Dont Take Other Medications Unless Youve Talked To Your Doctor First
Many drugs can interfere with your hepatitis C medications, so its important to tell your doctor exactly what youre taking or thinking about adding to your regimen, says James J. Lee, MD, a gastroenterologist and medical director at the James J. Lee, MD Center of Excellence for Digestive Health in Orange, California. This includes medicines used for acid reflux, an enlarged prostate, birth control, high cholesterol, and seizures.
Whats more, some drugs can be hard on your liver, including over-the-counter pills such as acetaminophen. If you need treatment for more than one health condition, work closely with your doctors, including your primary care physician and your gastroenterologist or hepatologist, to determine the best methods.
If You Have Hepatitis C Can You Have Sex Without Infecting Your Partner
Hepatitis C is a virus that is transmitted by blood. The most common ways people become infected with hepatitis C are through needle sharing, such as during injection drug use, or from blood transfusions received before 1992.
Becoming infected from sex is not common, but it does happen. If you have hepatitis C, the chance of infecting a sex partner is higher if you are with a new partner or if you have had many different partners over time. If you have hepatitis C, the chance of infecting a sex partner is lower if you are with a longtime stable partner and if you are in a monogamous relationship.
If your sex partner is new to you, or if you have many different partners, it is safer if you use condoms during sex to reduce the chance of transmitting hepatitis C.
It is always best to talk directly with your health care provider to assess whether you should start using condoms. If you are in a sexual relationship and either you or your partner has hepatitis C, the other partner should be tested for hepatitis C and other sexually transmitted viruses once a year, or as advised by your provider.
Can You Get Hepatitis C From Alcohol Addiction
Research has shown a link between alcohol addiction and hepatitis C . While alcohol addiction may not directly cause HCV, it can make you more susceptible to the infection.
In one study, actively drinking alcoholics were more likely to have hepatitis C, despite not using drugs intravenously or having other known risk factors.
Alcohol can also lead to liver inflammation, which studies have found to be associated with hepatitis C antibodies. Again, this is without any other known infection risk factors.
And, if you have hepatitis C, alcohol can make it worse and speed its progression.
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What Does High/low Viral Load Mean
Viral load is the amount of virus present in the bloodstream. It is expressed as the amount of viral genetic material per milliliter of blood. The amount of virus does not predict how severe the liver disease is or will become. The level of the viral load does not tell us anything about the risk of liver damage or how sick someone is. In hepatitis C, it matters if virus is present or absent. Some treatment regimens can be shortened if the patient has a low viral load to start with, but most often, treatment regimens are the same for people with high hepatitis C viral loads or low viral loads.
The RNA test is essential for making the diagnosis of hepatitis C infection–having a positive RNA test is the definition of having infection. After the diagnosis is made, the RNA level does not need to be checked over and over unless it is checked during the time that the patient is undergoing treatment. During treatment, regular RNA tests are done to follow the dropping virus level until it reaches an undetectable state. But before treatment and after treatment, repeated RNA testing is not necessary.
Charles S Lieber Md Macp
Charles S. Lieber, M.D., M.A.C.P., is chief of the Section of Liver Disease & Nutrition, Alcohol Research Center, Bronx, NY Medical Center and professor of medicine and pathology at Mt. Sinai School of Medicine, New York, New York. The preparation of this article was supported in part by National Institute on Alcohol Abuse and Alcoholism grants AA11115 and AA12867, by the Department of Veterans Affairs, and by the Kingsbridge Research Foundation.
Hepatitis is an inflammation of the liver that is characterized by jaundice, liver enlargement, abdominal and gastric discomfort, abnormal liver function, and other symptoms. Although in many patients the diseased liver is able to regenerate its tissue and retain its function, severe hepatitis may progress to scarring of the liver tissue , cirrhosis, liver cancer , and chronic liver dysfunction. Hepatitis can have numerous causes, such as excessive alcohol consumption or infection by certain bacteria or viruses. One common cause of hepatitis is infection with one of several types of viruses . With the development of new diagnostic tools, infections with the hepatitis C virus have received increasing attention in recent years. In the United States, the number of deaths caused by HCV is increasing and may approach or even surpass the number of deaths from AIDS in the next few years .
EPIDEMIOLOGY AND NATURAL HISTORY OF HCV INFECTION
EFFECT OF ALCOHOLISM ON HCV INFECTION
Effects of Alcoholism on HCV Acquisition and Persistence
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If I Get Tested For Hepatitis C And The Result Is Positive Do I Need Any Other Tests To Be Sure
When your provider wants to test you for hepatitis C, the first test you will have is the hepatitis C antibody . If this test is positive, it means you were infected with the hepatitis C virus at some point in the past. But this test alone is not enough. You will still need another test to confirm if you still have the hepatitis C virus in your system. About 1 out of 5 people who get infected with hepatitis C will be able get the rid of the virus on their own, without treatment, very early after their infection. So some people will have a positive antibody test, but a negative HCV RNA .
