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.
Treatments For Hepatitis C
Hepatitis C can be treated with medicines that stop the virus multiplying inside the body. These usually need to be taken for several weeks.
Until recently, most people would have taken 2 main medicines called pegylated interferon and ribavirin .
Tablet-only treatments are now available.
These new hepatitis C medicines have been found to make treatment more effective, are easier to tolerate, and have shorter treatment courses.
They include sofosbuvir and daclatasvir.
Using the latest medications, more than 90% of people with hepatitis C may be cured.
But it’s important to be aware that you will not be immune to the infection and should take steps to reduce your risk of becoming infected again.
Theres Been A Demographic Shift In Whos Getting Hep C
Although baby boomers used to account for the bulk of hepatitis C cases , the disease has been rapidly spreading among young adults so much so that in 2020, the CDC reported that younger adults now make up the majority of newly reported chronic hepatitis C infections.
Millennials now account for 36.5 percent of these new infections according to the CDC. Generation X accounts for 23.5 percent of new infections.
People between ages of 20 and 40 are primarily acquiring hepatitis C through injection drug use, says Douglas Dieterich, MD, a professor of medicine with the division of liver diseases at Icahn School of Medicine at Mount Sinai in New York City. And, as he points out, people of those ages are a much larger group than the baby boomers.
The drug use explosion during the past COVID-19 year has increase hepatitis C exponentially, says Dr. Dieterich, who is a member of the American Liver Foundations national medical advisory committee.
Dr. Rizza adds that cocaine users may also spread the infection by sharing straws used for snorting.
If you get blood from the nose on the straw and share it with the next person, you can transmit the virus this way, she says. It takes only a drop of contaminated blood entering the bloodstream to transmit the disease, and the virus can live outside the body for at least four days.
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How Can I Prevent Hepatitis C Infection
Although there is currently no vaccine to prevent hepatitis C, there are things you can do to avoid becoming infected or re-infected and prevent the spread of hepatitis C virus. Hepatitis C is not spread through food or close personal contact such as handshaking, hugging and kissing. Hepatitis C is spread when the blood from an infected person enters the bloodstream of an uninfected person. To avoid this happening:
- do not share needles or other equipment to inject drugs or any other substances
- do not use personal items that may have come in contact with an infected persons blood such as shavers or toothbrushes
- avoid touching blood or open wounds
- avoid sexual practices that might risk blood contact including trauma, during menstruation, or in presence of genital ulcers.
How Muchis Hep C Treatment
Anyone hoping to hear that the medication used to treat HepC is inexpensive isnt going to like what we have to say here. DAA drugs workincredibly well to cure yourself of Hep C very quickly, but they are certainlynot cheap and especially so for people who dont have extended health insurancethat also covers prescription medication.
As mentioned, Sovaldi is one of the most commonly prescribed of these meds for treating Hep C. Other standard ones are Harvoni, Mavyret, Zepatier, and Technivie. To give you some idea regarding how much is Hep C treatment with these drugs, consider this:
- A Hepatitis C 12 week treatment with Harvoni can cost nearly $100,000!
- The same treatment with Technivie can cost $75,000 +
- Nearly $55,000 for a 12 week treatment with Zepatier
- Approximately $40,000 for a 12 week treatment with Mavyret
The reason these meds are so expensive is because of thelarge demand for them and the high costs associated with the manufacturersbeing able to bring them to market.
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Hepatitis C Management In Primary Care
- A new direct-acting antiviral oral regimen for the treatment of hepatitis C, glecaprevir + pibrentasvir will be subsidised without restriction from 1 February, 2019.
- Treatment with glecaprevir + pibrentasvir is simpler than with Viekira Pak regimens and patients with hepatitis C should now predominantly receive treatment in primary care.
- Glecaprevir + pibrentasvir can be prescribed to patients with hepatitis C virus infection due to any of the HCV genotypes.
- Glecaprevir + pibrentasvir is taken as a once daily regimen of three tablets, for eight weeks, regardless of HCV genotype.
- Glecaprevir + pibrentasvir can be prescribed to patients infected with any HCV genotype, therefore genotype testing prior to initiating treatment is no longer required.
- Ribavirin is not required for patients with genotype 1a infection receiving glecaprevir + pibrentasvir treatment.
- Patients should present prescriptions for glecaprevir + pibrentasvir to an enrolled pharmacy.
- Viekira Pak regimens will be delisted.
- Ledipasvir + sofosbuvir continues to be subsidised for patients with advanced disease.
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How Do Doctors Treat Hepatitis C
Doctors treat hepatitis C with antiviral medicines that attack the virus and can cure the disease in most cases.
Several newer medicines, called direct-acting antiviral medicines, have been approved to treat hepatitis C since 2013. Studies show that these medicines can cure chronic hepatitis C in most people with this disease. These medicines can also cure acute hepatitis C. In some cases, doctors recommend waiting to see if an acute infection becomes chronic before starting treatment.
