Thursday, May 19, 2022

After Being Cured Of Hepatitis C

It’s Different Than Hepatitis A And B

Ask the Expert: Hepatitis C cure

Each form of hepatitis has its own specific virus that spreads and is treated differently. “Hepatitis simply means inflammation of the liver, or that the virus has an affinity for hurting the liver,” Reau says.

  • Hepatitis A is an acute, short-term infection that often does not require treatment.
  • Hepatitis B hides deep in the body and, like hepatitis C, is treated in a variety of ways, from antiviral medications to liver transplants.

“The viruses are different, but all of them should be taken very seriously since they can lead to significant liver disease and even death,” she adds.

Safety Issues With Ribavirin

The use of ribavirin for the treatment of HCV has markedly declined in recent years, but ribavirin may occasionally be indicated as an adjunct to DAA therapy in treatment-experienced individuals. Ribavirin can cause severe hemolytic anemia, especially at higher doses. For persons taking ribavirin, regular monitoring of hemoglobin is recommended. Ribavirin is a teratogenic drug in rodents and may cause birth defects and fetal harm when administered to women who are pregnant. It is therefore contraindicated in pregnant women and in men whose female partners are pregnant. In addition, extreme care must be taken to prevent pregnancy in females taking ribavirin and in female partners of male patients taking ribavirin. Accordingly, ribavirin should not be started unless there is a documented report of a negative pregnancy test immediately prior to planned initiation of ribavirin. Women taking ribavirin should be instructed to use at least two forms of effective contraception during treatment that includes ribavirin and for 6 months after treatment has been stopped. Women receiving ribavirin should have monthly pregnancy tests during ribavirin treatment and for 6 months after treatment has been completed.

What Foods Should I Avoid

Everyone should avoid eating a lot of fat, cholesterol, salt and processed sugar, even if their liver is healthy. In addition, those with HCV should limit or avoid alcohol. Drinking alcohol will speed up liver damage.

Eating properly can help decrease some of the symptoms of Hepatitis C, like feeling tired and sick. Drink lots of water for general health benefits. HCV is not a digestive disease diet will not affect the disease. Your provider may put you on a special diet if you have advanced liver disease.

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Sharing Toothbrushes Scissors And Razors

There’s a potential risk that hepatitis C may be passed on through sharing items such as toothbrushes, razors and scissors, as they can become contaminated with infected blood.

Equipment used by hairdressers, such as scissors and clippers, can pose a risk if it has been contaminated with infected blood and not been sterilised or cleaned between customers. However, most salons operate to high standards, so this risk is low.

Are There Supplements That Are Bad For My Liver

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Taking too many vitamin and mineral supplements may do more harm than good to a damaged liver.

  • Avoid taking too much vitamin A.
  • Do not take protein or amino acid supplements.
  • Avoid iron supplements unless your doctor prescribes them. Excess iron can build up in the liver and speed up damage.
  • If you have cirrhosis and your liver is not working, you may have to avoid substances such as steroids, acetaminophen, birth control pills, cortisone, barbiturates, and many other drugs.
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    If I Have Hepatitis C Infection Does This Mean I Am Going To Have Other Health Problems

    Hepatitis C can cause scarring of the liver leading to cirrhosis and liver cancer. Other conditions have also been linked to hepatitis C and are known as extra-hepatic manifestations of hepatitis C. They include diabetes mellitus, arthritis, hypothyroid, and aplastic anemia among other conditions. Talk to your provider for more information.

    Food And Drug Administration Warning And Adverse Event Reporting Data

    The U.S. Food and Drug Administration issued a drug safety warning on October 4, 2016 in which they identified 24 cases of confirmed reactivation of HBV infection in persons receiving DAA medications for treatment of HCV. The FDA warning was based on a number of cases reported to the FDA and from published literature. The FDA has published findings that summarized a total of 29 patients with confirmed HBV reactivation during DAA therapy their summary was based on published reports and cases detected via their Adverse Event Reporting System database between November 2013 and October 2016. The following summarizes key findings from this report:

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    Building Healthy Sexual Relationships

    Rule number one for a healthy sexual relationship: Be open and honest with your partners. I believe in transparency, says Talal. This conversation can be difficult, but its important to have. Part of discussing your status is talking about what exposure you may have had to hepatitis C, even in the distant past.