So, the second test that your provider should request is called hepatitis C virus RNA or HCV RNA test. There are several different tests available to check the HCV RNA. What matters is that if the RNA test is positive, then you do have chronic hepatitis C virus infection. If the RNA test is negative, then you may need to have this test again to be sure. If these RNA tests are all negative, then you no longer have hepatitis C infection and do not have chronic hepatitis C.
If your hepatitis C antibody test is positive, be sure that you get tested for hepatitis C RNA to find out whether the infection has become chronic or whether it has cleared. If the infection has become chronic, there are treatments your provider can prescribe to fight off the hepatitis C virus and keep your liver healthy.
Alcohol Consumption And Outcome Of Antiviral Treatment
Since high HBV DNA levels in serum are associated with a higher risk of HCC, the primary aim of chronic hepatitis B treatment is sustained suppression of viral replication. HBV cannot be completely eradicated, due to the persistence of covalently closed circular DNA in the infected cell nucleus. Current guidelines recommend antiviral therapy with pegylated interferon- or nucleoside/nucleotide analogues, including entecavir and tenofovir, as first-line treatment.
In HBeAg-positive patients, female sex, high serum ALT level, low HBV DNA level, and genotype A were associated with an increased likelihood of sustained response to interferon- there are no strong pre-treatment predictors of viral response in HBeAg-negative patients. In patients with HCV, alcohol abuse appears to decrease responsiveness to interferon therapy, reducing both sensitivity and compliance. It was reported that increased oxidative stress from alcohol consumption can impair the cellular response to interferon- through interference with the JAK-STAT pathway. Although there are no data concerning an association between alcohol consumption and treatment outcomes in patients with HBV, probably because fewer patients receive interferon for treatment of chronic hepatitis B, excess alcohol could reduce the efficacy of interferon therapy by the same mechanisms reported for patients with HCV.
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Who Can Be Treated For Hepatitis C
Treatment decisions should be made by both you and your provider. Current treatments for hepatitis C are very successful and can cure most people of the virus.
Interrelation Of Serum Levels Of Alt Hcv Rna Titre And Histological Grading Of Necroinflammation
Since HCV RNA serum levels were not different in the alcohol and alcohol-free groups, we tried to establish whether histological activity of necroinflammation has any correlation with either serum levels of ALT or HCV RNA titre. We did not find any significant correlation between disease activity graded from 1 to 7 and serum levels of ALT , or between disease activity and serum HCV RNA titre . Again, analysis of the interrelation between serum levels of HCV RNA titre and ALT in different patient groups did not demonstrate any significant correlation between them . This indicates that alcohol intake in HCV-infected patients did not exacerbate the underlying disease activity caused by HCV RNA replication.
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Stage : Alcoholic Cirrhosis
Stiff and swollen at this stage, the liver has suffered extensive damage. Similarly, its functioning can be severely compromised. Alcoholic cirrhosis is considered to be irreversible.
Symptoms include:
Your healthcare professional can diagnose alcoholic cirrhosis with a physical exam, blood tests and imaging techniques.
A biopsy is the definitive method for diagnosing cirrhosis, however.
Once again, its vital that you stop drinking alcohol to minimize further damage. The survival rate for those with severe cirrhosis is 50 percent at two years and only 35% within five years. Cirrhosis is the ninth leading cause of death in the U.S.
Alcohol related cirrhosis puts you at a much risker risk for liver cancer.
Similarly, if you have hepatitis B or C and are a heavy drinker, your risk for cirrhosis increases substantially.
These stages are not necessarily linear or absolute. Someone can have evidence of two or three at once, especially if they have been abusing alcohol for a long time.
The good news is that there are treatments available for cirrhosis. They include dialysis, lifestyle changes, nutritional therapy, and, if all else fails, a liver transplant.
What Are The Tests For Hepatitis C
There are two blood tests needed to diagnose hepatitis C:
The antibody test–called HCV antibody, HCV Ab, or anti-HCV–is done first. If this test is positive, it means that you have been infected with hepatitis C at some point in the past. If your antibody test is negative, then you have never been infected with hepatitis C if you were infected within the past month or so, the test may not be accurate you may needed to be retested at a later date.
However, a positive antibody test does not tell you if you still have hepatitis C. For that, you need to have a HCV RNA test, which determines whether the virus itself is in the bloodstream.
If any RNA is present in the blood after 6 months from time of infection, then you have chronic hepatitis C.
If no RNA is detected in the blood after 6 months, you no longer have hepatitis C.
