How Is Hepatitis C Transmitted
Because HCV is primarily spread through contact with infected blood, people who inject drugs are at increased risk for HCV infection. HCV can also be transmitted from an infected mother to child at the time of birth, from unregulated tattoos or body piercings, and from sharing personal items that may be contaminated with infected blood, even in amounts too small to see. Much less often, HCV transmission occurs through sexual contact with an HCV-infected partner, especially among people with multiple sex partners and men who have sex with men. Currently in the United States, health care related transmission of HCV is rare, but people can become infected from accidental needle sticks and from breaches in infection control practices in health care facilities.
Effective Treatments Are Available For Hepatitis C
New medication to treat for HCV have been approved in recent years. These treatments are much better than the previously available treatment because they have few side effects and do not need to be injected. There are several direct-acting antiviral HCV treatments that cure more than 95% of people who take them in 8 to 12 weeks. HCV treatment dramatically reduces deaths among people with HCV infection, and people who are cured of HCV are much less likely to develop cirrhosis or liver cancer.
Take Action! CDCs National Prevention Information Network Service Locator helps consumers locate hepatitis B and hepatitis C prevention, care, and treatment services.
Causes And Risk Factors
HCV causes hepatitis C. People contract the virus through blood-to-blood contact with contaminated blood. For transmission to occur, blood containing HCV must enter the body of a person without HCV.
A speck of blood, invisible to the naked eye, can carry hundreds of hepatitis C virus particles, and the virus is not easy to kill.
The report the following risk factors for developing hepatitis C:
- using or having used injectable drugs, which is currently the most common route in the U.S.
- receiving transfusions or organ transplants before 1992, which is before blood screening became available
- having exposure to a needle stick, which is most common in people who work in healthcare
- being born to a mother who has hepatitis C
The CDC offer advice on cleaning syringes if it is not possible to use clean and sterile ones. Although bleach can kill the HCV in syringes, it may not have the same effect on other equipment. Boiling, burning and using alcohol, peroxide, or other common cleaning fluids to wash equipment can reduce the amount of HCV but might not stop a person from contracting the infection.
It is extremely dangerous to inject bleach, disinfectant, or other cleaning products, so people should make sure they rinse the syringe thoroughly. A person should only ever use bleach to clean equipment if new, sterile syringes and equipment are not available.
People who are at risk due to these factors can have screening to rule out HCV.
- peginterferon alfa-2a
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How Is Hepatitis C Diagnosed
To determine if you have hepatitis C, your doctor will do a blood test. The one most often used is called an HCV antibody test. It checks for antibodies for HCV. Antibodies are proteins that help your body fight disease.
If you test positive for HCV antibodies, this means youve been exposed to the virus. However, you may not have an active infection.
The next step is to have an HCV RNA qualitative test. This test will tell your doctor how much of the virus you have in your body, which will indicate whether you have an active infection.
If these tests show that you have an active HCV infection, your doctor will likely do another test called viral genotyping. This test can tell your doctor what type of HCV you have. The treatment you receive will depend on the type of HCV thats in your system.
What Can People Do To Help The Medications Work Best
- Take the medications every day
- Stay in touch with pharmacy to be sure that all refills are ready on time
- Take the medications exactly as prescribed
- Do not skip doses
- Get all blood tests done on time
- Go to all visits with providers as recommended
- Tell the provider about all other medications that are being taken – including over-the-counter medicines, vitamins, herbs, and supplements
- Complete the entire course of medication
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Diagnosis Of Hepatitis C
If you are at risk of hepatitis C infection, or think you may have been exposed to hepatitis C in the past, see your doctor for an assessment of your liver health. This will include blood tests and possibly a non-invasive test for liver damage .
There are 2 blood tests used to diagnose hepatitis C. Usually these can be done at the same time but sometimes they will be done separately.
The first test known as a hepatitis C antibody test can tell you whether you have ever been exposed to hepatitis C.
It may take 2 to 3 months from the time of infection until a blood test can detect antibodies to hepatitis C, so there is a window period during which you cannot tell if you are or have been infected. In this time, take precautions to prevent the potential spread of the virus.
The second test is called hepatitis C PCR, which will be done if the antibody test is positive. This determines if the virus is still present in your blood or liver or if you have already cleared the infection.
If you have cleared the virus or had successful treatment to cure it, the PCR test will be negative.
A liver ultrasound or Fibroscan can also be performed to assess if you have any liver damage.
If your doctor is inexperienced in diagnosing hepatitis C you can call the LiverLine on for information, and to find a GP who can help you.
