Chronic hepatitis C is inflammation of the liver that is caused by the hepatitis C virus and that has lasted more than 6 months.
- Hepatitis C often causes no symptoms until after it has badly damaged the liver.
- Doctors diagnose chronic hepatitis C based on blood tests.
- If chronic hepatitis C has caused cirrhosis, screening for liver cancer is done every 6 months.
- Chronic hepatitis C is treated with antiviral drugs.
Acute hepatitis C becomes chronic in about 75% of affected people.
An estimated 2.7 to 3.9 million people in the United States have chronic hepatitis C. Worldwide, 71 million people are estimated to have chronic hepatitis C.
Chronic hepatitis C, if untreated, causes cirrhosis in about 20 to 30% of people. However, cirrhosis may take decades to develop. The risk of liver cancer is increased usually only if cirrhosis is present.
There are different types (genotypes 1 through 6) of hepatitis C virus, which are sometimes treated with different drugs.
- Antiviral drugs
Chronic hepatitis C is treated with antiviral drugs called direct-acting antivirals. Usually, several drugs are used together.
For chronic hepatitis C, treatment is indicated if both of the following are present:
- Liver enzyme levels are elevated.
- Biopsy shows that inflammation is progressing and scar tissue is continuing to develop.
Treatment varies based on the type of hepatitis C virus causing the infection. New antiviral drugs to treat hepatitis C are being developed, and thus recommended treatments are rapidly changing.
Many antiviral drugs are available to treat hepatitis C. They include sofosbuvir, daclatasvir, paritaprevir, ritonavir, ombitasvir, dasabuvir, telaprevir, boceprevir, simeprevir, elbasvir, grazoprevir, velpatasvir, glecaprevir, pibrentasvir, and ribavirin (all taken by mouth).
Treatment can last from 8 to 24 weeks. Treating hepatitis C can eliminate the virus from the body and thus stop inflammation and prevent scarring, which can lead to cirrhosis.
Ribavirin, telaprevir, boceprevir, and simeprevir can cause birth defects. Both men and women who have to take these drugs should use birth control during treatment and for 6 months after treatment ends.
If chronic hepatitis C infection has severely damaged the liver, liver transplantation may be done. After liver transplantation, people with hepatitis C are often treated with antiviral drugs, which improve their chance of being cured.
After treatment is completed, doctors do blood tests to determine how much of the virus’s genetic material is present. If none is detected 12 weeks and 24 weeks after treatment is completed, depending on the drug regimen used, people are probably cured.