Additional Tests You Might Need
Once youve been diagnosed with Hepatitis C, your doctor will likely order a number of tests to find out about the health of your liver and decide on a treatment plan thats most appropriate for you.
Hepatitis C genotype
The Hepatitis C genotype refers to a specific strain or type of the Hepatitis C virus. There are six major types of Hepatitis C around the world: genotypes 1, 2, 3, 4, 5 and 6. In the United States, genotypes 1, 2, and 3 are common:
- Genotype 1: Most Americans with Hepatitis C have this type
- Genotype 2: About 10% of Americans with Hepatitis C have this type
- Genotype 3: About 6% of Americans with Hepatitis C have this type
The genotype of Hepatitis C does not change over time, so you only need to get tested once.
Genotype tests are done before a person starts treatment. Hepatitis C treatment works differently for different genotypes, so knowing your genotype helps your doctor choose the best treatment for you.
Testing for Hepatitis A and Hepatitis B
Your doctor may test to see if your body is immune to Hepatitis A and Hepatitis B. If these tests show no prior exposure or protection, he or she will recommend that you be vaccinated against these two viruses to eliminate the chance of becoming infected.
Liver function tests or liver enzymes
- ALT
- AST
Liver function tests also include ALP and total bilirubin, among other things.
Tests to measure liver scarring or fibrosis
- Liver Biopsy
- Elastography
- Serum markers
Imaging tests
Sharing A Fork Spoon And Glass
You’re at a restaurant and someone at your table offers a taste of their delicious cheesecake. Should you politely pass? Well, not if you’re worried about catching hepatitis C. Go ahead and taste that dessert because sharing eating utensils doesn’t spread the virus. Also, have a sip of their water, too. Remember, spreading hepatitis C requires direct contact with infected blood, not saliva.
Could I Get Hep C In The Hospital
Before the medical community identified hepatitis C as a dangerous virus, it existed in the blood supply that hospitals used for transfusions or organ transplants. People got hepatitis C if they received a transfusion before we knew how to test for it, says Dr. Fox. Today though, blood is screened before being administered to patients, so the odds of getting hep C from it is extremely unlikely.
There are also cases of babies who are born with hep C, but that has nothing to do with hospital itself: If a woman has the virus, there is a 6% chance her infant will be born with it, too, according to the CDC. For that reason, its important to be tested for hepatitis C if you are thinking about getting pregnant, and also during pregnancy.
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What Factors Are Linked To The Sexual Transmission Of Hepatitis C Among Gbmsm
A cluster of factors have been associated with the sexual transmission of hepatitis C.5,6 For sexual transmission of hepatitis C to occur, there must be exposure to the hepatitis C virus in one or more of these situations:
- condomless anal sex
- having an ulcerative STI
Drug use and sex
Where drug use is present, it is difficult to tease apart the extent to which drug use versus sex contributes to the transmission of hepatitis C. For example, party and play or chemsex is when certain drugs are used by gbMSM before or during sex to facilitate, sustain or enhance sexual encounters. The risk of hepatitis C transmission through party and play is twofold, through drug use and through sex. Hepatitis C can be acquired through shared drug use equipment. There is also concern that booty bumping or boofing can damage and/or irritate the tissue of the rectum, which could increase the risk of sexual transmission of hepatitis C.13 Party and play is also associated with types of sex that overlap with sexual risk factors for hepatitis C. For example, gbMSM who party and play are more likely to participate in condomless anal sex with one or more partners and participate in group sex compared with gbMSM who do not party and play.14 Thus, deciphering whether new hepatitis C infections among gbMSM who party and play were acquired through drug use or sex is challenging.
Can Hepatitis C Be Spread During Vaginal Sex
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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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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General Tips For Prevention
Refrain from engaging in IV drug use and be cautious with all procedures that involve needles.
For example, you shouldnt share needles used for tattooing, piercing, or acupuncture. The equipment should always be carefully sterilized for safety. If youre undergoing any of these procedures in another country, always make sure the equipment is sterilized.
Sterile equipment should also be used in a medical or dental setting.
