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.
Baby Boomers Are Especially Vulnerable
“The hepatitis C virus didn’t have a name or a screening test until in 1989,” Reau says. “That means people born between 1945 and 1965, the group referred to as ‘baby boomers,’ are at highest risk of infection. They grew up before health care facilities started taking standard precautions, like not sharing vials of medicine among patients and requiring staff to wear gloves.”
The CDC reports that baby boomers are five times more likely to have Hepatitis C than other adults, accounting for 75% of those living with the disease.
These are some other reasons you may be at risk:
- You have engaged in high-risk behaviors like IV drug use or unprotected sex
- Your biological mother has/had hepatitis C
- You received blood transfusions, an organ transplant or dialysis before 1989
- You were or are currently incarcerated
Contaminated Needles And Infected Blood
You can get hepatitis C from sharing contaminated needles, syringes and other injecting equipment during recreational drug use. Banknotes and straws used for snorting may also pass the virus on.
Being exposed to unsterilised tattoo and body piercing equipment can also pass hepatitis C on. Occasionally, you can get it from sharing a towel, razor blades or a toothbrush if there is infected blood on them.
Hepatitis C infection is also passed on in healthcare settings, from needle stick injuries or from medical and dental equipment that has not been properly sterilised. In countries where blood products are not routinely screened, you can also get hepatitis C by receiving a transfusion of unscreened blood and blood products.
You can prevent hepatitis C by:
- never sharing needles and syringes or other items that may be contaminated with infected blood
- only having tattoos, body piercings or acupuncture in a professional setting, where new, sterile needles are used
- following the standard infection control precautions, if youre working in a healthcare 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.
Patients With Resolved Hepatitis C Likely Still Contagious
- Patients with chronic hepatitis C that has been resolved through therapy or immune response may still be able to infect others with the virus.
Patients with chronic hepatitis C that has been resolved through therapy or immune response may still be able to infect others with the virus.
About 170 million people worldwide are infected with hepatitis C virus, which can progress to chronic hepatitis, cirrhosis and even liver cancer. In some individuals, the infection seems to resolve, either spontaneously from the efforts of the immune system, or after treatment with interferon and ribavirin.
Patients who achieve a sustained viral response show no clinical or biochemical evidence of liver disease and standard tests can no longer detect the virus in their blood. However, more sensitive research tests are finding that such patients often still have miniscule amounts of the virus in their bodies. No one knows if these trace remainders are infectious.
Researchers led by Tomasz I. Michalak of Memorial University of Newfoundland, Canada examined this question using a system that allows for propagation of HCV in human T cells in vitro.
They began with nine patients with HCV who had achieved a sustained viral response that persisted for at least two years after treatment. HCV RNA was detectable in their blood only with the more sensitive tests.
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How Is Hepatitis C Spread
The hepatitis C virus is spread through contact with infected blood and bodily fluids, such as semen and vaginal fluid. You will only be infected if the virus enters your bloodstream.
In Canada, most people are infected by:
- using or sharing drug paraphernalia contaminated with infected blood, including:
If you have hepatitis C, you can pass the virus to your baby during:
- breastfeeding if your nipples are cracked and bleeding, and your baby also has bleeding in or on the mouth
- it can be hard to tell if a baby has bleeding in or on the mouth
- cracked nipples may not be bleeding but may begin to during breastfeeding
You can also be infected if you receive contaminated:
- blood products
Although rare, hepatitis C can also be spread through unprotected sex especially if it involves blood contact, such as:
- contact with:
- open sores, cuts or wounds
- semen or vaginal fluid if blood is present
Unprotected sex means having sex without using a condom or other barrier safely.
Hepatitis C is not spread through:
- breast milk
How It’s Passed On
The hepatitis C virus is found in blood and is passed on when infected blood gets into another persons bloodstream. Its seen as unlikely that it can be passed on in semen.
