Is Hepatitis C treatable?

Hepatitis C was once considered a lifelong diagnosis. That’s no longer the case. Thanks to remarkable advances in antiviral medications, Hepatitis C is now one of the most treatable chronic viral infections in the world, and for the vast majority of people, a complete cure is not just possible. It’s expected.

Hepatitis C is an infection caused by the Hepatitis C virus (HCV). The virus spreads through blood and sexual contact, and mainly affects the liver.

There are two types of Hepatitis C infection:

• Acute Hepatitis C, which is a short-term infection that happens during the first six months after a person is exposed to the virus.
• Chronic Hepatitis C, which occurs when the virus stays in the body for more than six months. This is the most common outcome.

One of the biggest problems with Hepatitis C is that many people don’t know they have it. Most people with Hepatitis C have no symptoms. Signs of the infection may not appear for weeks, months, or even many years after exposure. Some people with acute Hepatitis C may develop symptoms within two to six months, while people with chronic infections can feel completely healthy. When symptoms do appear, they may include tiredness and yellowing of the skin or eyes (jaundice).

Because Hepatitis C can stay hidden for so long, it can slowly damage the liver without you noticing. Over time, the infection can cause liver scarring, called fibrosis. In some cases, this can lead to severe liver damage, liver failure, or liver cancer. By the time symptoms appear, some of the liver damage may already be serious.

Before 2014, Hepatitis C treatments were difficult and didn’t work as well as they do today. Most people were treated with a combination of interferon shots and a medicine called ribavirin. Treatment usually lasted 24 to 48 weeks (about 6 to 12 months) and often caused unpleasant side effects, such as flu-like symptoms, feeling sick to the stomach, depression, and loss of appetite. Even after all that treatment, fewer than 70% of patients were cured.

Things changed dramatically when new medicines called direct-acting antivirals (DAAs) became available. These medicines come as tablets and work by blocking parts of the Hepatitis C virus that it needs to make more copies of itself. Unlike older treatments, most people can now complete their treatment in just 8 to 12 weeks.

The results have been remarkable. More than 95% of people who take modern DAA treatments are cured, including many people who already have liver damage or other health conditions. Most people experience only mild side effects, if any.

Because these medicines work so well, health organisations around the world hope to greatly reduce or even eliminate hepatitis C as a major health problem in the future.

There are two important things to remember:

1. Being cured doesn’t make you immune. If you’re exposed to infected blood again, you can catch Hepatitis C a second time.
2. Being cured helps protect your liver. After successful treatment, the risk of serious liver damage becomes much lower. Liver scarring may stop getting worse and can sometimes improve, especially if treatment begins before severe liver damage develops.

The good news is that hepatitis C can usually be cured with a short course of antiviral tablets. In general, the earlier treatment starts, the better the chances of protecting long-term liver health.

The short answer: almost everyone. Virtually all adults with chronic HCV infection are now eligible for DAA treatment, regardless of route of infection or how long they have been living with the virus.

Groups that can still be treated effectively include:

• People with HIV co-infection
• Those with mild to moderate cirrhosis (compensated liver disease)
• People who inject drugs or are receiving treatment in custodial settings
• Individuals with previous unsuccessful treatment attempts

Not everyone who gets Hepatitis C will become seriously ill. However, untreated Hepatitis C can cause serious liver damage over time.

The disease usually progresses in stages:

1. Long-term liver inflammation damages healthy liver cells.
2. Fibrosis develops, which means scar tissue forms as the liver tries to repair itself.
3. Cirrhosis can occur if too much scar tissue builds up.
4. In severe cases, liver failure or liver cancer may develop.

Serious complications are more likely after many years of infection, often around 20 years or more. However, some factors can accelerate the damage. These include:

• Drinking alcohol
• Having Hepatitis B or HIV at the same time
• Being overweight or obese
• Having fatty liver disease

One challenge with Hepatitis C is that people can feel healthy for years while liver damage is slowly occurring. When symptoms finally appear, they can be serious and may include:

• Yellowing of the skin or eyes (jaundice)
• Swelling in the abdomen caused by fluid buildup
• Internal bleeding from enlarged blood vessels

Hepatitis C spreads through infected blood entering the body and unprotected sex – it’s not spread through casual contact like hugging, shaking hands, sharing food, or using the same toilet.

The most common routes of transmission today include:

• Sharing needles, syringes, or other equipment used to inject drugs – this is the most common transmission method in the UK
• Sharing equipment used to snort drugs, such as straws or rolled notes
• Unregulated tattoos or piercings performed without proper sterilisation
• Certain sexual practices that involve blood exposure, particularly anal sex or rough sex, especially where HIV co-infection is present

Blood transfusions before 1996 posed a risk for Hepatitis C infection, and anyone who received blood products during that era and has not been tested should consider arranging a Hepatitis C test. Modern screening of blood donors has made transfusion-related infections extremely rare in the UK today.

Hepatitis C can also be transmitted from mother to baby during birth, particularly if the mother has a high viral load at the time of delivery. Sharing personal hygiene items that may carry traces of blood – such as razors or toothbrushes – is another, less common route.

