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Vomiting blood, confusion, or rapidly deepening jaundice need emergency care today. These indicate decompensated liver disease and need treating locally before anything else is planned.

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Hepatitis C

Hepatitis C is curable. A course of tablets taken for eight to twelve weeks clears the virus in the great majority of people, with few side effects — and the treatment is manufactured in India at a fraction of Western prices.

This is the most straightforwardly hopeful page on our site. If you have been told hepatitis C is something to live with, that information is out of date by about a decade.

Clinically reviewed by Dr. Annie Varughese, Consultant Transplant Surgeon Clinical oversight Dr. Annie Varughese, MD, FACC Last reviewed August 2026 Editorial and medical review policy
Cure rate
Over 95 per cent
With direct-acting antivirals
Course length
8 to 12 weeks
Tablets, few side effects
Cost in India
A fraction of Western prices
Generics manufactured here
Even with cirrhosis
Still worth treating
It halts progression and lowers cancer risk
On this page
  1. What it is
  2. Symptoms and warning signs
  3. How it is diagnosed
  4. Treatment options
  5. How the choice is made
  6. How urgent is your case
  7. What to send us
  8. Questions patients ask
The condition

What hepatitis C is

Hepatitis C is a blood-borne virus. In the regions our patients travel from it has been spread chiefly through unsterile medical injections, blood transfusion before screening, and reused equipment — not primarily through the routes people often assume, which is worth saying because the stigma attached to it causes real harm and delays diagnosis.

Most people who acquire it develop chronic infection, usually without symptoms, for decades. During that time the liver is quietly inflamed and scarring accumulates, in some people progressing to cirrhosis and then to liver cancer or liver failure.

Treatment changed completely around 2014. The old interferon injections, which took a year, made people extremely unwell and cured only some, have been replaced by direct-acting antivirals — tablets taken for eight to twelve weeks that cure over ninety-five per cent of patients with few side effects.

India manufactures these drugs generically, which is why they cost here a small fraction of what they cost elsewhere. For many patients this alone is a reason to travel, or simply to arrange treatment through a proper consultation.

Symptoms

Symptoms and warning signs

Common symptoms
  • Usually none at all for many years
  • Fatigue, sometimes profound
  • Discomfort in the upper right abdomen
  • Joint and muscle aches
  • Poor concentration, sometimes described as brain fog
  • Nausea and loss of appetite
  • Symptoms of cirrhosis where damage has advanced
Warning signs of an emergency
  • Vomiting blood or black stools
  • Confusion or drowsiness
  • Rapidly deepening jaundice
  • New abdominal swelling
  • Fever with a swollen abdomen
  • Severe abdominal pain

If you were told hepatitis C is incurable, that advice is out of date

Before 2014, treatment meant interferon injections for up to a year, with severe side effects and cure in only a proportion of patients. Many people were told it was not worth attempting, or tried and failed. All of that has changed. Direct-acting antivirals cure over ninety-five per cent of patients with a short course of well-tolerated tablets, including people who failed interferon and people who already have cirrhosis. If you were advised years ago that nothing could be done, ask again.

Diagnosis

How it is diagnosed

Diagnosis is straightforward; the details determine which drugs and for how long.

Initial tests

  • Anti-HCV antibody — indicates exposure, but not whether infection is still present
  • HCV RNA — confirms current active infection; this is the test that matters
  • Liver function tests and full blood count
  • Hepatitis B and HIV testing — co-infection changes management

The deciding tests

  • HCV genotype — less critical than it once was, since modern regimens work across genotypes, but still used in some settings
  • Fibroscan or elastography — establishes whether cirrhosis is present, which affects the regimen and the follow-up
  • Ultrasound — baseline assessment and, where cirrhosis is present, ongoing cancer surveillance
  • HCV RNA twelve weeks after treatment — undetectable at that point means cure

An antibody test alone does not mean you are infected

A positive anti-HCV antibody shows you have been exposed. Some people clear the virus naturally and remain antibody-positive for life without active infection. The test that establishes current infection is HCV RNA. If you have only had the antibody test, that is the next step — and it may show you need no treatment at all.

Options

Treatment options

For almost everyone, the answer is a short course of tablets.

Option one

Direct-acting antiviral therapy

A combination of tablets taken once daily for eight to twelve weeks. Cure rates exceed ninety-five per cent across genotypes, including in patients with cirrhosis and those who failed older treatments. Side effects are usually mild — headache and tiredness are the commonest. Some regimens interact with other medicines, so bring your full drug list.

