What You Can Do
All of these things can scare the heck out of you. They scared me when I was facing them. You can die from hepatitis C from fatal complications. My friend recently passed away, another victim of cirrhosis. They had eventually treated for hep C but too much damage was done. Sounds bleak, doesnt it? Here’s what to do: Get treated as quickly as you can and give your body tender love and care. Thats what Im doing anyway.
What You Should Know About Hepatitis C
What is hepatitis C and in what ways is it contracted?
Hepatitis C is primarily a disease of the baby boomer generation people who are now in their 50s and 60s. You see, hepatitis C is a liver infection caused by a virus in the blood. It is only transferred in blood, and needles used to inject drugs are the most common causes.
In the 1960s and 1970s and even today people got infected by sharing needles to use drugs like heroin. Others became infected due to contaminated blood transfusions however, since 1992, weve eliminated hepatitis C from the blood supply.
People wonder whether you get hepatitis C from kissing or from having sex with an infected person. Never from kissing very rarely from sex. Of course, if skin gets broken, its possible to get the virus. But like any infection, a certain amount of virus has to be transferred before it has an effect, so small skin irritations wont be enough to transfer the infection. As a general precaution, we encourage condom use for people not in a committed relationship.
What are the long-term effects?
For most people who become infected, the symptoms are barely noticeable just a little fatigue, then its over and you feel fine. Very often, people dont even know theyre infected. They can live with the virus for all those decades and not know they have it.
The problem is, hepatitis C does have long-term health implications. As you get older, they can start to show up.
Is hepatitis C contagious?
Data Source And Collection
Qualitative interviewer and co-author conducted 4590-min-long one-on-one interviews with the participants at the opioid-agonist clinics. We used a semi-structured interview guide that explored participants perceptions of HCV, experiences initiating and undergoing HCV treatment, HCV medication adherence, and substance use. The Institutional Review Boards of the Albert Einstein College of Medicine approved this study.
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Component : Witnessing Hcv
In addition to using HIV as a construct to form HCV illness perception, the experiences of HCV-infected family and acquaintances also impacted participants illness perceptions. Participants spoke of the impact of illness in kin, of the impact of illness in acquaintances, and of the lasting impact of these recollections on their willingness to engage in HCV treatment.
Impact of illness in kin
Descriptions of the impact of HCV in family members were often very detailed and made a lasting impact on participants. One participant recalled witnessing his brother die of HCV-related liver disease. The following account describes the participants highly detailed memory:
My brother died of Hep C and then his wife died of Hep C thats a very ugly deaththe color, the way they swell. They lose their leg movements completely, some arm movements. My brother was never crippled, but he was in a wheelchair. He couldnt walk, he couldnt even wipe his own butt. It got real badI couldnt hold a conversation with him because hes being fed by tubes, a machine is breathing for him and hes swelling up. He always weighed like 160 lbs, hes solid, the Marine type. he swelled up like three times his size and then he got black, he had the jaundice thing. I just couldnt bear to see him so I told the doctors to pull the plug, just let him die. It was a hard decision
Impact of illness in acquaintances
Impact of witnessing on treatment uptake
Viral Loads During Treatment
Checking your virus count before, during, and after treatment tells your doctor if and how well your drugs are working. A rising viral load doesnât always mean youâre getting sicker, and a drop in the virus count isnât a sign that youâre on your way to being cured.
Unlike with HIV, where lower viral counts usually mean longer, healthier life, HCV viral loads donât say much about how fast your hep C is progressing or how your disease might turn out. For that, your doctor will need to check your liver enzymes and your liver tissues and run other tests.
Usually, your hep C treatment will be the same no matter how high or low your viral load is. Your doctor will use your virus levels to monitor how you respond to the medication. The drugs youâre prescribed will depend less on your viral count than on your overall health, genetic makeup of your HCV, and other things.
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What Is The Difference Between Relapse And Nonresponse
The goal of treating chronic hepatitis C is to completely clear the virus. This means that your “viral load” is zero or so low that the virus can’t be detected with standard blood tests.
Without treatment, the hepatitis C virus in liver cells constantly makes copies of itself, and the virus ends up not just in liver cells but also in the bloodstream. Treatment is intended to completely stop reproduction of the virus so that it doesn’t continue to enter the bloodstream or cause any more injury to liver cells.
Successful treatment results in a “sustained virological response.” This means the virus becomes completely undetectable before the treatment is finished, and it remains undetectable for 6 months after treatment is stopped.
A “relapse” means the viral load drops to an undetectable level before treatment is completed, but becomes detectable again within 6 months after treatment is stopped. Even if the virus returns at a level that is lower than it was before treatment, a relapse is still considered to have occurred. A relapse can be determined if the viral load starts to rise during treatment, or at any time after the virus becomes undetectable.
