5 Differences Between Older and Newer Hepatitis C Treatments

Medically Reviewed By William C. Lloyd III, MD, FACS

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:

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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  2. Hepatitis C. Mayo Clinic. https://www.mayoclinic.org/diseases-conditions/hepatitis-c/diagnosis-treatment/drc-20354284
  3. Patient Education: Hepatitis C (Beyond the Basics). UpToDate. https://www.uptodate.com/contents/hepatitis-c-beyond-the-basics
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  5. Hepatitis C in a New Era: A Review of Current Therapies. Pharmacy and Therapeutics. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5398625/
Medical Reviewer: William C. Lloyd III, MD, FACS
Last Review Date: 2022 Oct 25
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