Treatment

Effective treatment is available for both chronic hepatitis B and C.  Before you can see a liver specialist to talk about going on treatment, you need to get a referral from your GP first.

Hepatitis A

There is no medical treatment required for hepatitis A (as it is a short-term illness); however symptoms may be relieved by rest and adequate fluid intake.  Medications should be limited to those considered essential and alcohol should be avoided.

Hepatitis B

Some people with chronic (long-term) hepatitis B may benefit from treatment. There are currently two types of treatments available. One is Pegylated Interferon which is aimed at boosting your immune system and its ability to clear the hep B virus from your body.  Another type of treatment is anti-viral medication, which works by slowing down the reproduction of the virus. These anti-virals are sometimes called ‘nucleotide’ and ‘nucleoside analogues’.

Treatment may not be appropriate for everyone, and sometimes people develop resistance to medications. This means the medication may not work as well as it did when you first started.  Ask your doctor for a referral to a liver specialist to discuss whether treatment is right for you, and what type of treatment this should be.

Hepatitis B
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Hepatitis C

Treatment currently available for people with hepatitis C is Pegylated Interferon and Ribavirin; commonly called ‘combination therapy’ when both drugs are used together. Using combination therapy involves injecting Pegylated Interferon into the fatty tissue under the skin once a week and taking Ribavirin tablets daily, for either six or 12 months.

Pegylated interferon monotherapy is also available for people who cannot tolerate ribavirin (i.e. if you have an allergic reaction to it), although this has a lower success rate in clearing the virus.

Hepatitis C
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Stages of liver damage (scarring or fibrosis)

In the early stages of hepatitis, damage to the liver (caused by inflammation) is repaired by the formation of tiny scars.  This scarring (fibrosis) eventually makes it harder for the liver to do its job.  Ongoing inflammation and fibrosis can, over many years, result in large areas of the liver becoming severely scarred – a condition called cirrhosis.  This scarring is often permanent and prevents blood and other fluids from flowing freely through the liver; limiting its function.  When this happens the liver begins to shrink and becomes hard and lumpy.

Cirrhosis may eventually lead to liver failure and, in a small percentage of cases, progress to liver cancer.  In general it takes many years before someone develops the severe type of fibrosis that leads to cirrhosis.  And it is important to remember the worsening of fibrosis does not happen at the same rate for everybody.

	Fibrosis Scale	Symptoms of liver damage
	F0 Normal Liver	No scarring Smooth Firm to the touch
	F1 Hepatitis	Minimal scarring Enlarged Tender to the touch
	F2 Fibrosis	Scarring has occurred and is inside areas of the liver including blood vessels
	F3 Bridging Fibrosis	Inflammation Scarring Shrinkage and hardening Formation of nodules Fibrosis is spreading and connecting to other areas that contain fibrosis
	F4 Cirrhosis Compensated: liver can still perform most functions; or Decompensated: blood cannot flow through the liver and it cannot function properly	The liver is even smaller Hardened Extensive scarring Many nodules