Most people get the virus from sharing drug injecting equipment such as needles, syringes, water cups, tourniquets, spoons, filters and swabs. Sharing things like straws and banknotes that are used for snorting drugs might pass the virus on, as can sharing pipes.
In the UK piercing and tattooing should be safe but unsterilised equipment abroad can spread the virus.
An infected person risks infecting others if they share anything that might have blood on it like a toothbrush or razor. A pregnant woman with the virus can give it to her baby during pregnancy or childbirth.
Blood transfusions in the UK are safe as blood is screened.
You can also potentially get it from medical or dental treatment abroad in countries where hepatitis C is common and infection control is inadequate.
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How Can I Protect Myself From Hepatitis C Infection
If you dont have hepatitis C, you can help protect yourself from hepatitis C 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 and unopened ink
- not sharing personal items such toothbrushes, razors, or nail clippers
Hepatitis C can spread from person to person during sex, but the chances are low. People who have multiple sex partners, have HIV or other sexually transmitted diseases, or who engage in rough or anal sex have a higher chance of getting hepatitis C. Talk with your doctor about your risk of getting hepatitis C through sex and about safe sex practices, such as using a latex or polyurethane condom to help prevent the spread of hepatitis C.
If you had hepatitis C in the past and your body fought off the infection or medicines cured the infection, you can get hepatitis C again. Follow the steps above, and talk with your doctor about how to protect yourself from another hepatitis C infection.
If you think you may have been exposed to the hepatitis C virus, see your doctor as soon as possible. Early diagnosis and treatment can help prevent liver damage.
What Does It Mean When Different Types Of Blood Tests For Hepatitis C Give Different Results
The first test your provider probably will perform is called an “antibody” test. A positive result means that you were exposed to the hepatitis C virus at some point in your life.
If the result is positive, your provider will perform a second test called hepatitis C virus RNA to see if the virus is still in your body. If the RNA test result is positive, then you have chronic hepatitis C infection.
So what does it mean if you have a positive result for the first test but a negative result for the second?
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The Types Of Viral Hepatitis
There are five main types of viral hepatitis known as hepatitis A , hepatitis B , hepatitis C , hepatitis D , and hepatitis E . That said, there have been cases of acute hepatitis that could not be attributed to one of these five types of hepatitis viruses, alcohol, drugs, or autoimmune disease, which lead researchers to try to find another cause.
Though the etiology of these viruses have not yet been fully established, researchers have identified three other types of viral hepatitis , which they have named hepatitis F , hepatitis G , and transfusions transmitted virus . As relatively new diseases and viral discoveries, information about them and how they work is relatively scarce. We do know, however, that cases of TTV have only been associated with hepatitis in people who have had a blood transfusion.
Hepatitis C And Pregnancy: What To Know
Unfortunately, theres no way to prevent the spread of the hepatitis C virus to an unborn baby, per past research.
If youre infected, theres about a 1 in 20 chance that youll pass the virus to your child during delivery.
If youre thinking about getting pregnant, talk to your doctor. Although treatment during pregnancy isnt recommended, antiviral treatment prior to getting pregnant can help clear the virus from your body and lower the risk of mother-to-child transmission, notes the American Association for the Study of Liver Diseases. About 90 percent of those infected are cured after 8 to 12 weeks of antiviral therapy.
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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.
Is It Safe To Take Aspirin Or Tylenol If I Have Hepatitis C
Tylenol is an over-the-counter pain killer. It can be harmful in high doses. If you have hepatitis or liver disease, then you can take Tylenol, but no more than 2,000 mg total over 24 hours. In general, this could be one 500 mg tablet every 6 hours, at the most. Acetaminophen is also included as an ingredient in some opiate medications and in some over-the-counter cold/flu medications, so please be aware of the dose of acetaminophen you may be taking from some combination medicines.
Aspirin, ibuprofen , naproxen , and other nonsteroidal anti-inflammatory drugs , can be harmful if you have cirrhosis. They are safe in hepatitis patients who do not have cirrhosis. But, if a patient has cirrhosis, then NSAIDs cannot be taken at all. If you are not sure, always check with your provider.