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Relation Of Alcohol Consumption With Histological Severity Of Necroinflammation Degree Of Fibrosis And Risk Of Cirrhosis
Although the histological activity of necroinflammation was more severe in Groups B, C, and D compared to Group A patients with alcoholic liver disease only , there was no significant difference in severity of necroinflammation among Groups B, C or D . When we analysed the degree of fibrosis from stage 1 to stage 4 in all our enrolled patients, we found that the degree of fibrosis was significantly higher in HCV plus alcohol-intake group compared to patients with HCV infection alone or alcoholic liver disease only . There was no difference in the degree of fibrosis between Groups A and B, or between Groups C and D. It is interesting to note that, even though the severity of necroinflammation in Group A was significantly lower than the other groups, the degree of fibrosis was significantly higher and similar to Group B. When KruskalWallis regression analysis was performed for analysing the overall stage-dependent transition to fibrosis in all four groups of patients, we found a significant and increasing progression of fibrosis in Groups C and D in contrast to patients with HCV infection only or alcoholic liver disease only . A total of 59 patients developed liver cirrhosis among all four groups of patients. The risk of cirrhosis was significantly higher in Groups B, C and D, compared to Group A . Again, the risk of liver cirrhosis in HCV plus alcohol-intake groups was 1.52.5-fold greater than patients with HCV infection alone .
Serum Levels Of Hcv Rna Titre
We measured serum levels of HCV RNA titre in different patients, to demonstrate the relation of alcohol consumption with HCV RNA replication. HCV RNA titres in serum expressed as Meq/ml in different groups of patients are as follows: Group A, 0 Group B, 2.7 14 ± 14 2.9 Group C, 2.314 ± 14 2.6 Group D, 2.3 14 ± 14 1.7. We did not find any significant difference in serum HCV RNA levels between Groups B, C and D .
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Illegal Drugs And Cigarettes
Recreational drugs in general are no good for your liver. For example, may lead to faster liver scarring. And using a needle to inject substances can raise your odds of getting reinfected with hep C.
If you’re a smoker, you need to quit. It can make you more likely to get liver cancer. Talk to your doctor about ways to quit.
How Much Does Hepatitis C Treatment Cost
It is impossible to say what the exact cost is for the various regimens, but it is in the tens of thousands of dollars. In general, out of pocket cost would be very high for the average person, and most people are treated through a health insurer, federal health benefits, or veteran’s benefits. The cost of hepatitis C and the care of its complications, however, is much higher over a person’s lifetime, and the roughly estimated savings is believed to make treatment a good health and financial investment. Liver transplantation alone may cost several hundred thousand dollars for the procedure alone, followed by several hundred thousand for the medications needed in the first 6 months afterward.2 This does not include the many complications of liver transplantation.
Because negotiations are confidential business contracts, little is known about how much is actually paid for medical treatments by these drugs. One example is the medication sofosbuvir. Estimated costs for a standard 12-week treatment with sosobuvir was $84,000 in the US. Actual costs to individuals depend upon price contracts between pharmaceutical companies and health insurers, as well as government and private organizations. Thus, an individual with healthcare coverage may only pay a monthly co-pay.4
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How Does Hepatitis C Progress
When someone is first infected with hepatitis C, most likely they have no symptoms and are unaware. Occasionally people experience fatigue, loss of appetite, weakness or sometimes having a yellow color in their skin or eyes. Although having any symptoms at all is rare, if they do occur, they usually go away within a few weeks.
Around 15-25% of people who are infected will spontaneously fight off the virus on their own and they will not have a chronic hepatitis C infection and no long term damage occurs.
But around 75-85% of people will develop chronic infection. Most of the time, people with chronic hepatitis C have no symptoms at the time of infection and no symptoms for years or even decades of chronic infection. The virus will be with them until they are successfully treated with hepatitis C medications.
Around 10-20% of people with chronic infection will slowly have gradual damage in the liver over years and will eventually develop cirrhosis . This can take 20 years or more from the time of the initial infection.
Cirrhosis is the replacement of liver cells with permanent scar tissue. Cirrhosis can lead to problems such as bleeding from veins in the esophagus, fluid buildup in the belly, and damaged brain function.Approximately 15% of people with cirrhosis will develop liver cancer during their lifetime. Drinking excessively can double the chance of liver cancer in people infected with HCV.
Alcohol And Hepatitis C
If you’ve been diagnosed with hepatitis C, your doctor has probably advised you to give up alcoholic beverages. For some people, this can be one of the most difficult lifestyle adjustments to make. But it’s also one of the most important.
Several studies have shown that among people with hepatitis C, regular drinkers have higher levels of virus than nondrinkers, according to a report in the journal Hepatology. Studies also show that when people infected with the hepatitis C virus stop drinking alcohol, levels of the virus decrease.
Researchers have found that alcohol causes the hepatitis C virus to multiply in the liver by increasing the activity of a protein that triggers the virus to make new copies of itself. These new copies speed the progress of the infection and raise the risk of liver damage.
Protecting your liver
There are other compelling reasons not to drink alcoholic beverages if you have hepatitis: One of the liver’s jobs is to process alcohol. Too much alcohol can poison liver cells and cause a form of the disease called alcoholic hepatitis. If people continue to drink excessively, the condition can lead to permanent liver damage, or cirrhosis.
If you’ve been diagnosed with hepatitis C, drinking alcohol adds to the strain on the liver, increasing the risk of damage to cells. That raises the danger of cirrhosis and liver cancer. If your liver has already been damaged by the virus, drinking can make things even worse.
How to get help
Taking the step
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