NYU Langone doctors may recommend antiviral medication for chronic, or long-term, hepatitis B or hepatitis C. Recent research indicates that new antiviral medications are more effective and produce fewer side effects than previous treatments.
Your doctor considers many factors when recommending medical treatment for hepatitis B or C, including whether the viral infection is acute or chronic and the extent of liver damage.
Antiviral Medication for Hepatitis B
Doctors may recommend antiviral medication for people with chronic hepatitis B, which occurs when the virus stays in your body for more than six months.
Antiviral medication prevents the virus from replicating, or creating copies of itself, and may prevent progressive liver damage. Currently available medications can treat hepatitis B with a low risk of serious side effects.
NYU Langone hepatologists and infectious disease specialists prescribe medication when they have determined that without treatment, the hepatitis B virus is very likely to damage the liver over time. People with chronic hepatitis B may need to take antiviral medication for the rest of their lives to prevent liver damage.
There are many different types of antiviral medications available, and your doctor recommends the right type for you based on your symptoms, your overall health, and the results of diagnostic tests. A doctor may take a “wait-and-see” approach with a person who has a healthy liver and whose blood tests indicate a low “viral load,” the number of copies of the hepatitis B virus in your bloodstream.
Someone with HIV infection or AIDS may have a weakened immune system and is therefore more likely to develop liver damage. The U.S. Centers for Disease Control and Prevention strongly recommends that people with HIV infection who are diagnosed with hepatitis B immediately begin treatment with antiviral medication.
If your doctor prescribes antiviral medication, you take it by mouth once daily. Your doctor monitors the effectiveness of medication using blood tests and imaging tests during annual follow-up visits.
Doctors recommend avoiding alcoholic beverages and high doses of acetaminophen throughout treatment because these substances can lead to liver damage.
Antiviral Medication for Hepatitis C
For people with hepatitis C, the goal of treatment with antiviral medication is to prevent the virus from replicating, or copying itself, and to eliminate the virus from the bloodstream. If the hepatitis C virus has been in the body for more than six months, the infection is considered chronic. Without treatment, most people with acute hepatitis C develop the chronic form of the disease.
Your doctor decides which antiviral medication—or combination of medications—to prescribe based on the results of a blood test called a genotype test. There are six genotypes, or strains, of the hepatitis C virus, and people with certain genotypes respond more quickly to medical treatment.
For many years, the standard treatment for chronic hepatitis C consisted of the antiviral medications pegylated interferon and ribavirin. Ribavirin is taken by mouth every day, and interferon is an injection that you or a caregiver can administer once a week at home.
In 2013 and 2014, the U.S. Food and Drug Administration approved a group of new medications for the treatment of hepatitis C. These medications, which include sofosbuvir, are very effective and have fewer side effects than older medications, particularly interferon.
At NYU Langone, interferon-free treatment is now the standard of care. The new medications are taken by mouth daily for 8, 12, 16, or 24 weeks. Your doctor determines the specific medication or medications that are likely to be most effective for you based on which genotype of hepatitis C you have, whether there is scarring of the liver, and whether you have taken antiviral medication previously.
The arrival of effective new medications with fewer side effects may allow many more people with chronic hepatitis C to begin treatment and become disease free. Our scientists played an active role in the research and development of these new medications and remain engaged in pursuing new forms of treatment.
After the course of antiviral medication is complete, doctors consider hepatitis C cured when blood tests reveal no evidence of the hepatitis C virus for at least six months. Most people remain clear of the virus permanently if treatment is successful. However, it is possible to become reinfected or infected with a different genotype of the virus, so preventive measures remain important even for someone who has had treatment.