Dr Sarah Jarvis
Long-term consequences of hepatitis C include cirrhosis or scarring of the liver and up to one in 25 of these cases go on to develop liver cancer. Fortunately, several medicines have been developed in recent years to clear the virus for good from the body, and the prospects are getting better all the time.
Like most viruses, hepatitis C is a master at adapting to survive, and there are several strains of ‘genotypes’. Some are easier to eradicate than others, and different combinations of treatment will be tailored to the individual patient and genotype.
Hepatitis C – not so silent, not so deadly for some
If you are diagnosed with acute hepatitis C, you will usually be monitored closely for three months to see if your body clears the infection by itself. If it doesn’t, you’ll be offered treatment with a type of interferon to get rid of the infection, which at this stage is up to 95 per cent effective. Most people have their infection picked up in the chronic phase — either because they develop symptoms or because they have their liver tested for another reason. If blood tests reveal abnormal liver function tests which don’t go back to normal, it is standard practice these days for GPs to check for hepatitis, including hepatitis C. If your results are positive, you’ll be referred to a specialist to discuss the options. Genotype 1 is the most common kind in the UK and the most resistant to treatment. The standard treatment course for this type lasts 48 weeks, while 24 weeks is the norm for other genotypes.
The two standard treatments are Pegylated interferon injections (your body’s immune system makes its own form of interferon, which stops virus cells from multiplying and stimulates T ‘killer’ white blood cells to help you fight off infection) and Ribavirin tablets or capsules (these work directly against the virus). Given together, these medicines will cure about half of people with genotype 1 hepatitis C and up to 80 per cent of people with other kinds of hepatitis C.
2011 saw the launch of two new medicines to treat hepatitis C for people with genotype 1 hepatitis C. They are used in combination with pegylated interferon and ribavirin. All effective medicines carry risks as well as side effects, and these four are no exception. Side effects include flu-like symptoms, feeling sick, anaemia, loss of appetite and sleep and mood problems. But not everyone gets these symptoms, and some of them are only temporary. Some people will decide they don’t want treatment — perhaps because they’d rather live with the risk of getting cirrhosis later in life, perhaps because they feel the risks of treatment side effects are too high. But at least everyone with hepatitis C now has that choice, and can get the full range of treatment on the NHS.