Categories: Hepatitis C

Hepatitis C Treatment and Management

Both acute and chronic hepatitis are caused by the Hepatitis C Virus known in short as HCV. Acute hepatitis rarely leads to hepatic failure but can cause chronic infection. Chronic HCV infection progresses gradually over several years and can eventually result in more serious conditions such as hepatocellular carcinoma, cirrhosis, and even call for a liver transplantation. This article looks at the general management and counseling given to patients with chronic hepatitis C Virus infection by doctors who treat hepatitis C in Florida and elsewhere in the world.

Initial Evaluation

Various Hepatitis C Tests

The main objective of any initial evaluation of patients diagnosed with hepatitis C virus should include the following examinations:

  • Evaluation of how extensive the liver disease has spread. Identifying the extent of advanced fibrosis or cirrhosis will call for additional monitoring.
  • Evaluation of viral and host factors that help to determine the bet antiviral selection. Viral and host factors to be assessed include the stage of liver fibrosis, the patient’s medical history prior to the antiviral treatment, assessment of the patient’s renal function, and identification of any concurrent medicines the patient uses.
  • The objective of the initial evaluation should also focus on identifying comorbidities related to hepatitis C virus infection such as the renal disease associated with HCV, Cryoglobulinemia, and other autoimmune disorders.

Patients with HCV infection should also be tested for hepatitis B virus (HBV) and human immunodeficiency virus (HIV) since these viruses have a common mode of transmission and a rapid rate of progression.


Counseling plays a key role in treatment and management of hepatitis C virus infection. The latest treatment for hep C incorporates counseling as a critical component of the management of the condition. This is because most hepatitis C patients are usually asymptomatic at the diagnosis stage but as the infection progresses, the condition can have adverse physical, mental, and emotional consequences on the patient.

Counseling and control of depression are key factors to consider during diagnosis and follow up. Most patients usually have an easier time coping with the condition when they participate in support group sessions with fellow patients and counselors.

Counseling should also focus on the adverse effects of illicit drug use on a patient with HCV infection. There are many HCV patients who also have problems with illicit drug use. In such cases, the patients are advised to seek for psychiatric help, enroll in substance abuse treatment, or go for an opioid substitution therapy.

Hepatitis C counseling should also focus on the transmission of the virus. HCV is mainly transmitted via exposure to infected blood. Patients should be advised on specific routes of the virus transmission and how they can avoid or decrease chances of transmitting the virus to other people. Women who can still bear children should be advised on the risk of prenatal transmission too.

Diet and Lifestyle Behavior

Diet for Hepatitis C Management

It will be important to advise patients on the effect of some lifestyle behaviors to HCV. There are some lifestyle factors that can accelerate HCV infection to a full-blown liver disease or some other equally serious ailment. These habits include continued alcohol use, marijuana use, insulin resistance, and obesity.

Due to the close link between these habits and a rapid progression of liver disease, patients are advised to completely avoid alcohol and drugs. Obese patients are also encouraged to lose weight while cigarette and marijuana smokers are advised to quit the habits.   

For better nutrition, patients are encouraged to take at least two or three cups of coffee every day. Coffee is beneficial to liver health and has been linked to reduced risk of liver disease hospitalization. Taking more than two cups of coffee each day helps in the management of chronic viral hepatitis, alcoholic liver disease, and non-alcoholic steatohepatitis.

General Management of HCV

Hepatitis – C Treatment

Treatment of chronic HCV infection relies heavily on antiviral therapy. If you searched for the best liver doctor near me, you’ll notice that they all use and advocate for antiviral therapy. HCV is comparatively easier to treat today using modern antiviral therapies than it was in the past. The virus can be treated and completely eliminated in most cases using antiviral therapy.

General management of the illness will also involve symptom management, adjustment of medication dosage, and preventing further complications especially when cirrhosis is present. HCV patients will often complain of fatigue and may be susceptible to depression. To combat fatigue and improve the patient’s overall quality of life, a sustained virologic response (SVR) is highly recommended after the antiviral therapy.

Adjustment of medication dosage may not be necessary for prescriptions or over-the-counter medications for HCV-infected patients with normal hepatic function. Most patients may be concerned about taking medications such as acetaminophen because it is believed to cause liver injury when taken in high dosage. It is therefore important to ensure that the patient’s dose of acetaminophen does not exceed 2 grams in every 24 hours.    

Antiviral Therapy

The objective of antiviral therapy in HCV-infected patients is to eliminate HCV RNA through sustained virologic response (SVR). The RNA level should be undetectable 12 weeks after the completion of the therapy.

Monitoring Viral Levels During Antiviral Therapy

During treatment, viral levels are monitored with interferon-free regimens but this has proved to be less effective as large clinical trials on interferon-free regimens have shown that the threshold they achieve does not give an accurate prediction after 4 weeks of treatment. It is therefore recommended to check HCV RNA levels on the 4th week of treatment using quantitative testing.


Hepatitis C is caused by the HCV virus. The first step in the management of HCV-infected patients is an initial evaluation, which involves assessment of various factors including the extent of liver disease, and examination of viral and host factors such as viral genotype, the patient’s history of antiviral treatment, the stage of liver fibrosis, medication use, and renal function. These factors show optimal viral selection and identify the presence of comorbidities linked to HCV infection.  

Counseling is an important step in management of Hepatitis C. Patients are advised on how they can minimize transmission risk and about lifestyle factors that can accelerate liver diseases such as alcohol consumption, smoking, marijuana use, and obesity. Feel free to consult a liver specialist in south Florida for Hepatitis treatment or to get answers to any related question you may have. 

Vikram Tarugu

Dr. Vikram Tarugu is an award-winning Gastroenterologist with board certification earned from both the “American Board of Internal Medicine” and the “American Board of Internal Medicine Sub-Specialty in Gastroenterology“. Currently practicing in West Palm Beach & Okeechobee, FL. Dr. Vikram Tarugu is a proficient medical professional specializing in the diagnosis and treatment of digestive health complications. With over 20 years of in-the-field experience, 2,000+ procedures conducted, and 4,000 patients treated; Dr. Vikram Tarugu has been recognized as one of the best GI doctors, not only in the state of Florida in which he practices, but nationwide.

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