Are There Alternative Therapies For The Treatment Of Hepatitis C
Many people who have Hepatitis C choose to follow an alternative method of treatment due to the side effects and costs of current medical therapy. Complementary and Alternative Medicine is chosen as a means of treatment most commonly to boost the immune system, slow disease progression and improve quality of life.
The best CAM route in the treatment of Hepatitis C appears to be the approach that focuses on protecting and supporting the liver and keeping the immune system healthy however, none of these therapies are cures.
Some of the preferred alternative therapies for Hepatitis C include:
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How Long Before I Have Symptoms
Many people have mild symptoms or no symptoms, which is why hepatitis is sometimes called a âsilentâ disease.
Hepatitis A. The symptoms usually show up 2 to 6 weeks after the virus enters your body. They usually last for less than 2 months, though sometimes you can be sick for as long as 6 months.
Some warning signs that you may have hepatitis A are:
Hepatitis B. The symptoms are the same as hepatitis A, and you usually get them 3 months after you’re infected. They could show up, though, anywhere from 6 weeks to 6 months later.
Sometimes the symptoms are mild and last just a few weeks. For some people, the hep B virus stays in the body and leads to long-term liver problems.
Hepatitis C. The early symptoms are the same as hepatitis A and B, and they usually happen 6 to 7 weeks after the virus gets in your body. But you could notice them anywhere from 2 weeks to 6 months later.
For about 25% of people who get hep C, the virus goes away on its own without treatment. In other cases, it sticks around for years. When that happens, your liver might get damaged.
Remember, it’s possible to spread all the types of hepatitis even if you don’t show any signs of being sick.
What Medications Cure Hepatitis C Infection
Interferons, for example, Roferon-A and Infergen, and pegylated interferons such as Peg-IntronT, Pegasys, were mainstays of treatment for years. Interferons produced sustained viral response of up to 15%. Later, peglatedll forms produced SVR of 50%-80%. These drugs were injected, had many adverse effects, required frequent monitoring, and were often combined with oral ribavirin, which caused anemia. Treatment durations ranged up to 48 weeks.
Direct-acting anti-viral agents are antiviral drugs that act directly on hepatitis C multiplication.
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Questions For Your Doctor
When you visit the doctor, you may want to ask questions to get the information you need to manage your hepatitis C. If you can, have a family member or friend take notes. You might ask:
Is It Possible To Become Infected With More Than One Genotype Of Hepatitis C
Superinfection is possible if risk behaviors for Hepatitis C infection continue. A reasonable path for the highly mutable Hepatitis C virus, superinfection is when a cell previously infected by one virus becomes co-infected with a different strain of the virus. Unfortunately, viral superinfections are common causes of treatment resistance where a previously effective therapy loses its efficacy. In addition, superinfections have been known to reduce the overall effectiveness of the immune response.
Through studies conducted on intravenous drug users , researchers concluded that Hepatitis C re-infection and superinfection are common among actively injecting drug users.
Rare cases of sexually transmitted Hepatitis C superinfection in HIV/Hepatitis C virus-co-infected patients with high-risk sexual behavior have been reported. The patients had chronic Hepatitis C and a history of sexually transmitted infections. No risk factors for Hepatitis C were found except unprotected anal sex with multiple casual male partners.
Hepatitis C-infected kidneys transplanted into Hepatitis C-infected recipients have been shown to cause superinfection.
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What The Cdc Recommends
Were you born between 1945 and 1965? If so, then youre a member of the Hepatitis C generation. The CDC recently recommended that all people born between during this time have a 1-time screening test for Hepatitis C. We now have new drugs that can treat and cure Hepatitis C so you should go get tested today.
The life you save may be your own! Please contact your local healthcare provider.
How Genotypes Affect Treatment
Medications known as direct acting antivirals, or DAAs, stop the hep C virus from making copies of itself. Some DAAs appear to work well on all hepatitis C genotypes. Others work on only one or some.
Your doctor will probably prescribe some combination of these medications:
Some pills combine two drugs into one pill.
You’ll probably take these meds for anywhere from 8 to 12 weeks. But they may not be right for everyone because of things like cost or other illnesses.
Your specific genotype can tell your doctor important things about how to use those medications, what to watch for, and other drugs you might need.
For example, you may have a higher chance for cirrhosis if you have genotype 1.
Genotype 3, the second most common subtype worldwide, may not respond as well to DAAs alone. In addition, this type might suggest that:
- Liver cancer is more likely.
- Insulin resistance might happen. When your body resists or doesn’t respond to insulin as well as normal, you have a higher chance of heart disease and diabetes.
- You might need longer, more challenging treatment
Your doctor might adjust or change your DAA treatment if you have:
American Association for the Study of Liver Diseases: âInitial Treatment of Adults with HCV Infection,â âHCV Guidance: Recommendations for Testing, Managing, and Treating Hepatitis C.â
CDC: âHepatitis C Questions and Answers for the Public.â
Infohep.org: âHepatitis C treatment factsheet: Harvoni .â
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How Do People Get Hepatitis C
Hepatitis C virus is found in the blood of people with HCV infection. It enters the body through blood-to-blood contact.
Until reliable blood tests for HCV were developed , people usually got hepatitis C from blood products and blood transfusions. Now that blood and blood products are tested for HCV, this is no longer the typical means of infection.
