Can Hepatitis C Be Cured?

Curated by Claudia Shannon / Research Scientist / ishonest

Is there a cure?

Though there is no vaccine for Hepatitis C, treatments can reduce the viral load to undetectable levels which is considered cured or in remission.

The virus is considered cured when it is not detected in your blood 12 weeks after treatment is completed. This is otherwise known as a sustained virologic response (SVR).

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Hepatitis C is one of the most serious hepatitis viruses. However, with newer treatments developed over the past few years, the virus is much more manageable than it was in the past.

Current antiviral drugs that help cure hepatitis C may also help prevent the health complications of chronic liver disease.

The Centers for Disease Control and Prevention (CDC) reports less than half of people who contract the hepatitis C virus may clear it from their bodies without treatment. For this group of people, the virus will be a short-term acute condition that goes away without treatment.

But for most people, acute hepatitis C will likely develop into a chronic condition that requires treatment.

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Since the virus often doesn’t produce symptoms until after more significant liver damage occurs, it’s important to get tested for hepatitis C if you think you might have been exposed.

New treatments

In 2019, the Food and Drug Administration (FDA) approved the antiviral drug Mavyret (glecaprevir and pibrentasvir) for an 8-week treatment period for people with all genotypes of hepatitis C.

This treatment is now being used for many people instead of the 12-week treatment that was previously required.

It’s the first 8-week hepatitis C treatment approved for adults and children 12 years and older or weighing at least 99 pounds (45 kg) who haven’t previously been treated for the virus and have either no evidence of cirrhosis (scarring of the liver) or have only mild “compensated” cirrhosis.

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Noninvasive ways to test for liver damage caused by hepatitis C are also now available to aid in diagnosis.

A liver biopsy is often performed to assess the extent of the virus and any damage to the liver. Two newer imaging tests, magnetic resonance elastography (MRE) and transient elastography (TE), painlessly measure the stiffness of the liver to help in diagnosis.

These tests can assess the entire liver and can accurately determine the extent of fibrotic damage.

Emerging treatments

Ongoing research is being conducted that could lead to a vaccine that effectively prevents hepatitis C.

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Researchers with the National Institute of Allergy and Infectious Diseases are in the planning stages for future vaccine designs.

A clinical trial is underway to study the safety and effectiveness of a DNA (deoxyribonucleic acid) vaccine that may boost the immune system’s ability to clear the virus.

The goal of using a DNA vaccine would be to treat chronic hepatitis C in people who already have the condition.

Current treatments

Previously, a combination of ribavirin and pegylated interferon was used to treat chronic hepatitis C.

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Rather than just directly attacking the virus, these two medications also worked by enhancing the activity of the person’s immune system. The immune system would then try to kill the virus.

The goal of this treatment was to rid your body of the virus. These medications had a variable cure rate and could have significant side effects.

However, since 2011, the FDA has approved many antivirals that attack hepatitis C more directly.

These drugs have much better success rates and seem to be better tolerated than older treatments.

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Current, recommended antiviral treatments for different genotypes of hepatitis C include:

  • ledipasvir-sofosbuvir (Harvoni)
  • elbasvir-grazoprevir (Zepatier)
  • ombitasvir- paritaprevir-ritonavir (Technivie)
  • ombitasvir-paritaprevir-ritonavir and dasabuvir (Viekira Pak)
  • daclatasvir-sofosbuvir (Darvoni or Sovodak)
  • glecaprevir- pibrentasvir (Mavyret)
  • sofosbuvir-velpatasvir (Epclusa)
  • sofosbuvir-velpatasvir- voxilapresvir (Vosevi)

All of these drug combinations are direct-acting antivirals (DAAs), which means they aim to attack components of the virus itself.

Over a period of time, usually 8 to 24 weeks, this causes the virus to be reduced and cleared from your system.

For all the DAAs, the goal of hepatitis C treatment is sustained virologic response (SVR).

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This means that the amount of hepatitis virus in your system is so low that it can’t be detected in your bloodstream at 12 to 24 weeks after you finish treatment.

If you achieve SVR after treatment, it can be said that hepatitis C is cured.

Can a transplant cure hepatitis C?

If you develop chronic hepatitis C and it leads to liver cancer or liver failure, you may need a liver transplant. Hepatitis C is one of the most common reasons for a liver transplant.

A liver transplant removes a damaged liver and replaces it with a healthy one. However, there’s a high likelihood that the hepatitis C virus will be transmitted to the new liver in time.

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The virus lives in your bloodstream, not just your liver. Removing your liver won’t cure the disease.

If you have active hepatitis C, continued damage to your new liver is very likely, especially if hepatitis C remains untreated.

Are alternative medicines available?

