Hepatitis C (cont.)

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Medical Author:

Mary Nettleman, MD, MS, MACP

Mary D. Nettleman, MD, MS, MACP is the Chair of the Department of Medicine at Michigan State University. She is a graduate of Vanderbilt Medical School, and completed her residency in Internal Medicine and a fellowship in Infectious Diseases at Indiana University.

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Medical Editor:

Bhupinder Anand, MD

Hepatitis C Medical Treatment

If the patient is dehydrated, the health care practitioner may prescribe intravenous fluids to help the patient feel better.

If the patient is experiencing significant nausea and vomiting, he or she will receive medicines to help control these symptoms.

If the patient's symptoms are well controlled, they can be cared for at home. If dehydration or other symptoms are severe or if the patient is showing signs of confusion or delirium, then they may be hospitalized.

Medications are available to help eliminate HCV from the body or reduce its effects.

Decisions to start medications for the treatment of hepatitis C are usually made in consultation with a gastroenterologist or liver specialist (hepatologist). The medications have side effects and are expensive. Their use must be balanced against the fact that only 15% to 30% of patients will develop cirrhosis. Thus, most physicians only treat patients at high risk for cirrhosis.
The decision to treat is based on symptoms, the results of lab tests of liver function, results of viral load tests for HCV, and liver biopsy, and on the person's age and general medical condition.
The goal of treatment is to suppress the virus so much that it becomes undetectable in the blood. Some patients who have undetectable levels appear to have cleared the virus permanently. Others may relapse over weeks to months.
Treatment is much more complicated if the patient has other serious medical conditions such as heart failure or HIV/AIDS.

Certain medical conditions preclude the use of some HCV medications:

Depression and certain other mental and neurologic disorders
Active alcohol or drug abuse
Autoimmune diseases such as rheumatoid arthritis, systemic lupus erythematosus, or psoriasis
Low blood hemoglobin level (anemia) or blood cell counts
Cirrhosis that is severe enough to cause symptoms such as jaundice, wasting, fluid retention that causes swelling, or mental disturbances