A “nonresponse” means the viral load never drops significantly and the virus remains detectable throughout the course of treatment.
How Do You Die From Hepatitis A
A woman in Australia died after eating frozen pomegranate seeds that were linked to an outbreak of hepatitis A, health officials announced this week.
The 64-year-old woman’s death is the first in the hepatitis A outbreak tied to pomegranate seeds that has sickened 24 people in Australia, according to SA Health, the public health system in South Australia. Although the product tied to the outbreak packets of Creative Gourmet’s frozen pomegranate arils was recalled two months ago, it can take up to seven weeks for people to show symptoms of the viral illness after they’ve been infected, SA Health said in a June 5 statement.
But how do you die from a hepatitis A infection?
Hepatitis A is a contagious liver infection caused by the hepatitis A virus, according to the U.S. Centers for Disease Control and Prevention . The virus attacks and destroys liver cells, said Dr. Amesh Adalja, a senior scholar at the Johns Hopkins Center for Health Security, who was not involved in the Australia case. The vast majority of people with hepatitis A have only mild symptoms and recover completely from the infection without incurring lasting damage to their liver, he said.
But a small proportion of people, about 1 in every 250 people with hepatitis A , develop life-threatening complications from the infection, such as liver failure, according to the United Kingdom’s National Health Service .
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Search Strategy And Selection Criteria
We searched Medline with the terms âhepatitis Câ, âHCVâ, âreinfectionâ, âre-infectionâ, âdrug usersâ, âepidemiologyâ, âdiagnosisâ, ânatural historyâ, and âspontaneous clearanceâ to identify reports published in English before Sept 15, 2011. The reference lists of identified reports were manually searched for further relevant papers. Key abstracts at international meetings were also included. We selected reports on the basis of relevance to design, implementation, and analysis of studies related to HCV reinfection in injecting drug users and then assessed them for quality of methods and relevance of results.
Why Cirrhosis Is Worse For Some People
Close to one in four people will develop cirrhosis of the liver after living with a hep C infection for at least 20 years, according to a large review of clinical studies. Men and older people are more susceptible to the disease. In addition to genetic factors, chronic health conditions, and behaviors like heavy drinking and smoking, the type of viral strain you have can also increase the risk of cirrhosis: Genotype 3 is particularly harmful, accounting for about 20% of infections in the U.S.
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Undercooked And Raw Shellfish
Shellfish are animals that filter the water from their surroundings. Because of this, they can become contaminated with hepatitis A virus if they are grown in polluted waters. To be safe, cook shellfish thoroughly before eating it. Undercooked shellfish like oysters, mussels, and clams may harbor and transmit hepatitis A. You may prefer the taste of raw oysters, but cooked shellfish really is safer. Protect your health and skip the raw oyster bar.
History And Physical Exam
To diagnose all forms of hepatitis, your doctor will first take your history to determine any risk factors you may have.
During a physical examination, your doctor may press down gently on your abdomen to see if thereâs pain or tenderness. Your doctor may also check for any swelling of the liver and any yellow discoloration in your eyes or skin.
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What Are The Different Types Of Blood Tests How Often Should I Get These Tests Done
There are several different blood tests, or “labs” that your provider may order for you. The tests measure the amounts of various proteins and enzymes that the liver produces. This is a way of finding out how damaged the liver is. Your provider can determine how often each test needs to be done. Please see Understanding Lab Tests for more details about the tests you may have.
What Are The Side Effects Of Treatments For Hepatitis C Infection
Side effects of interferon or pegylated interferon
- The most common side effects of interferon or pegylated interferon include fever, flu-like symptoms, and depression. Patients must be monitored closely for depression. Risk of suicide is a reason to avoid interferons.
- Interferons also reduce white blood cell and/or red blood cell counts . This may cause increased susceptibility to infection. Interferons also increase the risk of certain cancers. Death rarely occurs as a result of therapy, but may occur from progression of liver failure in patients with advanced cirrhosis.
Side effects of ribavirin
- Ribavirin most commonly causes anemia due to destruction of red blood cells . This can be severe enough that people with heart disease may suffer a heart attack from insufficient blood flow, so people with heart disease should not receive this drug. Anemia improves with a reduction in the dose of ribavirin. Injected growth factor that stimulates the production of red blood cells often is used to improve the anemia associated with ribavirin. Ribavirin also accumulates in the testicles and ovaries and causes birth defects in animals. Although no birth defects have been reported in humans, both men and women should use contraceptive measures to avoid pregnancy during and for at least six months after ribavirin treatment.
Side effects of DAAs
- The most common and significant side effects of boceprevir , sofosbuvir , and ledipasvir/sofosbuvir include
- fatigue ,
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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.
