Acute viral hepatitis generally does not require treatment, as most patients will get better on their own. Acute hepatitis C is a notable exception, because only 15% of patients will clear the virus on their own and most people, if not treated, will develop chronic hepatitis C. In addition, there is a very high cure rate when patients are treated during the acute hepatitis infection stage.
Chronic hepatitis treatments are available for hepatitis B and C, the most predominant causes of chronic hepatitis. Chronic hepatitis B is usually treated by medications that interfere with the virus’ ability to multiply and replicate. These medications include oral medications as well as injectable medications. Approved medications for the treatment of chronic hepatitis B include the injectable pegylated interferons, as well as medications taken by mouth called directly acting antivirals (DAA’s). These DAA’s are virtually free of any side effects and are the mainstay of therapy. No medication is currently available which will rid the body completely free of the hepatitis B virus (cure). These medications keep the virus under excellent control, but will not completely eliminate the virus. The duration of treatment may vary from one year for the pegylated interferon to possibly indefinite for the oral DAAs. Research is ongoing on the medications that will completely eliminate the virus and achieve what scientists refer to as a functional cure.
Major advances have been made in the treatment of chronic hepatitis C infection. Currently, medications taken by mouth (called directly acting antivirals, or DAAs) have completely replaced the injectable medications (called pegylated interferons). These medications, which are taken by mouth, are specific for the type of virus the patient has, called genotype, of which there are six, (1-6). The oral medication ribavirin is still used in some patients with chronic hepatitis C. In the very near future, single tablet medications will be used to treat all of the six genotypes for hepatitis C! That cure rate with the currently available medications for hepatitis C is almost 100%. Although the cost of treatment for both viruses, especially hepatitis C have increased significantly, it is highly recommended that patients are treated as early as possible before they develop chronic liver disease and cirrhosis. The duration of treatment may be from eight weeks to 24 weeks.
Chronic viral hepatitis B and C should be treated by individuals who are knowledgeable of these conditions, the medications utilized to treat these conditions, and the side effects of these medications.