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.
Condoms And Dental Dams
Other things to think about:
- Check the expiry date on a condom before using one and make sure the packaging and the condom itself dont have any holes or tears.
- Never use a condom more than once, and dont use 2 condoms at the same time as that can cause breakage.
- Its recommended to use lubricants with condoms, but be sure to use the right type. Vaseline and other oil-based lubricants destroy latex.
Should You Get Tested
The CDC recommends that anyone over the age of 18 get tested for Hepatitis C. But you should especially consider being tested if you:
- Were born between 1945 and 1965
- Have used injected drugs
- Were born to a mother who had hepatitis C
- Were treated for a blood clotting problem before 1987
- Got a blood transfusion or organ transplant before July 1992
- Have been a long-term hemodialysis patient
- Work in health care or public safety and were exposed to blood through a needle stick or other sharp object injury
If you get tested and find out you have hepatitis C, tell your sex partner and anyone else who may have been exposed to your blood, including through drug use.
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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.
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.
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Is There A Way To Prevent Hepatitis C
Although currently theres no vaccine to protect people from contracting hepatitis C, there are vaccines for other hepatitis viruses, including hepatitis A and hepatitis B.
If you receive a hepatitis C diagnosis, your healthcare provider may advise you to get vaccinated against hepatitis A and B.
The vaccinations are recommended because these hepatitis viruses can lead to additional health and liver complications, especially in those with preexisting liver disease.
Since you cant prevent hepatitis C through a vaccine, the best prevention is to avoid exposure. Hepatitis C is a bloodborne pathogen, so you can limit your chances of exposure through these healthy lifestyle practices:
- Avoid sharing needles, razor blades, or nail clippers.
- Use proper safety precautions if youll be exposed to bodily fluids, such as when performing first aid.
- Hepatitis C isnt usually transmitted through sexual contact, but its possible. Limit your exposure by practicing sex with a condom or other barrier method. Its also important to openly communicate with sexual partners and to get tested if you suspect youve been exposed to the hepatitis C virus.
Because hepatitis C is transmitted through blood, its possible to contract it through a blood transfusion.
However, since the early 1990s, blood product screening tests have been standard protocol for minimizing the risk of this type of transmission.
Subsequent testing is based on risk. Talk to your doctor about your needs.
Can Hepatitis C Be Treated
Yes, since 2010 enormous progress has been made in the treatment of chronic hepatitis C. New therapies called direct-acting antivirals are pills that act on the virus itself to eradicate it from the body, unlike older medicines like interferon injections which work by stimulating an immune response. These new treatments are very effective and can achieve cure rates of over 90%. In most situations now, there is no need for interferon, which was responsible for many of the side effects previously associated with HCV treatment. The new treatment combinations require shorter treatment durations , have reduced side effects and appear to be effective at all stages of the disease.
Because these new therapies are very new, they remain very expensive. As such, drug coverage from both government and private companies may require that your liver disease has progressed to a certain stage before they are willing to cover the cost of these drugs.
Your primary care physician may refer you to a specialist to determine whether you are eligible for treatment. A specialist will help you decide which drug therapy is best for you based on the severity of your liver disease, your virus genotype and whether or not you have been treated in the past.
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If Im Cured Of Hepatitis C Virus Can I Get It Again
Yes. Having had hep C once does not make you immune from getting it again. You can contract HCV again whether you cleared the virus by successful treatment or by spontaneously clearing it on your own.
The chance of reacquiring hep C is much lower than the chance of a first-time infection. The risk of getting hep C again is higher among those who are HIV positive, men who have sex with men and active injection drug users.
The best way to avoid hep C is to avoid or reduce exposure. To learn more about HCV prevention and other issues related to the virus, .
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Symptoms Of Hepatitis C
Hepatitis C often doesn’t have any noticeable symptoms until the liver has been significantly damaged. This means many people have the infection without realising it.
When symptoms do occur, they can be mistaken for another condition. Symptoms can include:
- flu-like symptoms, such as muscle aches and a high temperature
- feeling tired all the time
- loss of appetite
Read more about the complications of hepatitis C.
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Can Hepatitis B Be Prevented
The hepatitis B vaccine is one of the best ways to control the disease. It is safe, effective and widely available. More than one billion doses of the vaccine have been administered globally since 1982. The World Health Organization says the vaccine is 98-100% effective in guarding against the virus. Newborns should be vaccinated.
The disease has also been more widely prevented thanks to:
- Widespread global adoption of safe blood-handling practices. WHO says 97% of the blood donated around the world is now screened for HBV and other diseases.
- Safer blood injection practices, using clean needles.
- Safe-sex practices.
You can help prevent hepatitis B infections by:
- Practicing safe sex .
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You Can Still Get Hepatitis C After It’s Cured Protect Yourself
Hepatitis C is spread by direct contact with an infected person’s blood. The symptoms of the Hep C virus can be very similar to those of the hepatitis A and B viruses. However, infection with the Hep C virus can lead to chronic liver disease.
Hep C acts very slowly most people dont have any symptoms. Even without symptoms, liver conditions can develop 10 to 30+ years after being infected. Thats why people can have Hep C for decades without knowing it.
Good news is that there are new and improved treatments available that can cure Hep C in 95% of people. Treatment is usually one pill a day for a few months.
As a Louisiana Healthcare Connections member, your Hep C treatment is covered at no cost to you!
Remember: Even if you are cured, you can get infected with Hep C again.
Preventing Hep C Infection
There is no vaccine to prevent Hep C. That is why it is important to find ways to prevent getting Hep C, even if youve been cured in the past.