Antiviral Medication For Hepatitis C
For people with hepatitis C, the goal of treatment with antiviral medication is to prevent the virus from replicating, or copying itself, and to eliminate the virus from the bloodstream. If the hepatitis C virus has been in the body for more than six months, the infection is considered chronic. Without treatment, most people with acute hepatitis C develop the chronic form of the disease.
Your doctor decides which antiviral medicationor combination of medicationsto prescribe based on the results of a blood test called a genotype test. There are six genotypes, or strains, of the hepatitis C virus, and people with certain genotypes respond more quickly to medical treatment.
For many years, the standard treatment for chronic hepatitis C consisted of the antiviral medications pegylated interferon and ribavirin. Ribavirin is taken by mouth every day, and interferon is an injection that you or a caregiver can administer once a week at home.
In 2013 and 2014, the U.S. Food and Drug Administration approved a group of new medications for the treatment of hepatitis C. These medications, which include sofosbuvir, are very effective and have fewer side effects than older medications, particularly interferon.
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Protease Inhibitor Antiviral Medications
Protease inhibitors work by preventing the spread of infection within the body by stopping viruses from multiplying.
Grazoprevir is a protease inhibitor for hepatitis C genotypes 1 and 4. Its only available in combination with elbasvir and sold as grazoprevir/elbasvir.
The drug combination is sold under the brand name Zepatier.
Meeting With Your Healthcare Provider
Keeping your medical appointments and regularly communicating with your healthcare provider is important to staying healthy, minimizing treatment-related side effects and maximizing your chance of treatment success. Here are some things you can do to get the most out of your medical appointments:
If you run out of time during your appointment and still have questions, ask if theres someone else on your healthcare team who can talk with you. If not, ask if you can leave a copy of your questions and request a time to discuss them on the phone.
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Managing Your Health While On Treatment
There are many things you can do to improve your health and feel better while on treatment for your Hepatitis C infection. And by taking good care of yourself, you will increase your chances of be able to take your medication as prescribed.
IMPORTANCE OF DIET AND NUTRITION
Contrary to some claims you might read on the Internet, there is no special Hepatitis C diet. However, a healthy diet can improve liver health in a person with Hepatitis C.
A well-balanced diet can lead to better liver functioning and lowered risk of cirrhosis of the liver. It can also help your immune system fight off illness. People with Hepatitis C tend to have higher rates of diabetes, but a good diet can help control blood sugar and reduce body fat, thereby lowering your risk for becoming diabetic.
Multiple studies have now demonstrated the benefit of drinking coffee to improve liver health in Hepatitis C. Studies suggest you need to drink more than two cups per day to gain this benefit. However, the research is not strong enough to make a recommendation to start drinking coffee and some people do not tolerate it well. But for those who currently do drink coffee enjoy!
General dietary recommendations include the following:
BE CAUTIOUS ABOUT DIETARY SUPPLEMENTS
Certain vitamins and minerals like vitamins A and D, iron and niacin can be harmful to your liver in high doses. Before taking a vitamin or supplement, its best to talk with your doctor, dietician or nutritionist.
What Might Not Help
This herb is widely used for liver disorders, including hepatitis B. Its active ingredient, silymarin, is thought to lower inflammation and spur new liver cells to grow. But the evidence is mixed on whether milk thistle works. Side effects can include nausea, bloating, and diarrhea.
This treatment has long been used for ongoing pain. You may find it helpful for your hep C-related pain and fatigue. But several studies found that acupuncture needles can get contaminated with the hepatitis virus and pass it to other people. Make sure your acupuncturist uses disposable needles. And check that theyâre state licensed and certified by the National Certification Commission for Acupuncture and Oriental Medicine.
This compound comes from the plant or its relative, hemp. CBD is legal in some states for both recreational and medical uses, and most other states allow it with a prescription. But despite its popularity for all sorts of ailments, not much research has been done to show that CBD helps with hep C or if itâs safe.
This product has tiny particles of silver that some people claim can help heal wounds and infections. But itâs not safe if you have hep C and may actually harm you. It can cause argyria, which is a permanent discoloration of the skin. The FDA warned consumers against taking it back in 1999.
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How Do Doctors Treat The Complications Of Hepatitis C
If hepatitis C leads to cirrhosis, you should see a doctor who specializes in liver diseases. Doctors can treat the health problems related to cirrhosis with medicines, surgery, and other medical procedures. If you have cirrhosis, you have an increased chance of liver cancer. Your doctor may order an ultrasound test to check for liver cancer.
If hepatitis C leads to liver failure or liver cancer, you may need a liver transplant.
Importance Of Adhering To Your Treatment Plan
Once you begin treatment for your Hepatitis C infection, youll want to do everything you can to make it a success. Adherence to your Hepatitis C medication regimen is an important predictor of successful treatment. When it comes to medications, this means that you want to adhere to taking them as prescribed meaning taking the right dose, the right way, at the right time, for as long as prescribed.
