What are the Different Types of Hepatitis C?
Hepatitis C is a type of liver disease that is among the most common viral forms of hepatitis in the United States.
Treatment is essential to easing hepatitis C infection and helping to prevent long-term complications. Knowing the type of hepatitis C you have can help your doctor in deciding which treatment to suggest.
What is hepatitis C?
The term 'hepatitis' refers to liver inflammation in general. Hepatitis C is inflammation due to infection with the hepatitis C virus (HCV).
There are five types of viral hepatitis, with HAV, HBV, and HCV the most common in the U.S. The other types are HDV and HEV.
How do you get hepatitis C?
Hepatitis C primarily spreads through direct contact with the blood of someone who also has the viral infection.
While treatable when detected in its early stages, about half of people with hepatitis C aren't aware they even have this condition. There is also currently no vaccine available for HCV to help prevent hepatitis C.
How are different types of hepatitis C classified?
Different types of hepatitis C are classified into different strains, or genotypes, of HCV, depending on the genetic makeup of the virus. Seven main genotypes are currently recognized.
Though some strains are seen worldwide, others are more regional.
Genotype Description
1 Genotype 1 is the most common HCV strain, accounting for about 60% of cases in the U.S. This strain may also be further divided into types 1a and 1b.
2 Genotype 2 also includes types 2a, 2b, and 2c. While cases have been noted worldwide, strain 2 is primarily seen in both central and western Africa.
3 Genotype 3 is another possible strain of HCV seen in the U.S. However, it's primarily diagnosed in Asia. Genotype 3 may also be further classified into types 3a and 3b.
4 Genotype 4 is mostly seen in the Middle East and northern Africa
5 Strain 5 is primarily seen in South Africa.
6 Genotype 6 mostly occurs in southeastern Asia.
7 Strain 7 is only seen in the Congo region of central Africa.
How does the type of hepatitis C affect treatment?
The differences between each strain of HCV may determine how well prescription direct-acting antiviral treatments can help treat hepatitis C. Each type can impact the effectiveness of the overall treatment.
The most commonly diagnosed hepatitis C genotypes in the U.S. are genotypes 1, 2, and 3. As such, your doctor will likely choose an antiviral treatment that can target one of these three strains. Testing can help confirm the exact genotype you have.
During treatment, a doctor will order regular blood testing to determine whether the medications you're taking are working.
How do you know which type of hepatitis C you have?
Genotype testing for hepatitis C can be important to determine exactly which type of HCV infection you have, so a doctor can make tailored treatment recommendations. This includes the type of antiviral treatment prescribed and how long you need to take these medications.
While genotype 1 is the most common type of hepatitis C in the U.S., it's important to let your doctor know if you've recently traveled internationally in case you have come into contact with other types.
The only way to know which type of hepatitis C you have is through a blood test. A doctor will then send a sample to a lab for further molecular testing.
A doctor can also confirm that you have hepatitis C by testing your blood for an HCV antibody.
»MORE: Learn more about symptoms, causes, and risk factors of hepatitis C.
How to treat different types of hepatitis C?
Treatment for any type of hepatitis C is important in clearing up the viral infection.
While some cases are short-term (acute), others may develop into chronic hepatitis C. Chronic cases can also increase your risk of developing liver cirrhosis or cancer.
According to the CDC, antiviral treatment for hepatitis C in the U.S. typically involves oral medications you take for 8 to 12 weeks. Hepatitis C treatment also has an estimated 95% cure rate.
The key is to determine which type of hepatitis C you have so a doctor can prescribe the right treatment. In some cases, you might need more than one medication.
Your doctor may first try a pangenotypic regimen, which means that it may treat all genotypes. Examples of medication include:
glecaprevir/pibrentasvir (Mavyret)
sofosbuvir/velpatasvir (Epclusa)
sofosbuvir/velpatasvir/voxilaprevir (Vosevi)
Genotypes 1 and 4 may respond best to ledipasvir/sofosbuvir (Harvoni) or elbasvir/grazoprevir (Zepatier).
Prescribing the right medication for your hepatitis C genotype may involve some trial and error. This is why regular blood testing is important to determine whether the antiviral medications are working.
»MORE: Discover a full list of heptatitis C medications.
The takeaway
Hepatitis C is an infection that results from the hepatitis C virus (HCV). Several strains of HCV exist worldwide – seven main ones are currently known. The type of HCV infection you have can be determined with a simple blood test.
While some direct-acting antiviral medications target all HCV genotypes, it may be useful to try a treatment that targets your specific genotype.
Testing your blood to see which type of HCV you have can help a doctor decide which treatment may work best for you.
Frequently asked questions
Find answers to some frequently asked questions about hepatitis C genotypes:
What is an HCV genotype?
An HCV genotype refers to different strains of HCV that arise due to variations in the genetic make up of the virus.
While new HCV genotypes are still being discovered, there are currently seven main genotypes that are known.
How common is each HCV genotype worldwide?
Genotype 1 is considered the most common worldwide and in the U.S. Genotypes 2 and 3 are also seen around the globe, while genotypes 4 to 7 are more regional.
Does my HCV genotype affect my treatment?
It's possible that the HCV genotype you have can affect how well antiviral treatments can work. However, newer medications are being developed that can treat all forms of hepatitis C and eliminate the need for genotype testing.
How is HCV genotype testing performed?
HCV genotype testing involves a blood test. A laboratory can then look for variations in the virus' genome to identify the strain, before reporting the results back to your doctor.
Can a person have more than one HCV genotype?
While uncommon, it's possible to have more than one HCV genotype at the same time. In this case, your doctor will need to make sure your treatment can treat all of them.
Does my HCV genotype affect how severe my symptoms are?
Some studies indicate that certain genotypes are associated with more severe hepatitis. For example, genotype 3 HCV infections may increase your risk of rapid fibrosis as well as liver cancer.
Can my HCV genotype change over time?
No, your HCV genotype will not change over time. You will usually only need to be tested to find out the genotype once.
However, if you get the virus again, you'll need to have a test to determine the genotype once more.
Are certain HCV genotypes more common in specific populations?
Certain genotypes are more likely in particular geographical locations. For example, while genotype 1 is the most common worldwide, some genotypes are more regional, such as genotype 7 that is mostly seen in the Congo.
Do HCV genotypes differ in how easily they spread?
While it's unclear whether certain HCV genotypes spread more easily than others, research suggests some genotypes may have higher viral loads.
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