How should I take care of myself if I have hepatitis C?
Talk to your doctor about medicines that you are taking, including over-the-counter medicine. Many medicines, including acetaminophen (brand name: Tylenol) are broken down by the liver and may increase the speed of liver damage. You should also limit alcohol use, as it also speeds the progression of liver diseases like hepatitis C. An occasional alcoholic drink may be okay, but check with your doctor first.
Is there a treatment for hepatitis C?
Good health habits are essential for those who have hepatitis C, especially avoidance of alcohol and other medicines and drugs that can put stress on the liver. There is not yet a proven cure for hepatitis C, but it is noteworthy that after taking medicines for 6 months to 1 year, a significant number of people (45% to 75%) do not experience any more problems from hepatitis C. You should discuss treatment with a doctor if you have hepatitis C.
The standard method of treatment for hepatitis C is a combination of antiviral medicines. Your doctor will prescribe a full course of the medicines, then check the level of hepatitis C in your blood after you have completed the treatment. If there is still a significant amount of the virus in your system, your doctor may recommend another course of medicine.
What are the side effects of drug treatment?
Side effects of treatment for hepatitis C may include the following:
Side effects are usually worst during the first few weeks of treatment and become less severe over time. If you are having trouble dealing with the side effects of your medicine, talk to your doctor. He or she can suggest ways to relieve some of the side effects. For example, if your medicine makes you feel nauseated, it may help to take it right before you go to sleep.
If taking medicine to treat hepatitis C makes you feel worse than the actual disease does, you may be tempted to stop taking your medicine before your treatment is done. However, if you don't prevent chronic inflammation from damaging your liver, you'll be much sicker in the long run. Don't stop taking your medicine until your doctor tells you to.
Do I have to have drug treatment?
The choice is up to you and your doctor. Some people who have hepatitis C don't have any symptoms. They only have slight inflammation of their liver. If you have hepatitis C but no symptoms, your doctor will want to closely monitor your condition. This is done by checking your blood at least once a year (maybe up to 3 times a year). Your doctor might decide to start drug treatment only if the hepatitis C virus reaches a certain level in your body or you start experiencing many symptoms.
The decision to use drug therapy can be hard to make because of the side effects. Your doctor will pay attention to the type of the virus and the amount of the virus in your body. Your overall health, the results of your blood tests and the liver biopsy are also important factors to consider before you and your doctor start drug treatment for your hepatitis C.
How will I know if my treatment works?
The goal of treatment is to reduce the amount of the hepatitis C virus in your blood to levels that can't be detected after 24 weeks of therapy. The amount of the virus in your blood is called your viral load. At the end of your treatment, your doctor will need to measure your viral load and find out how healthy your liver is. He or she may repeat many of the same tests that were done when you were first diagnosed with hepatitis C.
If your blood has so few copies of the virus that tests can't measure them, the virus is said to be undetectable. If it stays undetectable for at least 6 months after your treatment is finished, you have what is called a sustained virologic response (SVR). People who have an SVR have a good chance of avoiding serious liver problems in the future.
If treatment doesn't reduce your viral load, or if you don't have an SVR after treatment, your doctor will discuss other treatment options with you. For example, if 1 round of treatment did not decrease your viral load enough, your doctor may recommend a second round of treatment. Even if treatment doesn't keep you from having active liver disease, lowering your viral load and controlling chronic liver inflammation may help you feel better for a longer time.
How can I cope with my feelings about having hepatitis C?
Coping with hepatitis C isn't easy. You may feel sad, scared or angry, or you may not believe you have the disease. These feelings are normal, but they shouldn't keep you from living your daily life. If they do— or if they last a long time— you may be suffering from depression. People who are depressed have most or all of the following symptoms nearly every day, all day, for 2 weeks or longer:
- Feeling sad, hopeless and having frequent crying spells
- Losing interest or pleasure in things you used to enjoy (including sex)
- Feeling guilty, helpless or worthless
- Thinking about death or suicide
- Sleeping too much, or having problems sleeping
- Loss of appetite and unintended weight loss or gain
- Feeling very tired all the time
- Having trouble paying attention and making decisions
- Having aches and pains that don't get better with treatment
- Feeling restless, irritated and easily annoyed
Talk to your doctor if you notice any of these symptoms. Your doctor can help by recommending a support group or a therapist, and/or by prescribing a medicine for you to take.
Hepatitis C: Part II. Prevention Counseling and Medical Evaluation by LA Moyer, R.N., EE Mast, M.D., M.P.H., and MJ Alter, Ph.D. (American Family Physician January 15, 1999, http://www.aafp.org/afp/990115ap/349.html)
Written by familydoctor.org editorial staff