Frequently Asked Questions - Treatments
- What happens if I stop hepatitis C treatment early?
- My partner is on hepatitis C treatment but wants to start a family. Is that possible?
- Is there awaiting time to commence treatment for hepatitis C?
- How long does treatment take and what are my chances of clearing hep C?
- Is there an age limit to accessing hepatitis C treatment?
- I have previously experienced severe clinical depression. Will this stop me from accessing hepatitis C treatment?
Depending on your initial response to the treatment and the length of time you were on treatment (as a percentage of the time you were meant to do treatment) stopping early may put at risk your chance of achieving a Sustained Viral Response (SVR). SVR is measured six (6) months after treatment finishes and effectively constitutes a cure. It is extremely rare for the virus to recur or resurface after this time. Should you wish to try treatment again at a later date it may not be as effective the second time. If it is possible for you to complete your treatment, I would strongly urge you to do so to give yourself the best possible chance of clearing the virus.
Ribavirin is a category X drug (causes birth defects) and must not be given to pregnant women. It is not known whether or not ribavirin taken by the father can cause birth defects, however it is considered that the potential risk to an unborn child is sufficiently concerning that the S100 Criteria to access treatment in this country requires that:
- effective contraception be used by both partners (one for each partner) in a relationship (regardless of whether one or both partners are on treatment),
- that female partners of men on treatment are not to be pregnant, and
- females of child-bearing age on treatment must not be pregnant or breast-feeding.
These requirements extend to six months after treatment finishes to allow the ribavirin to have sufficiently left the body. Once this six month period has passed, it is safe to start a family.
There is a period of time prior to commencing treatment which will vary from one Liver Clinic to another and from one private specialist to another. In that time, a pre-treatment assessment consisting of blood tests, liver ultrasound, and psycho-social assessment will be done. As a very general rule, it may take up to three (3) months to have your first appointment and up to a further three (3) months to begin treatment. Hepatitis C is a slow progressing disease and this three to six month waiting period will not have adverse consequences. If your situation is urgent, your GP will advise the specialist or clinic and you will be seen more rapidly.
Treatment length is based on genotype (strain of the virus) and your liver health.
- Genotypes 2 and 3 generally receive 24 weeks of treatment.
- Genotypes 1, 4, 5 and 6 receive 48 weeks of treatment.
For people undertaking the 48 week course of treatment there is a requirement that certain objectives be achieved by week 12. These are as follows:
- The hepatitis C virus is undetectable in the blood (negative PCR), OR
- The viral load has decreased by at least a 2 log drop –after which the virus must be undetectable at week 24.
Genotypes 2 and 3 respond very well to the treatment and people with these genotypes have an 80 to 90% chance of clearing the virus.
Genotypes 1, 4, 5 and 6 respond less well to the treatment and people living with these genotypes have a 40 to 60% chance of clearing the virus.
A number of other factors affect the likelihood of clearing the virus and these include your age, gender, weight, liver health and length of time living with the virus.
The treatment is not currently approved for people under the age of 18 in Australia so there is a lower age limit of 18 under the S100 Criteria. There is no upper age limit for accessing treatment but other health issues need to be taken into consideration when assessing someone for treatment and such issues become more likely as we age. Also to be taken into account is a person’s liver health, the rate at which the disease is progressing and the likely benefit of undertaking treatment.
Provided you are not experiencing uncontrolled severe depression, your past experience will not prevent you from accessing treatment. Often, a psychological or psychiatric assessment will be performed and, if necessary, medication prescribed. The Liver Clinic or specialist may require that you have regular contact with a mental health professional, either a psychologist, psychiatrist or counsellor, and that you be on antidepressant medication. If you are not considered to be depressed prior to starting treatment, then they may ask that you agree that, if you are affected by the treatment in this way, you will begin antidepressant medication if requested.
Page last updated: Thursday 16 September, 2010