Usually appropriate whenEssentially everyone with active hepatitis C infection, including those with cirrhosis.
Option two

Treatment in decompensated cirrhosis

Patients whose liver has already decompensated can still be treated, but the regimen differs, some drugs are avoided, and it should be done under specialist supervision at a centre with transplant capability. Curing the virus can improve liver function enough to change the transplant decision.

Usually appropriate whenDecompensated cirrhosis with active hepatitis C, managed by a hepatologist.
Option three

Continued cancer surveillance after cure

Where cirrhosis was present before treatment, the risk of liver cancer falls after cure but does not disappear. Six-monthly ultrasound surveillance continues indefinitely. This is frequently stopped after cure, which is a mistake.

Usually appropriate whenAnyone who had cirrhosis or advanced fibrosis before treatment, regardless of cure.
Option four

Liver transplant

For decompensated cirrhosis that does not recover after viral cure, transplant with a near-relative living donor remains the treatment. Curing the virus first substantially improves outcomes after transplant.

Usually appropriate whenDecompensated cirrhosis persisting after antiviral cure, with a legally eligible donor.
The decision

How the choice is made

Is the infection active

HCV RNA rather than antibody. A meaningful number of antibody-positive people have already cleared the virus.

Is there cirrhosis

This affects the regimen, the duration, and whether lifelong cancer surveillance is needed after cure.

Other medicines you take

Several common drugs interact with antiviral regimens. Bring the full list, including anything bought without prescription.

If your only test was an antibody, we will ask for HCV RNA before recommending anything. You may not need treatment at all.

Urgency

How urgent is your case

Usually safe to plan travel
  • Chronic infection, compensated liver
  • On antiviral treatment
  • Cirrhosis compensated and stable
  • Planning assessment or treatment
Needs local assessment before travel
  • Vomiting blood or black stools
  • Confusion or drowsiness
  • Rapidly deepening jaundice
  • Fever with a swollen abdomen
  • Reduced urine output with rising creatinine

We will tell you which column you are in

Hepatitis C itself is not an emergency and treatment can be planned calmly. Decompensated liver disease is different and needs local stabilisation first.

Next step

What to send us

Photographs taken on your phone are fine. Reports in Arabic, Russian or Bengali are fine — we translate them ourselves.

Most useful

  • HCV RNA result — not only the antibody test
  • Liver function tests
  • Fibroscan or elastography if performed
  • Ultrasound report

Also helpful

  • HCV genotype if known
  • Details of any previous treatment, including interferon
  • Full list of all medicines you take
  • Hepatitis B and HIV status
Send my reports for review See published cost ranges
Questions

Questions patients ask

Yes. Direct-acting antivirals cure over ninety-five per cent of patients with an eight to twelve week course of tablets, including people with cirrhosis and people for whom older interferon treatment failed. Cure means the virus is undetectable twelve weeks after finishing treatment, and it does not come back unless you are reinfected.

Usually mild — headache and tiredness are the commonest, and most people continue working throughout. This is a completely different experience from the old interferon injections, which caused severe flu-like illness, depression and blood count problems for up to a year.

Because these drugs are manufactured generically here under licensing arrangements, and Indian generic production has driven the global price down enormously. The same molecules that cost tens of thousands elsewhere cost a small fraction here. For many patients this alone justifies arranging treatment through India.

No, and it is arguably more important. Curing the virus halts further damage, allows some recovery of liver function, and substantially reduces the risk of liver cancer and liver failure. It can even improve function enough to change the transplant decision. Treatment in decompensated cirrhosis needs specialist supervision, but it is worth pursuing.

Not necessarily. Antibody indicates exposure, and a proportion of people clear the virus naturally while remaining antibody-positive for life. The test that establishes active infection is HCV RNA. If you have only had the antibody test, that is the next step — and it may show you need no treatment.

Yes. Cure does not confer immunity, and reinfection is possible through the same routes as the original infection — chiefly unsterile injections, reused medical or dental equipment, and shared blades. This is worth knowing so that the same exposure is avoided.

RelatedOn this site
Organ transplant in IndiaRead → Liver cirrhosisRead → Hepatitis BRead → Liver cancerRead → Liver and digestive treatmentRead →
Contact

Send us your reports

Send your HCV RNA result — not just the antibody test — along with liver function tests and any Fibroscan or ultrasound.

Your reports go directly to our medical team. We do not share your records with hospitals until you tell us to.

WhatsApp +91 83035 86344  ·  Phone +91 83035 86344  ·  Email tibhind@gmail.com

Coordinators available 9:00–20:00 IST. We speak Arabic, English, Russian and Bengali.