a slew of unsavory side-effects that were intolerable for many patients. In these dark ages of HCV treatment, many patients stopped taking their medications to avoid these side effects, which left their liver vulnerable to further damage from the virus.
Ongoing or chronic hepatitis C can lead to scarring of the liver called cirrhosis. Although the liver is capable of regenerating itself, the regeneration process can’t happen in areas that are scarred. Excessive liver scarring is one of the top contributors to developing liver cancer or liver failure. In the past, patients often opted to risk irreparable liver damage than to live with the side effects of hep C medications.
Old hepatitis C treatments were also complicated in that age, race, and the condition of the liver all played significant roles in how effective it was. Each patient needed different medications for different durations, which further complicated the process.
New Hepatitis C Treatments
Now that you understand the downsides of the old hepatitis C regimens, you can throw it all out the window. Modern HCV treatments are everything the old medications were not. These new medications are called DAAs, or direct-acting antivirals. As the name suggests, the drugs target the hepatitis C virus specifically. They locate the virus and block it from progressing in its life cycle.
Evolved Hep C Drug Class
DAAs are taken orally and do not require an injection. This new drug class hones in on the hepatitis C virus specifically to shorten therapy times and dramatically reduce side effects.
DAAs are used in combinations that are clinically proven to cure hepatitis C. DAAs are individual drugs and, therefore, not interchangeable. These medications are used together to prevent virus-resistance and to remove the virus most effectively. When used in tandem, these drugs have cure rates ranging from 91% to 100%: a staggering improvement from their predecessors. DAAs include:
- Epclusa (sofosbuvir and velpatasvir)
- Harvoni (ledipasvir and sofosbuvir)
- Mavyret (glecaprevir and pibrentasvir)
- Technivie (ombitasvir, paritaprevir, ritonavir)
- Viekira Pak and Viekira Pak XR (ombitasvir, paritaprevir, and ritonavir with dasabuvir tabs)
- Zepatier (elbasvir and grazoprevir)
All hepatitis C genotypes are now treatable with DAAs. Some hard-to-treat hep C genotypes like genotype 3 may still require a combination treatment that includes pegylated interferon injections or ribavirin, but this is only the case if the virus is resistant to DAAs. DAA resistance is relatively uncommon. Most HCV cases in the U.S. are genotypes 1a and 1b.
Reliable Treatment Times
Modern hep C treatments are fast. Most people are free of the virus after only eight to 12 weeks. However, your healing journey doesn’t stop after your last dose. We must observe you for six months following your last dose of medication. Hepatitis C particles can hide in your system for up to half a year or around 24 weeks. After this period, it’s unlikely that the virus will replicate again.
When the virus is not detected six months after your last dose of medication, your diagnosis shifts to a sustained virologic response (SVR). SVR is the closest we can get to curing the virus. Often SVR indicates that the medication was successful in removing the virus from your system. Usually, achieving the SVR state means the infection is gone and will not return.
In some rare cases, patients may experience a resurgence of hepatitis C after six months. Only around 1% to 2% of patients experience a relapse during this time. It’s even rarer for a patient to relapse after SVR for one year. If you are free from HCV viral particles for one year, you are considered cured of the hepatitis C virus.
One Cycle Treatment
Overall, modern HCV treatment is incredibly streamlined. Most patients only need one cycle to clear the virus from their system. Instead of having a variable treatment and undefined treatment times, most patients can expect to take one full eight to 12 week course, visit us for period testing within the first year, and be finished with hepatitis C for good. In the medical community, we’ve come to look at hepatitis C as the infection that it is instead of the tough-to-treat disease it was once known as.
Minimal Side Effects
Better yet, DAAs and other modern hepatitis C treatments have far fewer side effects than the medications of the past. Getting treated for this virus before the introduction of DAAs meant struggling through life for many patients. The side effects were so severe that many people lost their jobs and relationships or could not function in ordinary ways. Depression, suicidal ideations, and illness were all highly prevalent side effects. Some people compare the old HCV treatment protocol to chemotherapy because it was that disruptive.
Can HCV Return After Treatment With DAAs?
One common misconception is that you cannot get hepatitis C again after clearing the virus from your system with DAAs. After treatment, you can become infected with HCV again. Treatment doesn’t make you immune to contracting the virus for a second time. It’s essential to protect yourself from reinfection.
Many people don’t know how they came into contact with the infection in the first place. Some people contract the virus from their mother at birth. Others may have been exposed to unsanitary medical equipment in a pre-regulated ambulatory environment.
Hepatitis C is spread through contact with infected blood. Even microscopic amounts of blood can spread the infection. Professionals in healthcare, body art, and athletics and others that may expose you to blood should take special precautions to avoid infection. Avoiding the following will prevent exposure to HCV infection:
- Sharing needles for intravenous drugs or tattoos
- Getting a tattoo or body piercing in an unregulated environment
- Sharing razors, toothbrushes, or other personal care items
- Having unprotected sex or sex with multiple partners
- Sharing equipment to snort drugs
What Can I Do to Speed Up HCV Treatment?
Great strides have been made in how long it takes to rid the body of the hepatitis C infection. After diagnosis, we’ll discuss your treatment options, medical history, and current health. From there, it’s vital to take care of your liver because it is more vulnerable while infected.
If you have cirrhosis, we’ll monitor your health closely and provide detailed information about how to best care for yourself. We may recommend that you receive the hepatitis A and hepatitis B vaccines to prevent further infections and liver damage. Eating a healthy diet filled with fresh vegetables is a pivotal step in caring for your liver. Avoid alcohol, salt, sugar, and always get any prescription, over-the-counter, herbs, and supplements approved by your doctor before taking them.
Taking care of your liver during treatment won’t make the medicine work faster, but it will prevent any further damage. The liver is a vital organ that you must protect.
Get the Help You Need
Hepatitis C treatments have come a long way from where they were a decade ago. Now, you can enter treatment with the peace of mind that the drugs are working for you. With fast treatment times and an almost perfect success rate, the best time to get treated is now. Contact us today at Batash Medical in Rego Park, NY to get tested for HCV or start a treatment cycle.