Hepatitis C has seen more dramatic advances in treatment than any other condition over the past couple years. Whereas we used to treat Hepatitis C infections with highly toxic interferon based therapies, click we now have several oral regimens with extremely high safety and efficacy.
We recommend screening for those at risk of Hepatitis C, including current or former injection drug users, recipients of blood products before 7/1992, hemodialysis patients, healthcare workers who have sustained needlesticks, HIV infected patients, and others. While sexual transmission is not very efficient and is uncommon in heterosexuals, transmission is more common between men who have sex with other men, particularly with HIV co-infection.
For those with chronic infection most may remain asymptomatic for many years, even decades. A small percentage will progress to cirrhosis, 5-20% over 20-30 years. These patients will be at risk of liver cancer, or liver failure.
But the good news is the high efficacy of current treatments- including Harvoni, Epclusa, Mavyret and others. The latter two medications Epclusa and Mavyret, are pangenotypic drugs, meaning they can be used for all viral genotypes. We now have therapy that can treat nearly all patients with an expectation of cure in > 95%.
Treatment decisions depends on the viral strain ( “genotype”), the degree of liver scarring, the viral load, and prior treatment history. All our Infectious Diseases physicians treat Hepatitis C, and are experienced prescribing all available medications.