Treatment

The treatment and what's changing

There are two main phases of hepatitis C infection: acute (short-term) and chronic (long-term). With medical advances these treatments are improving constantly.

 Treatment for hepatitis C is dependent on:

  • Whether it is an acute or chronic infection.
  • What genotype you are infected with; there are currently 6 different genotypes of hepatitis C. Genotypes 1 and 3 are the most common in Ireland.
  • The progression of liver disease.

 Before 2011, treatment of hepatitis C was limited to two drugs, pegylated interferon given as an injection under the skin once a week and ribavirin, a tablet taken twice a day.  These treatments had their limitations.  They were only effective in 50% 0f those infected with genotype 1 and in 80% of those infected with genotype 3. They ware also quite toxic and has severe side-effects for many most especially for those with advanced liver disease – cirrhosis. The duration of treatment was also long, from 24 weeks with genotype 3 to 48 weeks with genotype 1.

In 2011, boceprevir and telaprevir were approved as the first directly acting antiviral agents (DAAs) that target hepatitis C specifically.  DAAs target different stages of hepatitis C’s replication (ability to make copies of itself) and prevent it from killing off more healthy liver cells. These first two DAAs were licensed with pegylated interferon and ribavirin and achieved better results than pegylated interferon alone.  There were however additional toxicities and cure rates were still not 100%.

The current goal in hepatitis C treatment is to eradicate the virus and cure the patient. In 2015 cure rates are approaching 100% for certain patient types. New treatments are free from interferon leading to greatly improved side-effects. Treatment duration is currently 12 to 24 weeks.

Other information that might be useful