We Are Going To Beat This
In Tias case, Bordon ran the requested tests. He filed an appeal with the insurance company providing Tias Medicaid coverage.
This is crazy, Tia said as she waited to hear if she would be covered. I called back again and again. How can an insurance company say theyll only cover one treatment in a patients lifetime?
Because she had developed some cirrhosis, a board finally determined she was eligible to receive a second round of treatment. She was sick enough to qualify for Vosevi, a combination of three hepatitis C drugs thats approved for cases like hers.
She started taking it in April and is feeling optimistic. I am hoping my liver will regenerate, she said.
Bordon said indications are that Tias will, and the medication is knocking down the virus, he said. Shell be taking the pills for three months.
Two weeks in, Tia had good news. The virus is almost undetectable, she said.
I feel good, she added. I have a plan. We are going to beat this.
Update: As of July 20, after six weeks of treatment, a blood test could not detect any hepatitis virus in Tias blood.
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How Do You Treat Hepatitis B
Like hepatitis A, medical treatment for acute hepatitis B is focused on getting plenty of rest and fluids and eating a healthy diet, although sometimes antiviral drugs are recommended for severe cases to help prevent liver failure. Patients with chronic hepatitis B may be given an oral antiviral drug to control the viral infection and minimize liver damage. These drugs are effective, but they rarely cure chronic hepatitis B. Therefore, these medications often have to be taken for life.
Hiv And Hepatitis B And Hepatitis C Coinfection
Hepatitis B and hepatitis C are liver infections caused by a virus. Because these infections can be spread in the same ways as HIV, people with HIV in the United States are often also affected by chronic viral hepatitis.
Viral hepatitis progresses faster and causes more liver-related health problems among people with HIV than among those who do not have HIV. Liver disease, much of which is related to HBV or HCV, is a major cause of non-AIDS-related deaths among people with HIV.
Given the risks of hepatitis B or hepatitis C coinfection to the health of people with HIV, it is important to understand these risks, take steps to prevent infection, know your status, and, if necessary, get medical care from a health care provider who is experienced in treating people who are coinfected with HIV and HBV, or HIV and HCV.
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How Is Hepatitis Diagnosed
The first step in diagnosing a hepatitis infection is to receive a medical exam from your doctor. The doctor will perform a physical to look for signs of the illness. All the varieties of hepatitis present with a very similar set of symptoms, which includes:
You may also experience jaundice or a yellowing of the skin and eyes and bowel movements that appear gray. Michael says, Fortunately, most patients are asymptomatic. If you have hepatitis B and its an active condition, meaning youre sick from it, your skin and eyes are going to have a yellow tint.
The doctor will look for these telltale signs and then order blood work to spot the viral load for the type of hepatitis and whether the infection is dormant or active. If the virus is active, you are contagious. The blood test can also determine if the infection is acute or chronic .
If the blood test confirms hepatitis, the doctor may also order an ultrasound of the liver to see if it is inflamed. The ultrasound should also show if the liver is scarred with cirrhosis. You may also have a CT or MRI to look more closely at the liver or signs of liver cancer. This is especially important if you have a family history of the disease.
Finally, in the unusual event that the imaging tests arent shedding light on the situation, the clinician may order a liver biopsy.
What Are The Risk Factors For Hepatitis B And C
Hepatitis B: Although most commonly acquired early in life, adults can also contract it. Hepatitis B is largely transmitted through bodily fluids. It can be passed at birth from a hepatitis B-infected mother or through exposure in early childhood to body fluids, blood or contaminated medical instruments. Hepatitis B can also be transmitted through intranasal and injection drug use as well as infected tools used during tattooing and body piercing.
Hepatitis C: The key risk factors are also intranasal and injection drug use, tattoos and body piercings, high-risk sexual contact, blood transfusions before 1992 and organ transplantation.
Another key risk factor for hepatitis C is being born from 1945 to 1965, during the baby-boom years. Eighty percent of all people who currently have hepatitis C in the United States were born in that timeframe.
Although the reasons that baby boomers are more likely to have hepatitis C than others arent entirely understood, its believed that most were infected in the 1970s and 1980s, when rates of hepatitis C were at their peak.
The Centers for Disease Control and Prevention and the U.S. Preventive Services Task Force recommend that all U.S. adults born from 1945 to 1965 undergo a one-time screening test for hepatitis C. Connecticut is one of several states that has written this recommendation into law. In Connecticut ,the law requires that primary care clinicians screen all adults born within those years.
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Is Hepatitis B Worse Than Hepatitis C
Michael says, At the end of the day, its not which ones worsetheyre both bad. He points out that both can lead to liver cancer if left untreated.
Together, hepatitis B and C account for more than 80% of all liver cancers in the world. However, hepatitis B does seem to be more dangerous in some ways than hepatitis C for several reasons:
- Hepatitis B is certainly more virulent and contagious than hepatitis C.