The CDC estimates that 75% of new Hep C infections are from sharing injection drug use equipment. All equipment used to prepare and inject drugs can spread Hep C when contaminated and shared.
It is important to never share drug use equipment including: needles, syringes, cotton, rinse water, cookers, spoons, straws or pipes or any other drug use supplies.
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Reducing Sexual Hep C Risk
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How Can I Cope With My Feelings About Having Hepatitis C
Coping with hepatitis C isnt easy. You may feel sad, scared or angry, or you may not believe you have the disease. These feelings are normal, but they shouldnt keep you from living your daily life. If they do or if they last a long time you may be suffering from depression. People who are depressed have most or all of the following symptoms nearly every day, all day, for 2 weeks or longer:
- Feeling sad, hopeless and having frequent crying spells
- Losing interest or pleasure in things you used to enjoy
- Feeling guilty, helpless or worthless
- Thinking about death or suicide
- Sleeping too much, or having problems sleeping
- Loss of appetite and unintended weight loss or gain
- Feeling very tired all the time
- Having trouble paying attention and making decisions
- Having aches and pains that dont get better with treatment
- Feeling restless, irritated and easily annoyed
Contact your healthcare provider if you notice any of these symptoms. Your healthcare provider can help by recommending a support group or a therapist, and/or by prescribing a medicine for you to take.
Tips For Avoiding Reinfection
The best way to prevent reinfection is to avoid contact with blood containing the virus. That means not sharing needles and syringes, and not engaging in sex without a condom or other barrier method.
Injection drug use is one of the main ways hepatitis C reinfections occur. Stopping the use of these drugs can reduce exposure to the virus.
Opioid agonist therapy is a treatment that helps people stop taking heroin and other opioid drugs by preventing withdrawal symptoms and reducing cravings. This treatment might also lower the risk of hepatitis C reinfection.
For people who do use injected drugs, a syringe services program or needle exchange program can provide clean needles and syringes. These community-based programs also offer hepatitis C screening and refer people to substance use disorder treatment programs.
Untreated depression and other mental health issues can sometimes lead people to engage in behaviors such as sex without a condom or other barrier method as well as drug use. A mental healthcare professional can offer healthy ways to cope with lifes stressors.
Practicing safer sex practices is another way to reduce the risk of sexually transmitted hepatitis C infection. Use a barrier method like condoms every time you have sex.
Routine hepatitis testing is recommended for people who have had a hepatitis C infection and for those who inject drugs. People who test positive and get prompt treatment can reduce their chances of developing liver disease and liver cancer.
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Medical Treatment For Hepatitis A B & C
Treatment for hepatitis A, B, or C is based on which type of hepatitis is present in the bloodstream and the severity of the resulting liver damage. Depending on the results of diagnostic tests, our specialists at NYU Langone may recommend antiviral medication to stop the virus from replicating and protect your liver from further damage.
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If I Have Hepatitis C Infection Does This Mean I Am Going To Have Other Health Problems
Hepatitis C can cause scarring of the liver leading to cirrhosis and liver cancer. Other conditions have also been linked to hepatitis C and are known as extra-hepatic manifestations of hepatitis C. They include diabetes mellitus, arthritis, hypothyroid, and aplastic anemia among other conditions. Talk to your provider for more information.
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You Might Need To Get Vaccinated Against Hepatitis A And B
Hepatitis A, B, and C are three different viruses that all cause inflammation of the liver. If you have hepatitis C and contract one of the other two hepatitis viruses, your symptoms will be even more severe, says Massoud.
If you havent already been vaccinated against hepatitis A and B and also have cirrhosis, the CDC recommends getting the shots after youve finished your hepatitis C treatment, to prevent additional liver damage.
Reduce Your Chance Of Infection
You can reduce your chance of hepatitis B infection by
- not sharing drug needles or other drug materials
- wearing gloves if you have to touch another persons blood or open sores
- making sure your tattoo artist or body piercer uses sterile tools
- not sharing personal items, such as toothbrushes, razors, or nail clippers
- using a latex or polyurethane condom during sex
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Who Should Get Tested
You should consider getting tested for hepatitis C if youre worried you could have been infected or you fall into one of the groups at an increased risk of being infected.
Hepatitis C often has no symptoms, so you may still be infected if you feel healthy.
Some groups of people are at an increased risk of hepatitis C, including:
- ex-drug users and current drug users, particularly users of injected drugs
- people who received blood transfusions before September 1991 or blood products before 1986 in the UK
- UK recipients of organ or tissue transplants before 1992
- people who have lived or had medical treatment in an area where hepatitis C is common high-risk areas include Africa, the Middle East and central Asia
- babies and children whose mothers have hepatitis C
- anyone accidentally exposed to the virus, such as health workers
- people who have received a tattoo or piercing where equipment may not have been properly sterilised
- sexual partners, family members and close contacts of people with hepatitis C
If you continue to engage in high-risk activities, such as injecting drugs frequently, regular testing may be recommended. Your doctor will be able to advise you about this.
Testing For Hepatitis C
Hepatitis C is usually diagnosed using 2 blood tests: the antibody test and the PCR test. These can be as part of a routine blood test or are often combined as a dried blood spot test. The dried blood spot test is similar to a blood sugar test in pricking the finger to get a blood spot that is put on a testing card. This is then sent to a laboratory to be tested.
Another similar test is an antigen test, which if used can often get the results back in 90 minutes. This is very expensive and not many services have access to the machine needed.
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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.