Effective control of viruses
90 per cent of all hepatitis B cases heal spontaneously. There is no medication for treating acute hepatitis B infections. Chronic hepatitis B can be treated with antiviral medicines or pegylated interferon-alpha. Because genetic make-up of the virus remains in the liver even after successfully treating the infection, chronic hepatitis B can almost never be healed completely. But the treatment reduces the viral load in the blood and serious complications of liver cirrhosis such as bleeding and liver cancer can be prevented. During a successful treatment, liver function usually improves again and fibrosis of the liver is reduced. Patients with advanced liver disease (cirrhosis and/or liver cancer) or a serious hepatitis B infection may need a liver transplant.
High cure rates thanks to new therapies
A chronic hepatitis C infection is curable in the vast majority of cases today. While earlier therapies with interferon and ribavirin were a great physical and psychological burden for patients, the latest generation of antiviral drugs have few side effects. In addition, the duration of therapy has also been drastically shortened and now lasts 8 to 12 weeks. The chance of cure is also very high for patients who are difficult to treat, i.e. those with liver cirrhosis, HIV/HCV coinfection and liver transplants. And this is how the new drugs work: The antiviral substances, known as Direct Acting Antiviral Agents (DAAs), act directly on the life cycle of the hepatitis C virus and disrupt it. DAAs inhibit various viral proteins (protease, polymerase or the NS5A protein) and prevent viruses from multiplying in hepatic cells and attacking other cells. Introduction of DAAs: At the end of 2011, two protease inhibitors for genotype 1 hepatitis were released as the first representatives of DAAs in Switzerland. Genotype 1 is the most common type of hepatitis C in Switzerland, affecting almost half the people infected, and it had been difficult to treat so far. The first protease inhibitors, who still need to be combined with interferon and ribavirin, have brought an improvement of healing rates. The side effects, however, were still severe. This improved with the second generation of DAAs. The first agent, a polymerase inhibitor, was released in the summer of 2014. Others followed. The new medicines only have to be taken once or twice a day, produce considerably less side effects and need to be taken over a substantially shorter period of time. They can be combined with each other, showing that interferon-free treatments are the future.
Cure rates: In clinical studies, more than 90 per cent of hepatitis C patients have been able to be cured thanks to the new medication, and with considerable fewer side effects. Because of the large number of affected people and the high treatment cost, the Federal Office of Public Health (FOPH) first decided to restrict prescriptions. Since 1 Octobre 2017, all treatments are paid for by health insurances.
All in all, the new medicines open up a perspective that, up until now, has not been thought possible: the possibility of eliminating hepatitis C in the foreseeable future, and thus saving millions of lives.
Where to get treatment?
Since the beginning of 2022, all doctors can prescribe all medicines for hepatitis C therapy. General practitioners can obtain uncomplicated advice on hepatitis C therapy from specialists via the HepCare HepCare service.
Below you will find a map with test and treatment centres as well as addresses for people with addictions.
- Counselling for people with hepatitis C
Would you like to find out more about the experience with the therapy? Counselling for people with hepatitis C is offered by the Swiss Hepatitis C Association.