If you have hepatitis C, you probably have a lot of questions. One of the biggest may be, “Can I be cured?” Thanks to new medications, the answer is probably yes. But to get there, you'll need to work closely with your doctor for quite a while.
Building an open, honest relationship and asking smart questions are the keys to your success.
First, draft the right team.
Ask your primary care doctor if he normally treats people with hep C. If the answer is no, he'll probably refer you to a liver doctor (hepatologist), an infectious disease expert, or both. These doctors regularly treat people with the virus, are familiar with the latest medications, and can anticipate any complications, says Alexea Gaffney-Adams, MD, an infectious disease expert in Smithtown, NY.
Come Prepared With Questions
“The doctor is not going to answer your questions if you don't ask them,” says Bob Rice, of Boston, who was cured of hep C in 2015.
Think of questions before your appointments and write them down. That way, you won't forget to ask something important.
You may want to find out:
What's my genotype? That's the type of hep C you have. There are six. Your doctor will craft a treatment plan based on your genotype and any other health problems you have.
What's my viral load? This tells you how much of the virus is in your blood. If you decide to treat your hep C, you'll be tested during and after your treatment to see if this number falls to an undetectable level and stays there.
Is my liver damaged? It could be. Your doctor probably will give you blood tests and may order special scans of your liver. You may even need a biopsy. That's a test that takes a sample of liver tissue to see if there's damage.
How can I protect my liver? Your doctor likely will tell you to go easy on the booze or lay off it completely. They may also tell you to use little or no acetaminophen. Let them know about all medicines and supplements you take. They may need to tweak some doses, and they may tell you to stop taking some things.
A healthy diet and losing weight -- if you need to -- can help, too. Ask if you need to be vaccinated against hepatitis A and B.
You may want to bring a loved one to your appointments. They can act as a second set of ears to remember what the doctor said. Ask them to take notes, too.
Is Treatment Right for You?
If your doctor thinks you got the virus recently, she may watch you for 6 months to see if it goes away, Gaffney-Adams says. About 15% to 25% of people are able to clear what's called an acute infection on their own.
But if it's chronic (long-lasting), your doctor may recommend treatment. Your plan will depend on your earlier test results and other health conditions you have.
Questions to ask your doctor include:
Which medication should I take? There are several. Your doctor will tell you which one is the best for your hepatitis. You may be able to take just one pill a day.
Will it be successful? Ask about the numbers, says Stella Armstrong, of Las Vegas, who was cured of hep C in 2014. Ask, “What are the statistics that this treatment will cure me?” Generally, today's medications cure at least 90% of people.
How long will treatment last? It depends on your situation and what medication you're on. It may take as little as 2 or 3 months. You'll need to take meds exactly as prescribed, or they might not work. Make sure you understand what to do.
Keep all your appointments, and get any tests or lab work your doctor orders.
What are the side effects? Find out about the likely ones and the rare problems. Ask which ones you'll need to see a doctor for, and which to go to the emergency room for, Gaffney-Adams said.
Common side effects are mild and include stomach upset and diarrhea. But call your doctor if you have:
- Trouble breathing
- Terrible pain in your abdomen
- Yellow eyes or skin
Share any symptoms or side effects you're having, even if you're not sure they're related to your hep C or treatment. Your doctor needs to know what's going on to give you the best care.
Talk Openly With Your Doctor
If you have doubts about your treatment plan, say so right away. Your doctor may be able to explain it better and put your mind at ease. If you're still worried, ask if there is something else to try.
“You are your own … advocate, and you have to tell [the doctors] what you want,” Armstrong says. If you have symptoms that worry you and want certain tests run, press the doctor to order them, she adds.
It's important to be honest with your doctor about your lifestyle choices, too. If you're drinking or doing drugs, you need to say so, even though you might be embarrassed. Treatment could hurt you if you're using drugs or alcohol. Or your medicine may not work as well.
“You should feel open enough that you can talk to your doctor about pretty much anything,” Rice says.
"If you don't feel comfortable with your doctor, get another doctor.”
Alexea Gaffney-Adams, MD, infectious disease specialist, Smithtown, NY.
Bob Rice, of Boston, cured of hepatitis C and a member of the American Liver Foundation national patient advisory committee.
U.S. Department of Veterans Affairs: “Hepatitis C genotype,” “Viral Load.”
Mayo Clinic: “Liver Disease.”
CDC: “Hepatitis C FAQs for the Public.”
Stella Armstrong, of Las Vegas, cured of hepatitis C and a member of the American Liver Foundation national patient advisory committee.
FDA: “Hepatitis C Treatments Give Patients More Options,” “FDA approves Mavyret for Hepatitis C.”
American Liver Foundation: “Importance of Adhering to Your Treatment Plan,” “Meeting with Your Healthcare Provider.”