There are highly effective cures for hepatitis C with a success rate of 95% and little or no side effects. These treatments are available on the Pharmaceutical Benefits Scheme (PBS).
These direct acting antiviral (DAA) drugs available in Australia are: sofosbuvir, daclatasvir, sofosbuvir/ledipasvir, sofosbuvir/velpatasvir, grazoprevir/elbasvir, and a combination of ombitasvir, paritaprevir, ritonavir and dasabuvir.
Hepatitis C treatment regimens depend on genotype and other individual factors such as disease severity, co-morbidities and previous treatment experience.
Hepatitis C DAAs are taken as tablets, mostly once a day, in various combinations with each other and/or with ribavirin. Interferon is no longer recommended first line treatment.
The following information about hepatitis C treatment is not meant to replace your doctor's advice. Your specialist will advise you on the best treatment option for you and provide details about the regimen prescribed for you.
Preparing for treatment
Your viral hepatitis nurse will ensure that all the necessary tests are done before you begin. The tests may include:
- Fibroscan - a non-invasive scan to assess the extent of fibrosis, if any, in your liver.
- Genotype test to determine your strain of so that the most suitable therapy can be prescribed.
- Viral load test to determine the amount of virus in your blood. This is used as a baseline for monitoring your progress through treatment.
- HBV test to determine whether you have been exposed to the hepatitis B virus. People who have been exposed to HBV require additional monitoring during hepatitis C treatment.
Your nurse will also help you prepare physically and mentally to cope with side effects and put in place social supports during treatment.
Who can prescribe the new treatments?
Your specialist can prescribe the new treatments. Your GP may also prescribe the new treatments, provided they are experienced in the treatment of chronic hepatitis C or do it in consultation with a specialist experienced in the treatment of chronic hepatitis C. More information.
Who can dispense the new drugs?
The new medicines can be dispensed by hospital or community pharmacies depending on who wrote the script. Hepatitis SA has compiled a guide to South Australian pharmacies which dispense the new drugs.
All genotypes can now be treated in 12 weeks with sofosbuvir + velpatasvir — a precombined single pill also referred to as Epclusa. Drugs which can treat all genotypes are referred to as “pangenotypic”. Efforts are underway to develop other pangenotypic drugs.
The most common hepatitis C strains in Australia are genotype 1 (54%) and genotype 3 (37%). Both have other treatment options besides Epclusa. These genotype specific treatments vary in duration from 8 to 24 weeks.
Some people may have ribavirin added to their treatment and a very small number may still be prescribed interferon. However, interferon is not recommended as an option for people who haven’t previously undergone treatment.
The treatment recommended for you will depend on your individual circumstances such as whether you have undertaken treatment before, the condition of your liver and other health conditions you may have.
Direct acting antivirals are generally well tolerated with few recognised side effects. Possible side effects vary from drug to drug but may include fatigue, nausea, headache, diarrhoea, itching, insomnia, weakness, tiredness, anaemia and feeling as though you have a cold. Speak to your doctor or nurse about which side effects may occur with your prescribed treatment.
Side effects associated with ribavirin include anaemia, rashes, nausea and birth defects. Contraception is a must for BOTH men and women during, and for six months after, treatment.
For the best chance of a cure, it is vital that you take all medicines as directed by your doctor. For tips on sticking to your schedule see Hepatitis SA Community News #73.
If you are taking other medicines including over the counter drugs or herbal remedies, please check with your specialist as there may be harmful interactions which may affect your chance of a cure.
There are recognised drug interactions between these DAAs and some HIV medicines, anti-mycobacterials, St John’s Wort and some other common medicines.
You will receive regular monitoring during treatment. This is done with blood tests that measure the level of virus in your blood.
If the amount of virus in your blood drops to an undetectable level and remains undetectable for 12 weeks after you complete treatment, it is known as a Sustained Virological Response (SVR). This effectively means you are cured.
What if treatment doesn't work?
There is on-going research into new drugs and combinations so even if available treatments didn't work for you, stay in touch with your liver nurses or doctors.
It is important to maintain regular liver health checks and keep up to date on when new and more suitable treatments may be available.
For information about clinical trials, talk to your doctor or viral hepatitis nurse. Information on clinical trials in Australia can also be found on the Australian Clinical Trials. Read more about it here.
Support and information
Hepatitis SA can answer many of your questions and talk to you about any concerns you have. We can also put you in touch with other people who have been on treatment who can share their experiences. Having a supportive network of friends, family and services could be helpful if you decide to start treatment.
How do I get started?
The best way to get started on hepatitis C treatment is to contact the viral hepatitis nurses:
Margery ‐ 0423 782 415 or Debbie ‐ 0401 717 953
Lucy ‐ 0401 717 971 or Michelle ‐ 0413 285 476
Rosalie ‐ 0466 777 876 or Jeff ‐ 0466 777 873
Helpline: 1800 437 222
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More details on new hepatitis C medicines
Factsheets, FAQs & videos on new hepatitis C medicines.