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Tips For Preventing Transmission Through Sex
If youre sexually active with a person who has hepatitis C, there are ways that you can prevent contracting the virus. Likewise, if you have the virus, you can avoid infecting others.
A few steps you can take to reduce the likelihood of sexual transmission include:
- using a condom during every sexual contact, including oral sex
- learning to use all barrier devices correctly to prevent ripping or tearing during intercourse
- resisting engaging in sexual contact when either partner has an open cut or wound in their genitals
- being tested for STIs and asking sexual partners to be tested too
- practicing sexual monogamy
- using extra precautions if youre HIV-positive, as your chance of contracting HCV is much higher if you have HIV
If you have hepatitis C, you should be honest with all sexual partners about your status. This ensures that youre both taking the proper precautions to prevent transmission.
Direct Exposure To Blood
Exposure to large amounts of contaminated blood increases the risk for hepatitis C transmission. If you get a cut and need help tending it, whoever helps you should first put on disposable gloves to prevent exposure in case he or she has a cut. You can also help prevent hepatitis C transmission by covering any cuts or sores with bandages until theyre healed and disposing of used bandages properly.
Uninfected people should take steps to avoid getting someone elses blood in their eyes, nose, and mouth. If an uninfected persons skin is exposed to contaminated blood, wash the area with soap and water immediately. If blood gets in the eyes, rinse them with running water right away and call a doctor to find out about further steps that should be taken.
When cleaning blood from surfaces, Dr. Lee recommends using a solution of one part bleach to 10 parts water. Dried blood should also be handled with care because the virus can live for several days outside the body.
The CDC recommends that if youve ever tested positive for hepatitis C, you should abstain from donating blood, organs, or semen.
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Five Ways Hepatitis C Can Be Spread
If you want to get a tattoo, make sure to get it from an established and safe place, and make sure they use a different needle in each customer, says Sashini Seeni MD, a general practitioner of medicine at DoctorOnCall, an online doctor consultation platform. The tattoo artist should wear gloves, and the surroundings and equipment should be cleaned and sterilized, she further notes.
Also, make sure the tattoo parlor is licensed. You can check with your local or state health department for licensing information, and only use parlors that come recommended by friends and family.
Dont be afraid to ask questions about safety measures. How do they sterilize their counters, tables, chairs, and equipment? Do they use a bleach-based disinfectant? A reputable tattooist shouldnt have an issue answering your questions.
If you detect annoyance or attitude from the tattooist, follow your gut and get out. Also, speak up if you dont see your tattoo artist apply a fresh pair of disposable gloves, or if they dont open a new pack of needles or pigment trays in your presence. If needles and pigment trays arent sealed, ask for a fresh one.
How Do Doctors Treat The Complications Of Hepatitis C
If hepatitis C leads to cirrhosis, you should see a doctor who specializes in liver diseases. Doctors can treat the health problems related to cirrhosis with medicines, surgery, and other medical procedures. If you have cirrhosis, you have an increased chance of liver cancer. Your doctor may order an ultrasound test to check for liver cancer.
If hepatitis C leads to liver failure or liver cancer, you may need a liver transplant.
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Enteric Routes: Transmission Of Hepatitis A And Hepatitis E
The Hepatitis A and hepatitis E viruses are both transmitted by enteric, that is digestive or by fecal, routes. This is also known as the fecal-oral route. To be exposed to these viruses, you must ingest fecal matter that is infected with the virus. While there are several ways in which this fecal-oral route can be established, poor hygiene and poor sanitary conditions in some countries lead to higher rates of infection of these viruses.
As a result, some areas of the world, like India, Bangladesh, and Central and South America, are particularly prone to the hepatitis E virus. About one-third of people in the United States have been exposed to the hepatitis A virus.
It is believed that the hepatitis F virus may also be spread by enteric routes.
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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