Because most people with Hepatitis C infection have few or no symptoms, testing is the only reliable way to know whether you carry the virus. Without a test, even the most effective treatments in the world cannot help.

The standard testing pathway involves two steps:

1. Antibody test: A blood test that detects whether your immune system has ever produced antibodies to Hepatitis C, indicating past or present exposure.
2. PCR test: This confirmatory test checks for active virus in the blood, distinguishing current chronic infection from a past infection that has already cleared.
3. Core antigen test: This test detects antigens produced during a Hep C infection, allowing for early detection.

A positive antibody result does not always mean you have a chronic infection. Some people’s immune system clears acute Hepatitis C naturally. However, the confirmatory test is essential to know for certain.

Getting treatment for Hepatitis C is usually simple, and there are a few healthy habits that can help protect your liver during and after treatment.

During treatment:

• Don’t drink alcohol, because alcohol can make it harder for your liver to stay healthy.
• Eat a balanced diet and try to maintain a healthy weight.
• Stay active with regular exercise that feels comfortable for you.
• Get enough rest and drink plenty of water, which can help if you experience mild side effects such as tiredness or headaches.

97% of people who complete treatment are cured. Most people feel well during treatment and can continue with their normal daily activities, including work, school, and spending time with friends and family. There is usually no need to change your routine in a major way. Most people report very few side effects during treatment.

After treatment:

For the vast majority of people, the treatment journey lasts just 8 to 12 weeks and ends with confirmed clearance of the virus.

Talk to your doctor about getting vaccinated against Hepatitis A and Hepatitis B if you have not already received these vaccines.

Some people, especially those who had severe liver damage before treatment, may still need regular check-ups to make sure their liver stays healthy. People who were treated earlier usually need less follow-up care. Even after being cured, it is important to keep looking after your liver by avoiding things that can damage it, such as heavy alcohol use.

Even after successful treatment and cure, it’s possible to become reinfected if you are exposed to infected blood again. Key strategies to prevent reinfection include:

• Never sharing needles, syringes, or other injecting equipment
• Use condoms for sexual activity that could involve blood exposure
• Avoid unlicensed tattoo or piercing providers – always choose regulated healthcare settings or reputable studios
• Don’t share personal hygiene items such as razors or toothbrushes that may carry traces of blood

It’s worth repeating: simple day-to-day contact – hugging, shaking hands, sharing cutlery – doesn’t spread Hepatitis C and doesn’t require any special precautions. Breast milk is also not considered a transmission route, though mothers with cracked or bleeding nipples should discuss this with a healthcare professional.

Our data shows that tests for Hepatitis C featured in approximately 20% of Better2Know bookings, and demand for Hep C testing grew by around 13% year on year. The UK Health Security Agency estimates that around 50,200 adults in England were living with chronic Hepatitis C in 2024. While this represents a 61% decrease since 2015, tens of thousands of people remain undiagnosed and therefore unable to access treatment that could cure Hepatitis C for them.

This is exactly why accessible testing matters. Better2Know continues to expand clinic locations across the UK, offer discreet home sampling kits, and provide clear pre- and post-test advice.

Is Hepatitis C treatment safe during pregnancy or breastfeeding?

DAAs are not routinely used during pregnancy because safety data remain limited. Most clinicians recommend deferring treatment until after giving birth, with careful monitoring throughout. Breastfeeding is generally considered safe for mothers with Hepatitis C, as the virus does not spread through breast milk. However, if you have cracked or bleeding nipples, discuss this with your healthcare provider to manage any potential risk.

Will I need to change all my medications to start Hep C treatment?

Some medicines can interact with DAAs, but many can be continued safely with appropriate monitoring. Your doctor will review all prescriptions, over-the-counter medicines, and supplements before treatment begins. Never stop long-term medicines suddenly without medical advice – instead, bring a complete list to your appointment so a safe and effective treatment plan can be agreed.

Do I still need liver check-ups if I’m cured of Hepatitis C?

People who had significant liver scarring or cirrhosis before treatment often need ongoing monitoring, including scans and blood tests, even after the virus has been cleared. A liver biopsy is rarely needed today, as non-invasive procedures provide reliable assessment. Those treated at an earlier stage with minimal fibrosis typically require less intensive follow-up, but should still attend periodic health checks and avoid heavy alcohol consumption.

Is there a vaccine for Hepatitis C like there is for Hepatitis A and B?

There is currently no approved vaccine for Hepatitis C, which is why prevention, testing, and treatment are so critical. The European Medicines Agency has approved several Hepatitis B vaccines, and many people at risk of Hepatitis C are advised to get vaccinated against both Hepatitis A and B to protect their liver.

Hepatitis C is both highly treatable and usually curable, with modern direct-acting antivirals having transformed what was once a lifelong diagnosis into a short, manageable course of antiviral tablets with an outstanding cure rate.

Better2Know makes that step easy. Contact us today to book a sexual health test at a clinic near you.