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5 Differences Between Older and Newer Hepatitis C Treatments

Medically Reviewed By William C. Lloyd III, MD, FACS
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Hepatitis C is considered the most common bloodborne infection in the United States. Without proper treatment, hep C can cause long-term inflammation of the liver, which can lead to complications like cirrhosis (liver scarring), liver cancer, and liver failure. Thankfully, in the last 10 years, major advances in hepatitis C treatment have emerged. Let’s take a look at how these new medications are an improvement over what was previously available.

1. New hepatitis C treatments are much more effective.

Historically, hepatitis C was treated with a combination of two drugs: a weekly injection of interferon and twice daily pill of ribavirin. These older hep C medications were only able to successfully clear the virus in about 40 to 50% of cases.

The development of new direct-acting antiviral (DAAs) medications were a game changer for treating hep C. Taken as a pill, DAAs boast a hepatitis C cure rate over 90% by directly targeting the virus’ ability to replicate itself. Several DAAs and combinations are now approved for use.

2. Older hepatitis C medications had more side effects.

In the past, hep C medications caused such intolerable side effects that people would stop their treatment before their hep C was cured. Some of those harsh side effects included:

  • Flu-like symptoms, such as fever, aches, and pains
  • Nausea, vomiting, and weight loss
  • Psychiatric problems, such as anxiety and depression
  • Decreased neutrophils (a type of white blood cell) and platelets
  • Autoimmune reactions, such as the development of hypo- or hyperthyroidism

In contrast, the new DAAs are better tolerated due to much milder side effects, such as fatigue and headaches.

3. Treatment times are shorter with new hepatitis C medications.

Not only were older hep C treatments difficult to endure, but they required 6 to 12 months of treatment time. New hepatitis C medications are faster acting. Often, the virus is undetectable in the body after only 8 to 12 weeks.

Shorter durations of treatment, fewer side effects, and the ease of taking a pill versus getting a shot have also resulted in improved adherence to the newer regimens.

4. New treatments can be selected based on hepatitis C genotype.

It’s now recognized that hepatitis C has seven genotypes–a collection of genes–each with a different genetic makeup. For example, 75% of people with hep C in the United States have genotype 1.

Research has shown that some of the new DAAs work best on certain genotypes. After a diagnosis of hepatitis C, patients are routinely screened to identify the specific hepatitis C genotype to determine which treatments will be most effective.

5. More people are candidates for the new hepatitis C treatments.

Certain groups of people with hepatitis C were unable to receive the older interferon-ribavirin treatments due to side effects and underlying conditions. For example, those with severe cirrhosis couldn’t be treated because the interferon would make their condition worse. A history of depression or other mood disorder was also considered a contraindication to older hepatitis C treatments.

DAAs, however, don’t have as many restrictions. Appropriateness will be determined on an individual basis, but new hep C medications can be safely used in most cases.

The outlook for treating hepatitis C is increasingly optimistic, though about half of all cases remain undiagnosed because most people don’t experience any symptoms. Hepatitis C is spread through the blood; injecting illicit drugs, getting tattoos or piercings with non-sterile equipment, and sharing personal care items like razors can put you at a high risk of infection. If you have hepatitis C or think you are at risk of developing it, be sure to talk to your doctor. With the right treatment, most cases of hepatitis C can be cured.

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Medical Reviewer: William C. Lloyd III, MD, FACS
Last Review Date: 2022 Oct 25
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THIS TOOL DOES NOT PROVIDE MEDICAL ADVICE. It is intended for informational purposes only. It is not a substitute for professional medical advice, diagnosis or treatment. Never ignore professional medical advice in seeking treatment because of something you have read on the site. If you think you may have a medical emergency, immediately call your doctor or dial 911.
  1. Hepatitis C Treatment and Management. Medscape.
  2. Hepatitis C. Mayo Clinic.
  3. Patient Education: Hepatitis C (Beyond the Basics). UpToDate.
  4. Hepatitis C Treatments Give Patients More Options. U.S. Food and Drug Administration.
  5. Hepatitis C in a New Era: A Review of Current Therapies. Pharmacy and Therapeutics.