- Hepatitis B is prevalent around the world and it causes more liver cancer than hepatitis C.
- People with hepatitis B are more likely to die from complications to their liver than people with any of the other hepatitis infections.
When comparing hepatitis B and C, we should note that these viruses attack our cells in completely different ways. Hepatitis C operates in the standard virus way, by invading our cells and reproducing copy after copy of itself until it overwhelms the healthy cells. Hepatitis B, however, goes beyond cloning itself to reproduce and instead inserts itself into the healthy cells DNA. This is a more ominous process because it is much harder to destroy the hepatitis B cell when it takes root at the DNA level.
Additionally, hepatitis C typically causes cirrhosis, which is scarring of the liver that interferes with its function, leading to liver cancer. However, in some cases, hepatitis B can cause liver cancer without any signs of cirrhosis. That can make liver cancer itself difficult to diagnose.
Healthmainare Supplements Really Necessary
They can cause drug toxicity. They can interfere with liver enzymes which can reduce the levels of the drugs. The most common one is St. Johns wort. St. Johns wort is a plant that many people use to treat depression symptoms, but its metabolized in the liver in a way that can interfere with many pharmaceutical drugs.
Tia had no idea that herbal or natural supplements could do this.
It was part of her normal life to take all these supplements, Bordon said.
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How Are Hepatitis B And C Diagnosed
Hepatitis B is diagnosed by a series of blood tests. The test may show an ongoing infection or antibodies that indicate that the patient is protected against hepatitis B. In patients who have a positive screening test that suggests the possibility of ongoing infection, further testing is done to determine the levels of the virus in the bloodstream.
Hepatitis C is diagnosed via a blood test called a Hepatitis C Antibody Test. A positive result means that hepatitis C antibodies are present in the blood. But a positive antibody test doesnt necessarily mean a person has hepatitis C. A further blood test is needed to confirm the diagnosis. This second blood test quantifies the amount of the virus or the viral load in the liver and the bloodstream.
How Long Does It Take To Cure Hepatitis C
Depending on the drug combination, the specific genotype of hepatitis C that is to be treated, any prior treatment, and whether the person has cirrhosis, the duration of medical therapy may be as few as 8 weeks, or up to 24 weeks. Most regimens are for 12 consecutive weeks. This is much shorter than the interferon-based treatments years ago that lasted up to 48 weeks. Generally, a person is not considered cured until the RNA viral load is undetectable for 24 weeks after therapy is stopped. This is called sustained virologic response or SVR.
The presence of cirrhosis or liver fibrosis is determined by liver biopsy, noninvasive fibrosis scans, or formulas that estimate liver fibrosis based on blood tests, such as AST-to-platelet Ratio Index or Fibrosis-4 Index.3
A very important aspect of treatment is the elimination of all alcohol consumption. Alcohol adds fuel to the fire when it comes to chronic hepatitis. Drinking alcohol greatly worsens liver fibrosis and speeds progression to cirrhosis, and there is no safe amount to drink for someone with chronic hepatitis. Drinking alcohol also makes it harder for the medications to be effective and may interfere with proper dosing.
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How Do You Get Hepititis B Or C
You can get hepatitis B or C by coming into contact with the blood or body fluids of someone who has hepatitis B or C.
This can be through:
- sharing toothbrushes, razors, towels, facecloths
- sharing needles or syringes used for skin piercing, tattooing or injecting
- having contact with blood or body fluids
- having sexual contact without condoms
- having contact with cuts or scratches .
How Do You Get Hepatitis B
In the U.S., people usually get hepatitis B infection through sexual transmission or intravenous drug use. In other parts of the world where hepatitis B is more common, such as Southeast Asia, mother-to-child transmission at birth is the most common way people get infected. Unlike hepatitis A infection, hepatitis B has the potential to become a chronic infection that requires lifelong management.
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How Common Are These Diseases In The United States And Around The World
Hepatitis is a very common problem on a global scale, affecting over 240 million people worldwide, according to the World Health Organization. In the United States, approximately 4 million people have chronic Hepatitis, with around 40 thousand new cases of acute Hepatitis being reported each year.
Unfortunately, many cases of acute Hepatitis also go undiagnosed and unreported, leading to an overall total that is likely greater than what we officially know. Further research and development of effective screenings and treatments for this debilitating virus remain crucial to curbing its impact on public health now and in the future.
Now that you know the primary differences between types of Hepatitis, how they’re contracted, and their symptoms, you can better arm yourself against these diseases. Be sure to see a medical professional right away if you think you may have any type of viral Hepatitis so that you can get started on treatment as soon as possible.
There is no one-size-fits-all solution for preventing hepatitis infections since the viruses that cause them are spread in different ways, but being up-to-date on vaccines and practicing safe sex are both good places to start.
