Lactose is NOT a treatment for hepatitis C virus infection
Lactose has no role in the treatment of hepatitis C and should not be used for this purpose. There is no evidence in any clinical guidelines or research literature supporting lactose as a therapeutic agent for HCV infection.
Standard Treatment for Hepatitis C
The established treatment for chronic hepatitis C consists of direct-acting antiviral agents (DAAs), which target specific viral proteins and achieve cure rates exceeding 90% 1, 2.
Current Recommended Therapies
All patients with chronic HCV infection should be offered treatment without delay, regardless of disease stage 3. The approved therapeutic options include:
- Sofosbuvir/ledipasvir - Fixed-dose combination for 12 weeks without ribavirin in most patients 1
- Sofosbuvir/velpatasvir - Pangenotypic regimen for 12 weeks 1
- Grazoprevir/elbasvir - For specific genotypes with duration based on resistance testing 1
- Other DAA combinations targeting NS3/4A protease, NS5A protein, and NS5B polymerase 2
Treatment Priorities
Patients requiring immediate treatment include 3:
- Those with significant fibrosis or cirrhosis (compensated or decompensated)
- Individuals with clinically significant extrahepatic manifestations
- Patients at risk of rapid disease progression (transplant recipients, HIV/HBV coinfection, diabetes)
- Persons at risk of transmitting HCV (people who inject drugs, high-risk sexual practices)
Why Lactose is Not Appropriate
The question may arise from confusion with lactoferrin, a milk protein that has been studied in small pilot trials 4, 5. However, even lactoferrin showed only modest effects in very limited studies and is not part of any treatment guidelines 4.
Critical Distinction
- Lactose = a milk sugar with no antiviral properties
- Lactoferrin = a milk protein with theoretical antiviral activity in laboratory studies only 4, 5
Neither substance is recommended for HCV treatment by any major guideline organization 1.
Essential Management Components
Multidisciplinary Care
HCV treatment should be delivered within a multidisciplinary team with experience in HCV assessment and therapy 1.
Patient Counseling
- Patients must be counseled on adherence importance for achieving sustained virological response (SVR) 1
- Alcohol abstinence should be advised during therapy 1
- Education about preventing HCV transmission is essential 1
Post-Treatment Monitoring
- Non-cirrhotic patients with SVR should be retested at 48 weeks post-treatment, then discharged if HCV RNA is negative 1
- Cirrhotic patients with SVR require lifelong HCC surveillance every 6 months 1, 6, 3
Common Pitfall to Avoid
Do not delay evidence-based DAA therapy in favor of unproven substances like lactose or lactoferrin 1, 3. Modern DAA regimens cure >90% of patients with minimal side effects and short treatment durations (typically 12 weeks) 1, 2. Any delay in initiating appropriate treatment allows continued liver damage and disease progression 3.