Hepatitis C Treatment in Northwest Arkansas
Hepatitis C is curable. Most patients are cured in 8 to 12 weeks with modern oral medications. Care available in Fayetteville and Rogers.
Hepatitis C Is Curable Today
Hepatitis C used to require months of injections with significant side effects, and even then many patients were not cured. The treatment landscape changed dramatically with the arrival of direct acting antivirals, often called DAAs. Modern DAA regimens are oral pills taken once a day for 8 to 12 weeks. Cure rates are above 95 percent across most patient populations, including those with cirrhosis or prior treatment failure. Our physicians have prescribed these medications since they first became available and have helped hundreds of Northwest Arkansas residents achieve a cure. If you have been told you have Hepatitis C, you can almost certainly be cured.
Who Needs Testing and Treatment
The CDC recommends one time Hepatitis C screening for all adults age 18 and older, and screening during every pregnancy. People with risk factors should be tested more often. Risk factors include current or past injection drug use, receipt of blood products before 1992, hemodialysis, occupational needle stick exposure, HIV infection, abnormal liver enzymes, and being born to a mother with Hepatitis C. If a screening test is positive, a confirmatory RNA test tells us whether you have an active infection. Anyone with active Hepatitis C should be evaluated for treatment, regardless of how long ago they were infected.
Treatment Process from Diagnosis to Cure
After your initial visit, we order labs to confirm active infection, identify the virus genotype, and check liver function. We assess the degree of liver scarring with a noninvasive test (FibroScan or blood based score). Once the workup is complete, we choose the best DAA regimen for your situation, submit prior authorization to your insurance, and help you obtain the medication through your pharmacy or a copay assistance program. Treatment typically lasts 8 or 12 weeks. We see you a few times during therapy and again 12 weeks after the last dose. An undetectable RNA at that point confirms cure.
What to Expect During Treatment
Most patients tolerate Hepatitis C treatment very well. The medications are taken once daily, often without regard to food. The most common side effects are mild fatigue and headache, and these usually fade after the first week or two. Serious side effects are uncommon. We review your other prescriptions and supplements before starting because some drug interactions need to be managed. You should not stop other medications without checking with us. Throughout treatment we are available by phone or patient portal if anything comes up between visits.
Long Term Outlook After Cure
Cure means the virus is permanently gone from your body. Once cured, your liver enzymes normalize, ongoing damage stops, and the risk of liver cancer drops substantially, especially if treatment occurred before significant scarring developed. Reinfection is possible if you are exposed again, so we discuss prevention with each patient. People with significant cirrhosis at the time of cure still need ongoing liver cancer screening every six months. For most patients, life after cure looks just like life before infection, only without the worry of progressing liver disease.
Common Questions from Our Patients
Will my insurance cover Hepatitis C medications?
Most commercial plans, Medicare, and Medicaid now cover Hepatitis C treatment. The medications were very expensive when first introduced, and some insurers had restrictive criteria, but coverage has expanded substantially. Our practice handles the prior authorization paperwork. For patients with high copays or no coverage, manufacturer copay cards and patient assistance programs can lower the cost dramatically, sometimes to zero. We will tell you exactly what your out of pocket cost will be before you start treatment.
How long does Hepatitis C treatment take?
Most patients complete treatment in 8 or 12 weeks with a single oral pill taken once a day. The exact duration depends on your virus genotype, prior treatment history, and the degree of liver scarring. After the last dose, we wait 12 weeks and check the RNA again. An undetectable result at that point confirms cure. So the total timeline from start of medication to confirmed cure is typically about 5 or 6 months, though most of that time is just routine follow up.
What are the side effects of Hepatitis C medications?
Modern direct acting antivirals are very well tolerated. The most common side effects are mild fatigue and headache during the first week or two of therapy. Some patients notice nausea or trouble sleeping. Serious side effects are rare. The medications can interact with other drugs, including certain heart, cholesterol, and seizure medications, so we review all your prescriptions and over the counter supplements before starting. If you take herbal supplements like St. John's wort, those need to be stopped before treatment.
How will I know if I am cured, and could the virus come back?
Cure is confirmed with a Hepatitis C RNA test 12 weeks after the last dose of medication. An undetectable result at that point is called sustained virologic response and is considered a cure. The virus does not come back on its own once cleared. Reinfection is possible if you are exposed again, for example through new injection drug use or unsterile tattoo equipment. We discuss prevention strategies with every patient and offer follow up testing for those at ongoing risk.
When should I start treatment?
Treatment can begin as soon as the workup is complete, which usually takes two to three weeks after your first visit. Earlier treatment is better because it stops ongoing liver damage, prevents transmission to others, and reduces the long term risk of cirrhosis and liver cancer. Even patients who feel completely well benefit from treatment because Hepatitis C silently injures the liver for years before symptoms develop. Pregnancy and certain other situations may delay treatment briefly, and we discuss timing on a case by case basis.