What Is Hepatitis C Infection How Many People Are Infected
Hepatitis C virus infection is an infection of the liver caused by the hepatitis C virus . It is difficult for the human immune system to eliminate hepatitis C from the body, and infection with hepatitis C usually becomes chronic. Over decades, chronic infection with hepatitis C damages the liver and can cause liver failure. In the U.S., the CDC has estimated that approximately 41,200 new cases of hepatitis C occurred in 2016. When the virus first enters the body there usually are no symptoms, so this number is an estimate. About 75%-85% of newly infected people become chronically infected. In the U.S., more than 2 million people are estimated to be chronically infected with hepatitis C. Infection is most commonly detected among people who are 40 to 60 years of age, reflecting the high rates of infection in the 1970s and 1980s. There are 8,000 to 10,000 deaths each year in the U.S. related to hepatitis C infection. HCV infection is the leading cause of liver transplantation in the U.S. and is a risk factor for liver cancer. In 2016, 18,153 death certificates listed HCV as a contributing cause of death this is believed to be an underestimate.
Those who have cirrhosis from HCV also have a yearly risk of liver cancer of about 1%-5%.
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Natural History Of Reinfection
As recorded in chimpanzees, evidence indicates that HCV RNA concentrations after reinfection in people are lower, generally more transient, and shorter in duration than during initial infection. In a longitudinal study of IDUs, median duration of HCV viraemia was four times longer during initial infection than during reinfection and peak median log HCV RNA concentration was lower , suggesting people develop adaptive protective immunity .
HCV infection, clearance, and reinfection
HCV reinfection events after spontaneous clearance have lower HCV RNA concentrations and shorter infection durations than initial HCV infection. HCV=hepatitis C virus.
However, Osburn and colleagues detected new HCV-specific T-cell responses and cross-reactive neutralising antibodies in reinfected individuals who did not clear reinfection. Therefore, although improved cellular and humoral immune responses play a part in control of reinfection, they are probably not sufficient for protection against HCV reinfection with persistence in all cases. Further longitudinal investigation of adaptive immunity during primary infection and reinfection is necessary for reliable identification of the characteristics of protective immunity associated with repeated clearance of HCV infection and hence for future vaccine research.
Favorite Hep C Alternative Medicine Resource
Although hep C can be successfully treated with modern medicine, many people turn to dietary supplements with the goal of curing their illness. The most commonly used is silymarin . Although the NCCIH says that no supplement is effective for hep C, the center provides the latest scientific data on a range of products, including probiotics, zinc, licorice root, and colloidal silver.
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How Do I Know If I Have Hepatitis C Virus
Diagnosis of hepatitis C virus requires a blood test your doctor can order. Other blood tests can determine which subtype of HCV you have to better target your drug treatment, if needed. Your doctor will also want to know your viral load . In some patients, a liver biopsy is required to determine the level of damage.
Symptoms of chronic HCV may not appear for 2 to 3 decades after infection, so the disease may develop silently in your body for many years. This is the reason you should be tested for HCV infection, to start treatment if needed and to help protect your liver from damage.
The US Centers for Disease Control and Prevention recommends anyone 18 years or older be tested for hepatitis C virus at least once in their lifetime. Women should be tested for hepatitis C testing during each pregnancy. Some high risk groups may need more frequent testing, such as people who share drug preparation equipment and those on hemodialysis.
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Viral Attachment Entry And Fusion
Viral entry into the host cell involves a complex series of interactions including attachment, entry and fusion. The initial viral attachment to its receptor/co-receptors may involve HVR1 in HCV E235,36 with facilitation by heparan sulfate proteoglycans expressed on hepatocyte surface.3740 While LDL receptors can bind HCV and promote its cellular entry,41 HCV-LDLR interaction may be non-productive and can potentially lead to viral particle degradation.40 Following attachment to the entry factors, HCV is internalized into the target cells via a pH-dependent and clathrin-mediated endocytosis.4245
Multiple cellular receptors and entry factors for HCV have been identified, including the scavenger receptor class B type I ,46 and CD8147 as well as tight junction proteins, claudin-1 48 and occludin .49,50 Additional recently identified entry factors include the receptor tyrosine kinases epidermal growth factor receptor , ephrin receptor A2 51 and Niemann-Pick C1-like 1 cholesterol absorption receptor .52 The various entry factors are briefly described below:
Scavenger receptor class B type I
CD81
The tight junction proteins Claudin 1 and Occludin
Receptor tyrosine kinases and Niemann-Pick C1-like 1 cholesterol absorption receptor
Collectively, these receptors and entry factors provide potential avenues to prevent HCV infection and spread, provided that modulation of their physiological role does not lead to significant toxicity.
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