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Advanced Hepatitis C Treatment

The treatment of advanced hepatitis C depends largely on whether or not cirrhosis is advanced and what genotype (genetic strain) of hepatitis C virus (HCV) has been contracted by the patient. Although it is possible to clear people with advanced hepatitis C of the virus, it appears that response to initial treatment with antiviral drugs is a strong indicator of whether or not an individual patient will experience further complications.

  1. Identification

    • In the treatment of chronic hepatitis C, it is important for a physician to determine which genotype of HCV her patient has. Genotype affects treatment options: people with HCV 1, which is the most common cause of HCV infection in the United States, must be treated longer with antiviral drugs than people with HCV 2 or 3, according to the Centers for Disease Control and Prevention (CDC).

    Effects

    • In addition to determining the genotype of HCV contracted, it is important to determine the level of cirrhosis present in a patient with advanced hepatitis C. A biopsy may be performed to detect scarring of the liver, although liver function tests are used to determine how severe the cirrhosis is, according to Jorge L. Herrera, MD, of the Division of Gastroenterology at the University of South Alabama College of Medicine.

    Significance

    • A patient with only mild cirrhosis may safely be treated for hepatitis C infection with antiviral drugs, which improve liver function if the course of treatment is effective. However, it may not be possible to treat the underlying HCV infection if the cirrhosis is advanced.

    Considerations

    • People who cannot be or are not treated with antivirals and who have some cirrhosis of the liver may not necessarily experience further complications of liver disease. Seventy-five percent of people who are diagnosed with HCV cirrhosis do not develop complications even ten years after the diagnosis is made; however, people with advanced cirrhosis may require liver transplant.

    Warning

    • Patients who do not respond to an initial course of antiviral therapy are unlikely to respond positively to the continued use of antiviral therapy. These patients are not less likely over time to develop cirrhosis and other complications of advancing liver disease.

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