Your doctor may prescribe one or more of these newer, direct-acting antiviral medicines to treat hepatitis C:
You may need to take medicines for 8 to 24 weeks to cure hepatitis C. Your doctor will prescribe medicines and recommend a length of treatment based on
- which hepatitis C genotype you have
- how much liver damage you have
- whether you have been treated for hepatitis C in the past
Your doctor may order blood tests during and after your treatment. Blood tests can show whether the treatment is working. Hepatitis C medicines cure the infection in most people who complete treatment.
Hepatitis C medicines may cause side effects. Talk with your doctor about the side effects of treatment. Check with your doctor before taking any other prescription or over-the-counter medicines.
For safety reasons, talk with your doctor before using dietary supplements, such as vitamins, or any complementary or alternative medicines or medical practices.
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Are Alternative Medicines Available
Some people believe certain forms of alternative medicine help cure hepatitis C.
However, the National Center for Complementary and Integrative Health reports that there are no effective, research-proven forms of alternative treatment or complementary medicine for hepatitis C.
Silymarin, also known as milk thistle, is an herb commonly suggested to help cure hepatitis C liver disease. But a rigorous did not find any beneficial effects from this supplement.
Who Is At Risk
Your risk of infection with HCV is increased if you:
- Had tattoos or body piercings in an unclean environment using unsterile equipment
- Worked in a place where you came in contact with infected blood or needles, for example, healthcare workers
- Received a blood transfusion or organ transplant before July 1992
- Received a blood product for clotting problems made before 1987
- Needed to have your blood filtered by a machine for a long period of time because your kidneys werent working
- Were born to a mother with HCV
- Had unprotected sex with multiple partners
- Have or had a sexually transmitted disease
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If You Notice Symptoms See A Doctor Right Away
Symptoms of hepatitis C include the following:
- Jaundice a yellowish tone to the eyes and skin
- Mild, chronic right belly pain
- Loss of appetite
If you believe you have been exposed to hepatitis C or notice any symptoms, visit your primary care doctor as soon as possible. If you test positive for the virus, your doctor can refer you to a hepatologist to discuss your options.
“I strongly encourage all baby boomers and others who are at high risk to get tested, even if you don’t look or feel sick,” Reau says. “If you do have hepatitis C, the earlier we discover it, the more likely we can prevent it from progressing and causing more serious damage.”
What Is Chronic Hepatitis
Hepatitis is an inflammation of the liver. In chronic hepatitis, liver inflammation continues for at least six months. This condition may be mild, causing relatively little damage, or more serious, causing many liver cells to be destroyed. Some cases lead to cirrhosis and liver failure.
Chronic hepatitis from infection is most often caused by these viruses:
- Hepatitis B and C. Often the person infected is unaware of any initial symptoms. Or the symptoms were so mild that the person did not seek medical attention. This is especially true for chronic hepatitis C. Over time, perhaps a decade or more, both types may lead to the serious complication of cirrhosis due to ongoing destruction of liver cells and resultant scarring. A minority of patients with cirrhosis develop liver cancer over time.
- Hepatitis D. Hepatitis D infects only patients already infected with hepatitis B, and it generally results in a flare of active hepatitis.
This information helps to determine the best treatment and to assess your risk of developing cirrhosis and liver failure. A liver biopsy also can help to check for other disorders, such as alcoholic liver injury or fatty liver.
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Unlikely Sources Of Infection
Trace levels of HBV can also be found in saliva, tears, urine, and feces but in amounts that are highly unlikely to cause infection.
While vaccination remains the cornerstone of HBV prevention, there are ways to further reduce the risk of transmission, especially if you or someone in your household has hepatitis B:
- Wash your hands with soap and water if exposed to blood.
- Avoid sharing razors or toothbrushes.
- Use condoms during sex.
Should I Be Screened For Hepatitis C
Doctors usually recommend one-time screening of all adults ages 18 to 79 for hepatitis C. Screening is testing for a disease in people who have no symptoms. Doctors use blood tests to screen for hepatitis C. Many people who have hepatitis C dont have symptoms and dont know they have hepatitis C. Screening tests can help doctors diagnose and treat hepatitis C before it causes serious health problems.
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How Many People Have Hepatitis C
During 2013-2016 it was estimated that about two and half million people were chronically infected with HCV in the United States. The actual number may be as low as 2.0 million or as high as 2.8 million.Globally, hepatitis C is a common blood-borne infection with an estimated 71 million people chronically infected according to the World Health Organization .
Getting Tested For Hepatitis C
Seek medical advice if you have persistent symptoms of hepatitis C or there’s a risk you’re infected, even if you do not have any symptoms.
A blood test can be carried out to see if you have the infection.