    Its a good opportunity for you both to share your sexual history, as well as your experiences with other ways hepatitis C can be transmitted, such as using injection drugs or being exposed to items that may have blood on them, including needles, razors, and toothbrushes.

    Sherman explains that even if you consistently use condoms during sex, other activities, such as sharing needles to inject drugs or sharing straws to snort them, increase your risk of spreading hepatitis C. People do not want to hear about this, he says. Its difficult to get the word out about risk.

    If you and your partner find that hepatitis C is disrupting your relationship or your sex life, you might also consider working with a marriage and family therapist or a sex therapist.

    What Can People Do To Help The Medications Work Best

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    • 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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    Can I Drink Alcohol Once In A While If I Have Hepatitis C

    Alcohol can clearly contribute to worsening liver disease. You must discuss with your health care provider if any amount of alcohol is safe for you.

    Alcohol can cause inflammation and scarring in the liver. If you have any underlying liver condition, such as hepatitis C or hepatitis B or damage from long-term alcohol use, your liver will be more sensitive to alcohol. When you have hepatitis C virus, alcohol on top of the hepatitis C can cause the inflammation and scarring to be worse, and overall damage to the liver may happen much faster when you drink alcohol.

    Here is some helpful information about alcohol and hepatitis:

  • No one knows exactly what amount of alcohol is “safe” when you have hepatitis C. Some small amounts of alcohol may be safe while you have hepatitis C and have mild damage in the liver, but if you have cirrhosis, then no amount of alcohol is safe and you should not drink at all.
  • All forms of alcohol can be damaging. In other words, beer and wine are not “safer” than whiskey.
  • If you have severe scarring , then you should not drink any alcohol at all.
  • If you are awaiting a transplant, you also cannot drink any alcohol at all.
  • Hepatitis C And Health

    How can health-care personnel avoid exposure to HCV?

    Avoiding occupational exposure to blood is the primary way to prevent transmission of bloodborne illnesses among health-care personnel. To promote blood safety in the workplace, health-care personnel should consult infectious-disease control guidance from the National Institute for Occupational Safety and Health and from CDC. Depending on the medical procedure involved, Standard Precautions may include the appropriate use of personal protective equipment .

    What is the risk of acquiring hepatitis C after being accidentally exposed to HCV-contaminated blood or body fluids in the workplace?

    Although sharps injuries have decreased in recent decades due to improved prevention measures, they continue to occur, placing health-care personnel at risk for several bloodborne pathogens like hepatitis C. A recent analysis of several studies revealed an overall 0.2% risk for infection among those exposed to HCV-antibody-positive blood through needlestick or sharps injuries . Updated guidelines for management and treatment of hepatitis Cexternal icon are available to provide guidance for health-care personnel who become infected via exposure to contaminated blood at the workplace.

    Other than needlesticks, do other exposures place health-care personnel at risk for hepatitis C?

    Should HCV-infected health-care personnel be restricted in their work?

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    What Is Hepatitis C

    Hepatitis C is a virus that injures the liver.

    The injury often happens slowly over a long time. You can live for many years with hepatitis C and not know you have it because you dont feel sick or have any symptoms. Over time, hepatitis C can make you very sick.

    There are six different strains of the hepatitis C virus and they can all be cured.

    Can Hepatitis C Be Spread During Vaginal Sex

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    Its rare for the hepatitis C virus to be transmitted through vaginal intercourse. Unless the vaginal walls arent lubricated or intercourse is very rough and leads to tears in the vaginal wall, theres no opportunity for blood to be exchanged. The risk for transmission with vaginal intercourse is about 1 in 190,000, according to research published in the March 2013 issue of the journal Hepatology.

