Treatment of Hepatitis C

Section Eight

(Revised November 28, 2014)

Treatment of Hepatitis C

Conventional interferon alfa, pegylated interferon alfa, ribavirin, and several HCV inhibitors (also called Direct Acting Antivirals —DAA’s) are approved by the U.S. Food and Drug Administration (FDA) to treat hepatitis C.

Interferon works by stimulating the immune system and protecting cells. Ribavirin works to enhance the antiviral effects of treatment. HCV inhibitors or DAAs work by preventing the virus from replicating (making copies of itself).
The current treatments for chronic hepatitis C include:

  • Genotype 1:
    • Harvoni (sofosbuvir plus ledipasvir) is taken once a day for either 8, 12 or 24 weeks.
    • Olysio (simeprevir) is taken in combination with pegylated interferon and ribavirin. Treatment duration is 12 weeks with the triple combination followed by another 12 or 24 weeks with pegylated interferon plus ribavirin, but most people are able to complete treatment in a total of 24 weeks.
    • Sovaldi (sofosbuvir) plus Olysio (simeprevir) with and without ribavirin for people who are interferon intolerant. The combination also is prescribed ‘off-label.’  Treatment duration is 12 weeks.
  • Genotypes 1 and 4:
    • Sovaldi (sofosbuvir) is taken in combination with pegylated interferon and ribavirin. Treatment duration is 12 weeks.
  • Genotypes 2 and 3:
    • Sovaldi (sofosbuvir) is taken with ribavirin. Treatment duration is 12 weeks for HCV genotype 2 and 24 weeks for genotype 3.

Note: Harvoni (pill) is a combination of two drugs in one pill (sofosbuvir and ledipasvir) taken once-a-day; Olysio (pill) and Sovaldi (pill) are taken once-a-day; pegylated interferon is injected once-a-day; ribavirin (pills) are taken twice-a-day—the dose is based on a person’s body weight.

The goal of treatment is to obtain viral clearance or a sustained virological response, also called a viral cure. The current standard-of-care regimens listed above produce a cure in up to about 90% of people with HCV genotypes 1, 2, 3 and 4. There has been less research, yielding mixed data, on patients with other genotypes.


Note: Do not take St. Johns’ wort with sofosbuvir (Sovaldi, Harvoni) or Olysio (simeprevir) containing medications.  Be sure to notify your medical provider if you are taking any prescription drugs, over-the-counter medications or herbal remedies.  

Ribavirin Warning: Ribavirin has been shown to cause birth defects and miscarriages. Women of childbearing age, their male partners, and female partners of male patients taking ribavirin must use at least two forms of effective contraception during treatment and during the six-month post-treatment follow-up period. A woman should have a pregnancy test at certain time points during therapy.


Self-help Tip:

  • Your doctor or nurse will give you instructions on how to take the medications
  • Olysio (simeprevir) and ribavirin are taken with food
  • If you miss a dose of medicine your medical provider will give you instructions on when to take the next dose
  • Always check in with your medical provider if you have any questions about treatment



Next: Treatment Considerations


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