GPs, sexual health clinics, genitourinary medicine clinics or drug treatment services all offer testing for hepatitis C.
Early diagnosis and treatment can help prevent or limit any damage to your liver, as well as help ensure the infection is not passed on to other people.
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After Treatment Begins When Is A Patient ‘cured’
For the pivotal trials leading to the approval of the current hepatitis C antiviral drugs, the researchers defined treatment success as an undetectable RNA level for the virus 12 weeks after completing the therapy, otherwise known as sustained virologic response 12.
Relapses beyond SVR 12 are extremely rare. In a large study evaluating late relapse, hepatitis C RNA was detected in just 12 of 3004 patients with SVR12 between weeks 12 and 24. Phylogenetic sequencing showed 7 to be new infections.
Still, providers should test for the virus at 24 to 48 weeks after the end of treatment , Terrault says. When no hepatitis C RNA is detectable at SVR48, providers can confidently tell patients they are cured and do not need any further testing for hepatitis C. The exception to this, she says, is if a patient is determined to be at risk for reinfection.
Can Hep C Be Cured Completely
Well, the good news is hepatitis C is curable. Though it is a chronic infection, recently developed drugs can clear the virus completely from the system. If the viral load is nil after three months of treatment completion, people are considered cured. This is called sustained virologic response and data suggest that, in these cases, people will stay virus-free for life.
However, people must remember that hepatitis C is a lot more than just liver disease. Hepatitis C is often associated with many medical complications, such as a heightened risk of developing kidney diseases and cancer in the future. The drugs used in the treatment are accompanied by adverse reactions like every other drug. Hence, prevention is the best cure in this case.
Intensive therapy with antivirals against hepatitis will significantly reduce the risk of liver failure, liver cancer and the need for a liver transplant. However, often, the disease causes severe liver scarring. This scarring of the liver is irreversible and can cause potential complications, such as liver failure. Hence, people with hepatitis C need lifelong monitoring.
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How Do My Healthcare Professional And I Decide On Treatment
Your healthcare professional will look at your health history and decide if treatment is right for you. The treatment you receive and the length of treatment may depend on:
- How much virus is in your body
- Your genotype of hep C
- Whether you have liver damage
- Whether or not youve been treated previously
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Complications Of Chronic Hepatitis C
Unless successfully treated with medication, chronic Hepatitis C infection can cause other serious health problems, such as cirrhosis, liver cancer and liver failure. However, with recent advances in Hepatitis C treatment we now have higher cure rates, shorter treatment times, and all-oral treatment regimens for most people. If youre at risk for Hepatitis C, speak to your healthcare provider today about getting tested.
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How Do You Test For Hepatitis C
A simple blood test carried out by a healthcare professional will show whether you have the virus. You may also be given an extra test to see if your liver is damaged.
If youve got hepatitis C you should be tested for other STIs. Its important that you tell your recent sexual partner/s so they can also get tested and treated. Many people who have hepatitis C do not notice anything wrong, and by telling them you can help to stop the virus being passed on. It can also stop you from getting the infection again.
What Will My Doctor Need To Know To Treat Me
If you want to be assessed for treatment, you need to make an appointment with a doctor. They will be mostly interested in the condition of your liver. Your doctor will organise, if possible, for you to have a Fibroscan examination. If Fibroscan is not available, your doctor will probably use an APRI test. This is an online calculator that estimates the health of your liver. It involves a blood test called a liver function test.
Dont forget, its very important to get a PCR test 12 weeks after finishing treatment this will mean the doctor can make sure you are cured.
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Accessibility And Hbsag Clearance Rate
HBsAg clearance occurs spontaneously or via antiviral treatment in CHB patients. The most commonly used drugs are nucleoside analogue and pegylated interferon . NA drugs include entecavir , tenofovir disoproxil fumarate and tenofovir alafenamide fumarate . The 2018 AASLD guidelines recommend Peg-IFN, ETV, or TDF as the preferred initial therapy for adults with immune-active CHB. It also suggests that alanine transaminase levels be tested at least every 6 months for adults with immune-tolerant CHB to monitor for potential transition to immune-active or immune-inactive CHB . The 2017 EASL guideline recommends ETV, TDF and TAF as the preferred monotherapy regimens, and the extension of the duration of Peg-IFN therapy beyond week 48 may be beneficial in selected HBeAg-negative CHB patients . The potential side effects of NAs include lactic acidosis for ETV and nephropathy, osteomalacia, lactic acidosis for TDF. CHB patients should be clinically monitored. The most frequently reported side effects for Peg-IFN are flu-like syndrome, myalgia, fatigue, mood disturbances, weight loss, hair loss and local reactions at the site of injection, and these side effects may be partially managed with dose reduction . Currently, the clearance of HBsAg is based primarily on sequential or combined treatment with NA and Peg-IFN.
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