    Research published in the Journal of Coagulation Disorders in March 2014 reinforces these findings, emphasizing that transmission of the hepatitis C virus by sex in monogamous heterosexual couples is rare. And the Centers for Disease Control and Prevention states that couples in monogamous heterosexual relationships do not need to use condoms routinely, even if one partner has hepatitis C. Concerned couples, however, can discuss using a condom to lower the already very low risk of spreading the virus, says Talal.

    Just how safe sex is when a partner has hepatitis C hinges on some other factors as well. For example, its important to use a new condom with each sexual act that has the potential to expose the uninfected partner to the infected persons blood, even if youre in a committed relationship, says the CDC. Some of these situations include sex when you or your partner:

    • Has an open cut or sore
    • Has another sexually transmitted infection , especially one that causes sores or lesions
    • Is having her menstrual period

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    What Are Genotypes And What Do They Mean

    Viruses have genes, too. The genotype of virus you have can be one of six different groups, or genotypes. Most patients with hepatitis C in the United States have genotype 1a or 1b, but in other parts of the world, other genotypes are more common.

    There isn’t a “better” or “worse” genotype to have. In the past , genotype 1 was the most difficult to successfully cure but this is no longer the case. All the new direct-acting antiviral medicines work extremely well in treating all genotypes. Sometimes genotype 3 is a little harder to cure, but in general, all genotypes now have extremely high likelihoods of being cured with hepatitis C treatment.

    You May Not Feel Any Different

    If you experience symptoms of hepatitis C , it may take a few weeks or months after you finish your treatment to feel better if you notice any changes at all.

    There arent many symptoms directly related to hepatitis C, says K. V. Narayanan Menon, MD, a hepatologist and the medical director of liver transplantation at Cleveland Clinic in Cleveland. Fatigue is one that seems to be fairly common. its not like with an ear infection, where you take antibiotics and it gets better. You may not see the change.

    How can you be sure that youve been cured? Before your treatment, doctors test your blood for active hepatitis C. Theyll then test you again at the end of your treatment and often one more time a month later to be sure youre cured. Somewhere between 95 to 99 percent of people are considered cured after just one round of treatment, says Dr. Menon.

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    Monitoring Persons Who Achieve Svr

    Individuals who have an undetectable HCV RNA at week 12 after completing HCV therapy are considered to have achieved a virologic cure and this is associated with long-term reduced liver-related morbidity and mortality. In a review of 44 studies involving more than 4,228 patients who achieved an SVR with an interferon-based regimen, 97% of patients maintained the SVR during the long-term follow-up period. Some experts will obtain an HCV RNA level 24 weeks after completing treatment in selected individuals, such as those with cirrhosis. In a review by Manns, more than 99.2% of 1,002 study participants who achieved an SVR12 with interferon- or peginterferon-based therapy maintained undetectable HCV RNA levels for 5 years. Available long-term data for durability of treatment response with all-oral DAA therapy suggest SVR12 responses translate into sustained HCV clearance. All patients who achieve an SVR should clearly understand they are not immune to HCV and can become reinfected with HCV. The AASLD-IDSA HCV Guidance stratifies the follow-up for persons who achieve an SVR based on the degree of hepatic fibrosis and the risk of HCV reinfection.

