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.
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
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