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Why Getting Tested Is Important
A blood test is one of the only ways to confirm a diagnosis of hepatitis C. Additionally, hepatitis C often has no visible symptoms for many years.
Because of this, its important to be tested if you believe youve been exposed to the virus. Getting a timely diagnosis can help ensure you receive treatment before permanent liver damage occurs.
What Are The Symptoms Of Hepatitis C
During the acute phase most persons have no symptoms or might experience a mild illness. Symptoms of acute HCV infection, when present, may include:
- Jaundice
- Dark-colored urine, light-colored stools
- Diarrhea
- Fever
During the chronic phase hepatitis C usually progresses silently, with no symptoms at all during the first 10-20 years. Signs of severe liver scarring may include:
- Ascites
- Star-shaped vein pattern developing on the swollen belly
- Jaundice
- Itching
- Easy bruising and bleeding
Because symptoms of hepatitis C are usually absent, persons with risk for HCV infection should be tested. The blood test for hepatitis C infection is called the hepatitis C antibody test. People who have hepatitis C infection will show positive antibodies on this test. In many cases, it is necessary to confirm a positive hepatitis C antibody test with a more specific test, such as a test for HCV virus RNA.
If you think you have hepatitis C or have risk for hepatitis C, you should contact your doctor. The Communicable Disease Control Unit may be able to help answer your questions.
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Who Gets Hepatitis C
Who gets hepatitis C?
Anyone can get hepatitis C virus. But unlike a cold or flu virus, HCV isn’t easy to catch. The virus is transmitted only by direct contact with human blood that contains the virus. There are several ways infection can occur. Those at risk of being infected with hepatitis C virus include:
What about tattooing?
Several studies have shown there is no link between licensed commercial tattooing parlors and HCV infection, “but transmission of Hepatitis C is possible when poor infection-control practices are used during tattooing or piercing,” according to the Centers for Disease Control and Prevention .
The agency advises people thinking about getting tattoos or body piercing to consider the health risks. It’s possible to get infected with HCV, the CDC says, if the tools used have someone else’s blood on them, or if the piercer or tattoo artist fails to use proper hygiene, such as washing hands, sterilizing tools, and using disposable gloves.
Is it possible to contract HCV from a shared razor or toothbrush?
There are no documented cases of transmission, but the CDC warns that people should not share toothbrushes, razors, or other personal care items: They might have small amounts of infected blood on them.
The CDC stresses that the hepatitis C virus is NOT spread by casual contact or by breast feeding, hugging or kissing, sneezing, coughing, or sharing utensils, drinking glasses, food, or water.
Is sex safe?
Preventing the spread
References
Who Is At Risk For Hepatitis C
You are more likely to get hepatitis C if you
- Have injected drugs
If you have chronic hepatitis C, you probably will not have symptoms until it causes complications. This can happen decades after you were infected. For this reason, hepatitis C screening is important, even if you have no symptoms.
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What Happens In Your Body With Hep C
Once the virus enters your bloodstream, it heads for your liver. Hepatitis C is a viral infection, and its a virus that lives primarily in the liver, says Dr. Goff. The reason it causes trouble is our immune system tries to get rid of it, but the virus mutates quite quickly, so it keeps alluding being caught. The liver gets caught in the crossfire.
Over time, the chronic infection can lead to serious liver scarring and damage, increasing the risk of life-threatening liver failure and cancer, Dr. Fox says.
How Hepatitis C Is Spread During Sex
Hepatitis C is a viral infection of the liver. It can range in severity from a mild, short-lived illness to a serious, lifelong disease. The hepatitis C virus is spread primarily through contact with the blood of someone whos infected. Its still unclear whether the virus can live in saliva, semen, or vaginal secretions.
These factors increase the risk of spreading hepatitis C during sex:
-
Having multiple sex partners
-
Engaging in rough sex, which may lead to bleeding
-
Having a sexually transmitted disease
- Being infected with HIV
Especially in those who have the above risk factors, hepatitis C can occasionally spread through vaginal intercourse. It might also spread through anal sex, which can damage the lining of the rectum, making it easier for the virus to gain access to the bloodstream. Its not known whether the hepatitis C virus can be passed during oral sex. There is no proof that this has ever happened. The virus is not spread by more casual contact, such as hugging or holding hands.
