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Overview
Most people with an acute hepatitis C infection aren't treated. Often, they don't even realize they're sick until the disease has become chronic, and even when they do, treatment may not be advised. When liver disease is mild, the medications' side effects (and the fact that the drugs are not always effective) often tip the balance toward a wait-and-see approach. But recent studies indicate that early treatment with pegylated interferon (a long-acting form of interferon alpha) and ribavirin improves the clearance of virus from the bloodstream.
With chronic hepatitis C, the goal of treatment is to use medication to eliminate the virus. Eliminating the virus makes it possible to decrease the progression of fibrosis of the liver and the risk of developing liver cancer. In certain cases in which the viral load is decreased but not eliminated, it is thought that long-term "suppressive" therapy may be of benefit to thwart disease progression and prevent the development of liver cancer. Clinical trials are underway to test this hypothesis. In patients with manifestations of disease beyond the liver, there is an additional goal of relieving symptoms.
This section discusses
Drug therapy
Controversies about treatment
Liver transplantation
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