Some people believe certain forms of alternative medicine help cure hepatitis C.

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However, the National Center for Complementary and Integrative Health reports that there are no effective, research-proven forms of alternative treatment or complementary medicine for hepatitis C.

Silymarin, also known as milk thistle, is an herb commonly suggested to help cure hepatitis C liver disease. But a rigorous multi-center study did not find any beneficial effects from this supplement.

Is there a way to prevent hepatitis C?

Although currently there’s no vaccine to protect people from contracting hepatitis C, there are vaccines for other hepatitis viruses, including hepatitis A and hepatitis B.

If you receive a hepatitis C diagnosis, your healthcare provider may advise you to get vaccinated against hepatitis A and B.

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The vaccinations are recommended because these hepatitis viruses can lead to additional health and liver complications, especially in those with preexisting liver disease.

Since you can’t prevent hepatitis C through a vaccine, the best prevention is to avoid exposure. Hepatitis C is a bloodborne pathogen, so you can limit your chances of exposure through these healthy lifestyle practices:

  • Avoid sharing needles, razor blades, or nail clippers.
  • Use proper safety precautions if you’ll be exposed to bodily fluids, such as when performing first aid.
  • Hepatitis C isn’t usually transmitted through sexual contact, but it’s possible. Limit your exposure by practicing sex with a condom or other barrier method. It’s also important to openly communicate with sexual partners and to get tested if you suspect you’ve been exposed to the hepatitis C virus.

Because hepatitis C is transmitted through blood, it’s possible to contract it through a blood transfusion.

However, since the early 1990s, blood product screening tests have been standard protocol for minimizing the risk of this type of transmission.

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The CDC recommends universal screening for all individuals over 18 years of age and pregnant women during every pregnancy.

Subsequent testing (and frequency of testing) is based on risk. Talk to your doctor about your needs.

Per the CDC, these populations are at a higher risk for hepatitis C.

Cost of treatment

Most of the FDA-approved treatments take 8 to 12 weeks to cure the virus, with the most recently approved drug, Mavyret, taking the lowest amount of time for the full treatment.

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According to GoodRx, the 8-week course of Mayvret costs approximately $26,056.

Other antivirals such as Harvoni, Zepatier, and Technivie have 12-week treatment courses that cost between $55,000 and $95,000 depending on the antiviral chosen.

Patients may be able to get the required HCV medications with assistance from private insurance companies, state Medicaid and Medicare plans, or the Veterans Administration.

Research update

Recent research indicates that the antiviral drugs used for treating hepatitis C may have the additional benefit of helping to prevent serious complications of the virus, such as cirrhosis from chronic liver damage.

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According to a 2019 study, hepatitis C could be diagnosed more effectively after the initial first evaluation step by utilizing reflex testing. This type of testing involves automatically performing the second evaluation step if the first test step results are positive.

A simple blood screening test can tell your healthcare provider whether you have antibodies against hepatitis C in your blood. The presence of antibodies in your bloodstream means you’ve been exposed to the hepatitis C virus.

A second test for the level of hepatitis C virus (viral load) will confirm the infection and quantify the amount of virus in your bloodstream.

It’s thought that this “one-step diagnosis” practice could help to reduce the amount of time before treatment for the virus can begin.

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This could also help to reduce the amount of underdiagnosis in those who have acquired the hepatitis C virus.

There’s currently no vaccine available for hepatitis C. One clinical trial that ended in May 2018 concluded that an experimental vaccine wasn’t effective in preventing the virus in adults.

However, research continues in hopes of discovering an effective vaccine.

What are the symptoms of hepatitis C?

Every case of hepatitis C begins as an acute infection. It occurs within the first 6 months after exposure. For many people, this stage of the virus has no symptoms.

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If you do experience symptoms, they can begin weeks or months after exposure to the virus.

Possible symptoms include:

  • fever
  • fatigue
  • nausea
  • vomiting
  • dark urine
  • clay-colored bowel movements
  • joint pain
  • yellow skin or eyes

Most cases of acute hepatitis C will develop into a chronic infection.

Chronic hepatitis C usually has no symptoms until it causes a large amount of liver scarring (cirrhosis) and other liver damage.

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Over many years, the virus attacks the liver and causes damage. This can lead to liver failure or even death.

Since hepatitis C doesn’t always cause symptoms, the only way to be sure you have the virus is to get tested for it.

Takeaway

It’s definitely possible to have a positive response to treatment for hepatitis C. Antiviral medications that are currently available can cure more than 95 percent of people with the virus, according to the World Health Organization.

According to a 2015 study, people who achieve SVR have a 1 percent to 2 percent late relapse rate and a much lower risk for liver-related death.

Read this article in Spanish.

Read more on: hepatitis


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