Hepatitis C treatment recommendations

The U.S. National Institutes of Health have made the following recommendations on who should receive antiviral treatment for hepatitis C.1

Treatment recommended

Treatment is recommended for people at the greatest risk of developing cirrhosis. These are people ages 18 and older who have:

  • Detectable levels of the hepatitis C virus in the blood (positive hepatitis C virus RNA test). This is a sign of an active infection.
  • Evidence of mild to moderate liver damage or greater. This is detected with a liver biopsy.

Treatment uncertain

Immediate treatment may not be needed for people who:

  • Have persistently high liver enzyme test results but no signs of scar tissue or inflammation from a liver biopsy.
  • Are younger than 18 or older than 60.

But treatment may help reduce viral loads in your body and prevent serious liver damage. Talk to your doctor about whether antiviral treatment is right for you.

Treatment not recommended

Treatment is not recommended for people who:

  • Have normal liver enzyme (alanine aminotransferase) test results and no signs of scar tissue (fibrosis) or inflammation from a liver biopsy.
  • Have advanced cirrhosis.
  • Drink excessive amounts of alcohol or use illegal drugs.
  • Have major depression, low blood counts, heart disease, a risk of stroke, hyperthyroidism, kidney disease or transplant, or autoimmune diseases.
  • Are pregnant.


Author: Maria G. Essig, MS, ELSLast Updated: August 27, 2007
Medical Review: Kathleen Romito, MD - Family Medicine
W. Thomas London, MD - Hepatology

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