Blood Donations Before September 1991
Since September 1991, all blood donated in the UK is checked for the hepatitis C virus.
There’s a small chance you may have been infected with hepatitis C if:
- you received a blood transfusion or blood products before September 1991
- you received an organ transplant before 1992
Before 1992 donated organs were not routinely screened for hepatitis C and there is a very small risk a donated organ from someone with hepatitis C could spread the infection.
There are blood tests to check for hepatitis C infection
How Liver Failure Affects The Brain
Hepatic encephalopathy typically occurs when the liver is no longer able to perform its usual metabolic functions.
In persons with a normal liver function, nitrogen-containing compounds from the intestines are transported to the liver, where they are processed and excreted from the body. When liver function is impaired, the nitrogen-containing compounds begin to gradually build up, which causes an increase in ammonia levels.
These ammonia particles then spread throughout the bloodstream and pass through the semi-permeable membrane that that surrounds the brain. There, they cause the swelling of brain cells called astrocytes, which eventually slows the production of neurotransmitters vital to cognitive thinking.
The Hidden Mental Health Effects Of Hepatitis C
According to research, mental health has an impact on hepatitis C. According to a study, people with hepatitis C have more psychiatric disorders than people without the disease. Anxiety and depression can also be increased as a result of Hepatitis C virus infection. To stay clear of mood swings caused by Hepatitis C virus, it is critical to remember that you can also experience them, so it is important to consult your doctor if you experience any changes in mood.
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Posttest Counseling Of Patients With Psychiatric Illness And Hcv Infection
Patients who are found to be infected with HCV should be counseled regarding prevention of the spread of the virus to others.19,76 HIV testing should be offered given the comorbidity of HIV/AIDS and HCV .77 HCV can be transmitted through shared use of common household objects such as toothbrushes, shaving utensils, and other personal items, and patient and family counseling should emphasize not sharing such personal items. Although HCV infection has a low rate of sexual transmission , patients should still be advised to practice safe sex and use barrier protection to further reduce transmission risks of HCV and other sexually transmitted diseases.
Recent emerging research suggests that the most important component of posttest counseling for a patient with newly diagnosed HCV infection should be a candid discussion about alcohol use. An accumulating body of evidence suggests that alcohol use even in moderation can accelerate the progression of HCV-induced liver disease78 consequently, HCV patients should be advised to eliminate all alcohol use.79,80
Research in veterans with HCV infection and alcohol use disorders suggests that candid counseling about the need to eliminate alcohol use may be a motivator toward improved rates of abstinence from alcohol use and actually may yield a better eligibility for interferon treatment and improved treatment outcomes.79,80
How Do You Get Hepatitis C
The hepatitis C virus is usually spread through blood-to-blood contact.
Some ways the infection can be spread include:
- sharing unsterilised needles particularly needles used to inject recreational drugs
- sharing razors or toothbrushes
- from a pregnant woman to her unborn baby
- through unprotected sex although this is very rare
In the UK, most hepatitis C infections happen in people who inject drugs or have injected them in the past.
It’s estimated around half of those who inject drugs have been infected with the virus.
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Blood And Vessel Problems
People with hepatitis C often get a condition called cryoglobulinemia. This happens when certain proteins in your blood stick together in cold weather. They can build up in vessels and block blood flow, which causes swelling and damage. The condition can affect your skin, organs, nerves, and joints.
Hepatitis C also can cause problems with blood itself. You may not make enough white blood cells, which fight infections, or platelets, which help your blood clot.
The infection can also make you bruise easily or get red or purple spots under your skin. Those are signs of a bleeding disorder called immune thrombocytopenic purpura.
Can Hepatitis C Cause Paranoia
Hepatitis C is a virus that primarily affects the liver. It is the most common type of viral hepatitis, and is a leading cause of liver cancer. Hepatitis C is spread through contact with the blood of an infected person. The symptoms of hepatitis C can be mild, and many people who are infected do not experience any symptoms at all. However, the virus can cause liver damage, and in some cases, death. Hepatitis C can cause paranoia in some people. Paranoia is a feeling of distrust or suspicion towards others, and can lead to social isolation and anxiety. In severe cases, paranoia can lead to psychosis, a break from reality. While paranoia is not a common symptom of hepatitis C, it can be a serious side effect for some people. If you are experiencing paranoia, it is important to talk to your doctor.
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Where Do People Experience Stigma
Stigma can come from any part of a persons life, including family, friends, and co-workers. It can even come from the persons own feelings of shame or confusion about their diagnosis.
A lack of knowledge about the virus and how it spreads can increase stigma. Others may unknowingly ask hurtful questions like, How did you get it? or Am I going to catch it? Thats why sharing factual information and building awareness are important.
Those who worry that their loved ones wont understand hepatitis C may never reveal their diagnosis. Stigma can drive a wedge between friends, relatives, and romantic partners. It can lead to loneliness and isolation.
A doctor might seem like the one person who would understand what its like to have hepatitis C. But even some doctors stigmatize their patients by blaming or shaming them for behaviors that may have factored into their status.