    Defining Cure For Hepatitis C Virus Infection

    Mercy Health has cured 500 patients for Hepatitis C

    In the registration trials leading to approval of HCV therapies, an HCV RNA level below the limit of quantitation 12 weeks after completing the therapy defined treatment successthat is, sustained virologic response 12. This time point is highly correlated with SVR24. However, because relapses beyond SVR12 have rarely been reported, treatment guidelines recommend confirming cure by testing for HCV RNA at 24 to 48 weeks after the end of treatment ., Late relapse, when it occurs, typically happens between 12 and 24 weeks posttreatment. In a large study evaluating late relapse, 12 of 3004 patients with SVR12 were found to be HCV RNApositive between weeks 12 and 24. Interestingly, using phylogenetic sequencing, it was determined that 7 of 12 relapses were actually new infections and 5 of 12 were true relapses. Thus, the rate of late relapse was 0.2%. Very late relapse, beyond 24 weeks posttreatment, is exceedingly rare. However, the takeaway point is that the determination of cure requires repeat HCV RNA testing beyond 12 weeks posttreatment. I recommend obtaining both SVR12 and SVR48. If HCV RNA is undetectable at the later time point, the patient can be confidently informed that he or she is cured, and no further testing is indicated unless the patient is at risk for reinfection.

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    Know Who Is At Risk For Reinfection And Treat Accordingly

    Providers should advise patients that having antibodies for hepatitis C does not confer protection against reinfection. Antibody screening tests for hepatitis C are not useful in individuals who have already been infected and then treated, Reau points out.

    “A hepatitis C antibody test remains positive after spontaneous clearance or cure through antiviral therapy,” she says. “So if your patient is concerned about re-exposure, you have to look for the virus through polymerase chain reaction.”

    Providers should also counsel patients about avoiding exposure. Some risk factors for reinfection include injected illegal drugs, exposure through contaminated blood, and injections in substandard healthcare settings.

    In one recent meta-analysis, hepatitis C virus-monoinfected patients at low risk for recurrence had a 1% rate of hepatitis C virus RNA positivity at 5 years compared with 11% among people at high risk, such as intravenous drug users and prisoners.

    Among people who inject drugs, the rate of reinfection is 2%-3% annually. Similarly, about 3% of HIV-infected men who have sex with men are reinfected per year. Men who have sex with men while taking prophylaxis for HIV may also run an increased risk for reinfection, Terrault says.

    Terrault recommends annual hepatitis C testing for people who inject drugs, in HIV-positive men who have sex with men, as well as those with increased alanine aminotransferase levels.

      Tables

      What Are The Side Effects Of Treatment

      The direct acting antiviral regimens used to treat hepatitis C today are extremely well tolerated. You may experience mild side effects like headache or fatigue. For details on the side effects, review the handout specific to medication you take.

      In rare instances, providers may recommend the addition of the medication ribavirin for more difficult cases of hepatitis C. Ribavirin may cause additional side effects such as fatigue, shortness of breath, cough, anemia, or rash. Patients who receive ribavirin may need more frequent monitoring for side effects as well as adjustment of the dose if side effects are experienced. For detailed information on ribavirin, patients should review the ribavirin handout.

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      Is There A Way To Prevent Hepatitis C

      Although currently theres no vaccine to protect people from contracting hepatitis C, there are vaccines for other hepatitis viruses, including hepatitis A and hepatitis B.

      If you receive a hepatitis C diagnosis, your healthcare provider may advise you to get vaccinated against hepatitis A and B.

      The vaccinations are recommended because these hepatitis viruses can lead to additional health and liver complications, especially in those with preexisting liver disease.

      Since you cant prevent hepatitis C through a vaccine, the best prevention is to avoid exposure. Hepatitis C is a bloodborne pathogen, so you can limit your chances of exposure through these healthy lifestyle practices:

      • Avoid sharing needles, razor blades, or nail clippers.
      • Use proper safety precautions if youll be exposed to bodily fluids, such as when performing first aid.
      • Hepatitis C isnt usually transmitted through sexual contact, but its possible. Limit your exposure by practicing sex with a condom or other barrier method. Its also important to openly communicate with sexual partners and to get tested if you suspect youve been exposed to the hepatitis C virus.

      Because hepatitis C is transmitted through blood, its possible to contract it through a blood transfusion.

      However, since the early 1990s, blood product screening tests have been standard protocol for minimizing the risk of this type of transmission.

      Subsequent testing is based on risk. Talk to your doctor about your needs.

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