Is Everyone Tested For Both Hepatitis B And C
Hepatitis B
The US Centers for Disease and Control recommends testing for certain high-risk groups for hepatitis B.
- High-risk groups include people not born in the US, men who have sex with men, people who inject drugs, and people with hepatitis C, among other groups.
- If you think you have been exposed to hepatitis B, contact your doctor right away. A treatment is available that may reduce your risk of infection if you receive this medicine within 24 hours of exposure to the virus.
Hepatitis C
The CDC recommends that all adults 18 years and older be tested for hepatitis C at least once. Pregnant women should be tested during each pregnancy. Getting tested for hepatitis C is important, because HCV treatments can cure most people in 8 to 12 weeks. If you are at higher risk for HCV, youll need to be tested more frequently.
Treatments for both hepatitis B and hepatitis C are in a class called antivirals, but the medications that are used are different.
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Years Of Declining Treatment Rates
The study had some limitations, including that the findings are not generalizable to people who do not have health insurance or who have disruptions in their coverage. It also did not include information about patients who are incarcerated.
The researchers looked at patients who are diagnosed and have insurance coverage, so in many ways are the individuals who are set up to have the best access to care and treatment, Wester said on a media call Tuesday.
Additionally, the data was not specific enough to describe why each person did not receive treatment. Because the study period overlapped with the Covid-19 pandemic, many people may have been less likely than normal to seek and receive treatment due to disruptions to care. Still, hepatitis C treatment rates have been declining annually since 2015, the CDC said in an email.
It is likely that COVID-19 disruptions played a role in the low treatment numbers in this analysis however, other longer-standing barriers are also at play to prevent access to treatment. These include state Medicaid restrictions on what types of providers can prescribe treatment, patient eligibility restrictions, and prior authorization requirements before treatment can begin, the CDC added. Prior authorization is a process by which insurers review whether a treatment is medically necessary before it agrees to cover a drug.
The A B Cs Of Hepatitis
Hepatitis A
The hepatitis A virus causes acute inflammation of the liver that almost always gets better on its own, although it can be more serious if you get it when you are older or if you already have liver disease. It is easily spread from person to person, in food and water, and can infect many people at once. For example, if a food handler at a restaurant is infected with hepatitis A, those who eat food prepared by that handler may be infected. Hepatitis A can be prevented by getting vaccinated.
Hepatitis B
The hepatitis B virus can be both acute and chronic and is spread through blood or other body fluids in various ways. Hepatitis B is very common in Asia and Africa and those who were born or lived in these areas should be checked for hepatitis B. Like hepatitis A, a vaccine is available to prevent HBV infection as long as you have not been previously exposed. Although chronic HBV cannot be cured, there are oral medications available to treat and control the virus.
Hepatitis C
The hepatitis C virus is almost always chronic and spreads mostly by direct blood to blood contact. Although hepatitis A and B can be prevented by vaccination, hepatitis C cannot. However, there are currently oral medications available that are able to cure Hepatitis C in 95% of all cases regardless of prior treatment history.
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What Are The Symptoms Of Hepatitis B And C
In most patients, hepatitis B develops slowly over the course of several decades, and thus most patients have no symptoms. People who have advanced liver disease such as cirrhosis of the liver may experience complications and symptoms that reflect liver failure. Other symptoms include:
- A buildup of fluid within the abdominal cavity
- Confusion and tremors , which are complications due to the inability of the liver to filter out toxins that are normally cleaned out by a healthy liver
- Vomiting of blood, or blood within the stool . This is a complication in which enlarged veins within the esophagus or stomach bleed as a consequence of increased pressure around the diseased liver.
Most patients with chronic hepatitis C infection report no symptoms. But some patients may have very nonspecific symptoms related to fatigue and discomfort on the right side of the abdomen. Often, symptoms that lead to a diagnosis of hepatitis C are noticeable only at the end stage of liver disease, when the patient has developed liver cirrhosis and liver failure.
Because hepatitis B and C typically have no specific symptoms, many people who have the viruses dont even know it.
Who Should Be Vaccinated
Children
- All children aged 1223 months
- All children and adolescents 218 years of age who have not previously received hepatitis A vaccine
People at increased risk for hepatitis A
- International travelers
- Men who have sex with men
- People who use or inject drugs
- People with occupational risk for exposure
- People who anticipate close personal contact with an international adoptee
- People experiencing homelessness
People at increased risk for severe disease from hepatitis A infection
- People with chronic liver disease, including hepatitis B and hepatitis C
- People with HIV
Other people recommended for vaccination
- Pregnant women at risk for hepatitis A or risk for severe outcome from hepatitis A infection
Any person who requests vaccination
There is no vaccine available for hepatitis C.
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