The Role Of Primary Care Physicians And Psychiatrists In Screening For Hcv
Despite the association between HCV and psychiatric illness, screening for HCV has not been a routine practice in patients with psychiatric illness. These patients are at risk for contracting HCV by engaging in risky sexual behaviors and intranasal drug use but may not be forthcoming about these activities.65 Therefore, the only reliable way to rule out HCV infection would be to screen these at-risk populations. The CDC has recommended routine screening of incarcerated individuals in correctional facilities for HCV.66 Routine HCV screening is also recommended for all patients who are found to be infected with HIV.65 The Department of Veterans Affairs conducts routine HCV screening for all veterans being treated at Veterans Affairs hospitals.31,67,68
However, the US Preventive Services Task Force in 2004 recommended against routine screening for HCV in high-risk individuals because it found no data to support the efficacy of interferon alfa and ribavirin treatment in reducing morbidity and mortality from HCV infection despite 2 decades of research on the utility of interferon alfabased therapies in achieving viral clearance.69 Therefore, interferon alfa and ribavirin treatment for patients with HCV infection continues to be considered a therapeutic modality with an intuitive value but no evidence-based efficacy in reducing the overall morbidity and mortality associated with HCV.70
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Neuropsychiatric Adverse Effects Of Interferon Alfa And Ribavirin In Patients With Hcv
Neuropsychiatric side effects are common during interferon alfa and ribavirin therapy for HCV, ranging from 24% to 49% of patients experiencing such symptoms.47,107 Neuropsychiatric adverse effects can include fatigue, irritability, depression, anhedonia, relapse in alcohol or drug abuse, anxiety, anger, hostility, cognitive disturbances, manic symptoms, delirium, psychosis, and suicidal ideation.99,108111
During clinical trials conducted to gain US Food and Drug Administration approval of peginterferon alfa-2a and -2b, psychiatric adverse effects were among the most commonly reported adverse effects, occurring in 77% of patients.18 The most common psychiatric adverse effects were depression , irritability, and insomnia. The observance of high rates of insomnia and irritability in these early trials is interesting given that recent reports in the literature indicate that mania and hypomania are also common adverse effects of interferon alfa and ribavirin therapy for HCV.101,106,112,113 Suicidal ideation, suicide attempts, and actual suicides occurred in 2% of all patients studied during initial drug approval.114,115 Furthermore, psychiatric adverse effects have been among the most common reasons for therapy discontinuation, along with systemic and gastrointestinal effects.
How Manage Your Feelings
To help keep your anxiety and depression in check:
Look past your label. Youâre living with HCV, but it doesnât have to define you. Make a list of all the other roles you have, like parent, partner, or friend. That will help remind you that thereâs more to you than this illness.
Stop drinking alcohol and using drugs. These habits will cause serious damage to your liver. They can also make depression and anxiety worse. Practice ways to say no, and stay away from people who pressure you to partake.
Put your partner first. If youâre in a long-term relationship with one person, the risk that youâll pass HCV to them during sex is low. Still, some drugs youâre treated with can raise virus levels in your body. Talk to your doctor about safety steps you should take, then share them with your partner before youâre in the bedroom.
Practice safe sex. Latex condoms are the best way to prevent passing on HCV during sex. Youâll need to use them before sex with a new partner. Choose only water-based lubricants. Oil-based products can damage condoms. Donât brush or floss your teeth right before deep kisses or oral sex. It could make your gums bleed and raise your chances of infection.
Manage your worries. Get enough sleep and eat healthy food. It takes a lot of energy to keep tension in check. Work out when you can too. Exercise is a way to keep stress in check.
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Causes Of Hepatic Encephalopathy
While hepatic encephalopathy is associated with acute liver failure, there are usually other contributing factors at play. Many of these factors have nothing to do with either the liver or the brain they simply appear to either trigger an attack or further aggravate an existing episode.
Among the potential co-factors in people with acute liver failure:
- Excessive alcohol use
- Low potassium and/or sodium levels, often caused by diuretics used to treat ascites in later-stage disease
- Benzodiazepines, a sedative often prescribed to treat alcohol withdrawal
- Narcotics and anti-psychotic drugs
- The use of shunts , used to correct blood flow in the liver
Symptoms Of Hepatitis C Brain Fog
Symptoms of brain fog are more likely to occur in people with advanced hepatitis C or in those who have developed cirrhosis. Other symptoms of hepatitis C can contribute to that foggy feeling. Treatment can also contribute to this symptom. This may include direct-acting antiviral therapy with or without ribavirin. An older medication, interferon, used to have a significant number of side effects, but this medication is no longer typically used.
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What Are The Reasons For Stigma
A lot of the stigma surrounding hepatitis C has to do with misunderstandings about the way the virus spreads. It passes from one person to another through direct contact with blood thats carrying the hepatitis virus.
You cant get hepatitis C from hugging, kissing, or sharing a glass with someone. Still, people who dont understand the virus may be afraid to catch it.
This fear may cause people with hepatitis C to hide their diagnosis out of fear that theyll be shunned.