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How Is Hepatitis C Infection Prevented
Unfortunately, there is no vaccine to prevent hepatitis C. To reduce your risk of getting hepatitis C:
- Injection drug use is the most common way people get hepatitis C. Avoid injecting drugs to reduce your risk. If you do inject drugs, use sterile injection equipment. Avoid reusing or sharing.
- Avoid sharing personal care items that might have blood on them
- If you are a health care or public safety worker, follow universal blood/body fluid precautions and safely handle needles and other sharps
- Consider the risks if you are thinking about tattooing, body piercing, or acupuncture are the instruments properly sterilized?
- If youre having sex with more than one partner, use latex condoms correctly and every time to prevent the spread of sexually transmitted diseases, including hepatitis C.
Tests To Diagnose Hepatitis C
How is Hepatitis C diagnosed?
There are two main blood tests typically used to diagnose Hepatitis C. First, youll have a screening test that shows if youve ever had Hepatitis C at some point in your life. If this test is positive, youll have a second test to see if you have Hepatitis C now. These blood tests are described below:
Hepatitis C antibody test
This is the screening test used by doctors to show whether or not you have ever been exposed to Hepatitis C at some time in your life, by detecting antibodies in your blood. Antibodies are substances your body makes to fight off all kinds of infections. If you were ever infected with Hepatitis C, your body would have made antibodies to fight the virus.
If the test result is:
- Negative, it means you have not been exposed to Hepatitis C and further testing is usually not needed.
- Positive, you have had Hepatitis C at some point. However, it does not tell you whether you have it now. Youll need to see your doctor for another test the Hepatitis C RNA test to determine if the virus is still active and present in your blood.
Hepatitis C RNA Qualitative Test
This test will determine whether or not you are currently infected with Hepatitis C. It is often called the PCR test because of the process used . It looks for the genetic material of the Hepatitis C virus in your blood.
If the test result is:
Hepatitis C RNA Quantitative Test
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Other Sexual Practices And Risk Factors
Other sexual practices that increase the risk of hepatitis C transmission include:
- sharing sex toys that have been used anally or during menstruation
- fingering, which can cause bleeding
- fisting, which can cause bleeding
The risk of hepatitis C transmission is also higher among people with HIV. This is because HIV weakens the immune system, which can raise the risk of contracting viral infections and other illnesses.
2.4 million people in the United States live with hepatitis C, according to 2016 estimates from the Centers for Disease Control and Prevention .
Understanding how the virus is transmitted and taking protective measures can help protect you and your sexual partners from hepatitis C.
To reduce the risk of transmission during sex:
- Follow your doctors recommendations for STI testing. Talk with them about your sexual habits and other risk factors. Ask them if you should get tested for hepatitis C or other sexually transmitted infections .
- Talk with sexual partners about their STI status. Ask them if theyve been tested since their last sexual relationship.
- Get treatment forSTIs. Ask your doctor about treatment options if you test positive for hepatitis C or other STIs.
- Use barrier methods like condoms during sex. This is particularly important if you have multiple sexual partners or youre having anal sex, rough vaginal sex, or sex during menstruation when you or your partner may have hepatitis C.
Other ways to prevent hepatitis C:
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.
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Can You Get Hep C From Recreational Drug Use
The main way hepatitis C is spread is blood-to-blood, says Rena Fox, M.D., a professor of medicine at the University of California, San Francisco, and an internist and hepatitis specialist at UCSF Health. So any activity where you might come in contact with another persons blood, like sharing needles, puts you at risk.
In fact, sharing needles and syringes is the most common way hepatitis C is spread, says Dr. Fox. We started seeing the number of new cases per year rise again about four or five years ago, along with an increase in heroin use with the opioid epidemic, she says. If people become addicted to prescription opiates, but then lose access to them, she explains, they may turn to heroin which often involves sharing needles.