The goal of using medications to treat Hepatitis C is to:
- Clear the Hepatitis C virus from your body
- Prevent or slow down scarring of your liver
- Reduce your chance of developing cirrhosis and liver cancer
Proper adherence to Hepatitis C therapy will increase your chance of being cured and decrease the long-term complications of Hepatitis C.
Adhering to other aspects of your treatment plan is also important. Keeping your medical appointments and getting the necessary lab tests will help to maximize your chance of treatment success and minimize potential problems.
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Who Can Access The Cures
Hep C cures are now available to everyone in Australia who has hep C.* The national and state governments want everyone with hep C to be cured, including prisoners and people who inject drugs. Now is a very good time to consider testing for hep C or speaking to your doctor about the hep C cures.
*Cures are available to people who have a Medicare Card or Health Care Concession Card and who arent hospital inpatients.
You might be able to access healthcare and the cures via your computer or phone.
How Will My Provider Monitor Me During The Treatment
Your provider will meet with you during treatment to review how well you are tolerating treatment and review laboratory results. Laboratory tests help keep tabs on your health, track the viral load, and determine your response to treatment. You will be given specific dates to go get your blood tested at the lab during and after the treatment.
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What Is Hepatitis C
Hepatitis C is a viral infection that causes liver inflammation and damage. Inflammation is swelling that occurs when tissues of the body become injured or infected. Inflammation can damage organs.
Viruses invade normal cells in your body. Many viruses cause infections that can be spread from person to person. The hepatitis C virus spreads through contact with an infected persons blood.
Hepatitis C can cause an acute or chronic infection.
Although no vaccine for hepatitis C is available, you can take steps to protect yourself from hepatitis C. If you have hepatitis C, talk with your doctor about treatment. Medicines can cure most cases of hepatitis C.
A Revolution In Hep C Treatment
More than 3 million Americans have a long-lasting hepatitis C infection. Most donât know it, because there usually aren’t symptoms.
Sofosbuvir was one of the first direct-acting antivirals to target hep C,the viru a disease spread through direct blood-to-blood contact. DAAs work in different ways to stop hep C from making copies of itself.
These drugs are kinder and gentler than the old standard of care — interferon shots and ribavirin alone. That route could take as long as a year, it only cured about half of the people, and the side effects were brutal.
âImagine taking an injection and a pill that made you feel — every day — worse than you ever felt from the infection that was being treated,â says Alexea Gaffney-Adams, MD, an infectious disease specialist in Smithtown, NY.
Side effects included flu-like symptoms, joint pain, anemia, and depression.
Limes says the old treatment felt like pouring gasoline into his system. âIt was like killing me to keep me alive.â In fact, it made his hep C worse, so his doctors took him off it.
Todayâs therapies are pills only and donât need interferon. They have very few side effects and double the cure rate — to 90% to 100%. They work in as little as 8 or 12 weeks.
âMy who had been on the older regimens — and failed, and now have the luck of being able to experience these new medications — canât believe the difference,â says Gaffney-Adams.
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How Common Is Hepatitis C In The United States
In the United States, hepatitis C is the most common chronic viral infection found in blood and spread through contact with blood.14
Researchers estimate that about 2.7 million to 3.9 million people in the United States have chronic hepatitis C.13 Many people who have hepatitis C dont have symptoms and dont know they have this infection.
New screening efforts and more effective hepatitis C treatments are helping doctors identify and cure more people with the disease. With more screening and treatment, hepatitis C may become less common in the future. Researchers estimate that hepatitis C could be a rare disease in the United States by 2036.17
Treatments And Cure Rates For Hepatitis C
For many years, one of the only effective treatment options was the drug interferon. This drug required many injections over a period of six months to a year. The drug also produced unpleasant symptoms. Many people who took this drug felt like they had the flu after their treatment. Interferon treatments were only effective about half the time , and they couldnt be given to people with advanced HCV because it could worsen their health.
An oral drug called ribavirin was also available at this time. This drug had to be taken with interferon injections.
More modern treatments include oral medications that shorten the time needed to be effective. One of the first to emerge was sofosbuvir . Unlike other early treatments, this drug didnt require interferon injections to be effective.
In 2014, the U.S. Food and Drug Administration approved a combination drug made up of ledipasvir and sofosbuvir . Its a once-daily medication in a class of drugs called direct-acting antivirals. These drugs work on the enzymes that help the virus multiply.
Treatments approved after Harvoni were designed to target people with different genotypes. A genotype can refer to a set of genes or even one gene.
Researchers have found that different drugs are more effective based on a patients genotype.
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