Med Treatment

What is hepatitis C?

Hepatitis C usually causes long-term or chronic infection of the liver and unless successfully treated with medications, can lead to cirrhosis (scarring) of the liver, liver failure, and liver cancer.

Who is at risk of having hepatitis C?

HCV is spread by blood to blood contact. You may be at risk if you have:

Used intravenous drugs in the past and shared needles for injecting these drugs
Received blood transfusion in the past especially from unregulated blood banks
Chronic kidney disease on hemodialysis
Contact with infected needles or blood
Unprotected sex with multiple partners

What are symptoms of hepatitis C?

Patients during the early phase of infection have no symptoms and feel absolutely healthy. When the disease progresses and patient develops liver cirrhosis, symptoms occur such as tiredness, nausea, loss of appetite, skin itching, dark urine, and jaundice (yellowing of the skin and eyes). Once liver failure develops, patients develop swelling of the legs (edema), fluid in the abdomen (ascites), vomiting of blood, and mental confusion.

How is hepatitis C diagnosed?

Hepatitis C is diagnosed by simple blood tests. Specialized blood tests can also tell you about the amount of virus and the genotype of the virus. An Ultrasound scan and a Fibroscan will assess whether you may have developed cirrhosis. Sometimes a liver biopsy may be required.

How is hepatitis C treated?

There is effective treatment for HCV infection. New directly acting anti-viral drugs (DAA) have revolutionised the treatment of hepatitis C. These new drugs include Sofosbuvir (Sovaldi), Daclatsavir (Daklinza) and Ledipasvir/Sofosbuvir (Harvoni). Most patients are cured with three months of treatment. Some patients who have advanced disease or who have failed treatment in the past may require treatment upto 6 months. Such therapies are effective in curing 95% of patients.

Patients with Genotype 1 and 4 infection : Harvoni (Sofosbuvir / Ledipasvir) for 3 months
Patients with Genotype 2 infection : Sofosbuvir and Ribavirin for 3 months
Patients with Genotype 3 infection : Sofosbuvir and Daclatsavir for 3 months
Patients with cirrhosis : Treatment should be extended to 6 months to achieve optimal response

How can patients with Hepatitis C and liver failure be treated ?

Once patients with hepatitis C develops cirrhosis and liver failure, they cannot be treated with medicines. The only option in such patients is to undergo liver transplantation. Overall about 10 percent of patients with Hepatitis C require liver transplantation. However, patients who have only cirrhosis on a Fibroscan but no evidence of liver failure should take treatment with the new directly acting antiviral drugs as this can prevent further progression of disease.