Another part of the stigma comes from the association between hepatitis C and intravenous drug use. The most common way hepatitis C is passed from person to person in the United States is by sharing needles and syringes while using injected drugs.
But that doesnt mean everyone is exposed that way. And even if someone is exposed to the virus through drug use, theyre deserving of support, not judgment.
People whove used drugs face the dual stigmas of hepatitis C and addiction. Managing these health conditions can lead to stress and loneliness. It can be challenging to find support.
A portion of people with hepatitis C also has HIV, a virus that comes with its own stigma. Hepatitis C and HIV both spread through blood and are linked to IV drug use. People who have the two conditions together often have lower self-esteem and feel like other people are uncomfortable around them.
Preventing The Spread Of Hepatitis C
There is no vaccine available to prevent a person from being infected with hepatitis C. Recommended behaviours to prevent the spread of the virus include:
- Always use sterile injecting equipment. This can be accessed from your local needle and syringe program service.
- Avoid sharing personal items such as toothbrushes, razors, nail files or nail scissors, which can draw blood.
- If you are involved in body piercing, tattooing, electrolysis or acupuncture, always ensure that any instrument that pierces the skin is either single use or has been cleaned, disinfected and sterilised since it was last used.
- If you are a healthcare worker, follow standard precautions at all times.
- Wherever possible, wear single-use gloves if you give someone first aid or clean up blood or body fluids.
- Although hepatitis C is not generally considered to be a sexually transmissible infection in Australia, you may wish to consider safe sex practices if blood is going to be present, or if your partner has HIV infection. You may wish to further discuss this issue and personal risks with your doctor.
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Hcv Treatment Outcomes Among Persons With Alcohol Use
Most of the studies that have addressed whether alcohol use impacts treatment outcomes were performed in the pre-DAA treatment era and results from these studies were mixed.
DAA Treatment Era
- In the DAA treatment era, a large observational study out of the Veterans Affairs healthcare system evaluated the impact of alcohol use on HCV DAA-based treatment outcomes. Of the 15,151 persons who initiated DAA therapy and had a documented AUDIT-C score, 68.5% were categorized as abstinent, 22.6% as low-level drinking, and 8.9% as unhealthy drinking. Overall SVR12 rates were high among all persons in the study, regardless of alcohol use, with no statistical difference between HCV genotype or by cirrhosis status . These findings support current recommendations to not exclude persons from HCV treatment based on their alcohol use.
Interferon and Peginterferon Treatment Era
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Can Hep C Make You Delusional
It is also worth noting that while pegylated interferon alpha-2b therapy is effective in treating chronic hepatitis C patients, delusional parasitosis can occur. During the course of a medication discontinuation, an entire and sustained remission can be observed without the use of any psychopharmacologic medications.
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Hcv Treatment In Persons Who Use Cannabis
There is mixed evidence regarding cannabis use and HCV-related hepatic fibrosis progression. Two separate longitudinal cohort studies found no association between cannabis use and progression of liver fibrosis among patients coinfected with HCV and HIV. In addition, one study found a positive association between cannabis use and good adherence with HCV treatment. Although individuals living with HCV are generally advised to abstain from regular cannabis use, ongoing cannabis use is not considered a contraindication for initiating HCV therapy.
Tips For Managing Mental Health
Its natural to feel anxious or frightened when you are diagnosed with a condition such as hepatitis C. And because of the stigma surrounding the condition, you might not get enough support from the people closest to you.
Know that you do have places to turn for help. Organizations like the American Liver Foundation offer hepatitis C support groups. These groups offer a safe space to meet other people with hepatitis C, learn how to manage your condition, and be surrounded by people who know exactly what youre going through.
If a support group isnt enough, you might want to talk with someone one-on-one. Some therapists, counselors, and other mental health professionals specialize in dealing with stigma and other issues related to chronic conditions.
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How Stigma Can Impact Mental Health
People feel a range of emotions after a hepatitis C diagnosis. They may feel fearful or alone as they process what the diagnosis means for them. Living with a chronic disease can affect self-esteem, mood, and quality of life.
Stigma can worsen the anxiety and stress of living with this condition. It may also prevent people with hepatitis C from getting the support they need to care for themselves physically and emotionally.
The stigma surrounding hepatitis C prevents some people from even getting tested. Those who avoid testing cant get the treatment they need to prevent complications like cirrhosis and liver cancer.
Even people who have a diagnosis and are on treatment may not stay on their medication if they dont feel like they have good support.
2017 study surprised researchers when, contrary to their hypothesis, they found that increased knowledge about hepatitis C was associated with a greater experience of stigma.
The researchers suggested a few possible reasons that a deeper understanding of the virus could lead to feeling more stigma. Among their reasons are:
- Knowing more about the virus can also mean knowing more about stereotypes and stigma, leaving people more aware of when theyre perceived in this way.
- Increased fear of stigma may lead people to keep their diagnosis secret, thereby eliminating possibilities for support.
- Fear of transmission to a loved one or disease complications can cause internalized stigma or shame.