Currently, people usually get hepatitis C by sharing needles for injection drug use. An HCV-infected woman can pass the infection to her baby during birth. It is also possible to get hepatitis C from an infected person through sexual contact, an accidental needlestick with a contaminated needle, or improperly sterilized medical, acupuncture, piercing, or tattooing equipment.
Which Treatment Works For Each Genotype
- All Genotypes: see Epclusa fact sheet
- Genotypes 1 through 4: see Sovaldi, Viekira XR and Technivie, Harvoni, Olysio fact sheets
- Genotypes 1 or 4: see Zepatier fact sheet
- Genotypes 2 or 3: see Sovaldi, Daklinza fact sheets
- Genotype 6: see Harvoni fact sheets
Ribavirin causes birth defects and miscarriage. HCV treatment regimens that include RBV should not be used by pregnant women or by male partners of pregnant women. RBV stays in a persons body for months, so women and their male partners should avoid pregnancy until six months after stopping it .
This fact sheet is current as of December 2016. It is recommended to be read alongside the Adherence and HCV Diagnostics fact sheets. Always check for updated information.
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If I Have Hepatitis How Can I Avoid Giving It To Someone Else
For hepatitis A, one of the best things you can do is wash your hands a lot. That will keep the virus out of food and drinks.
If you have hepatitis B and C, you need to find ways to keep others from making contact with your blood. Follow these tips:
- Cover your cuts or blisters.
- Carefully throw away used bandages, tissues, tampons, and sanitary napkins.
- Don’t share your razor, nail clippers, or toothbrush.
- If your blood gets on objects, clean them with household bleach and water.
- Don’t breastfeed if your nipples are cracked or bleeding.
- Don’t donate blood, organs, or sperm.
- If you inject drugs, don’t share needles or other equipment.
How Is Hepatitis C Treated
There is no vaccine for hepatitis C. The aim of treatment for hepatitis C is to eradicate the virus from the blood completely, and to protect the liver from developing cirrhosis or liver cancer.
Several medications are available to treat hepatitis C. The hepatitis C virus has six different types or strains . The type and length of treatment may vary. Some hepatitis strains do not respond to antiviral medications as well as others. Some medications may not be suitable for all patients with hepatitis C, because of the side effects or the patients other medical conditions.
These are the medications approved for treatment of hepatitis C infection:
- Sofosbuvir : Tablet taken once a day. Used in combination with other antiviral drugs.
- Ledipasvir/sofosbuvir : Pill taken once a day for 12 to 24 weeks, depending on how serious the disease is.
- Simeprevir : Capsule taken once a day with other medications called peginterferon alfa and ribavirin
- Combination of paritaprevir/ombitasvir/ritonavir/dasabuvir
- Daclatasvir : Used in combination with other drugs
- Elbasvir/grazoprevir : Tablet taken once a day
- Sofosbuvir/velpatasvir : Tablet taken once a day
- Glecaprevir/pibrentasvir : Three pills a day in one dose
- Sofosbuvir/velpatasvir/voxilaprevir : Tablet taken once a day
- Ombitasvir/paritaprevir/ritonavir : Two tablets once a day in the morning, in combination with ribavirin
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Cost Of Hepatitis C Medicines
The newer direct-acting antiviral medicines for hepatitis C can be costly. Most government and private health insurance prescription drug plans provide some coverage for these medicines. Talk with your doctor about your health insurance coverage for hepatitis C medicines.
Drug companies, nonprofit organizations, and some states offer programs that can help pay for hepatitis C medicines. If you need help paying for medicines, talk with your doctor. Learn more about financial help for hepatitis C medicines.
How Do Doctors Treat Hepatitis C
Doctors treat hepatitis C with antiviral medicines that attack the virus and can cure the disease in most cases.
Several newer medicines, called direct-acting antiviral medicines, have been approved to treat hepatitis C since 2013. Studies show that these medicines can cure chronic hepatitis C in most people with this disease. These medicines can also cure acute hepatitis C. In some cases, doctors recommend waiting to see if an acute infection becomes chronic before starting treatment.
Your doctor may prescribe one or more of these newer, direct-acting antiviral medicines to treat hepatitis C:
You may need to take medicines for 8 to 24 weeks to cure hepatitis C. Your doctor will prescribe medicines and recommend a length of treatment based on
- which hepatitis C genotype you have
- how much liver damage you have
- whether you have been treated for hepatitis C in the past
Your doctor may order blood tests during and after your treatment. Blood tests can show whether the treatment is working. Hepatitis C medicines cure the infection in most people who complete treatment.
Hepatitis C medicines may cause side effects. Talk with your doctor about the side effects of treatment. Check with your doctor before taking any other prescription or over-the-counter medicines.
For safety reasons, talk with your doctor before using dietary supplements, such as vitamins, or any complementary or alternative medicines or medical practices.
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Does Genotype Predict Response To Daa Therapy Like It Did For Interferon Therapy
Maybe maybe not.
Each of HCVs essential proteins work the same, regardless of genotype. These essential proteins may be structurally different due to small mutations.
Because theyre essential for the HCV life cycle, the structure of their active sites is least likely to change due to random mutation.
Because a proteins active site is relatively consistent between different genotypes, how well a particular DAA agent works is affected by where it binds on the target protein.
The effectiveness of those agents that bind most directly to the proteins active site is least likely to be affected by virus genotype.
All DAA drugs suppress ongoing HCV replication, but they dont eject the virus from its host cell. They also dont remove infected cells. This job is left to the persons immune system.
The variable effectiveness of interferon treatment indicates that the immune system is able to clear cells infected with some genotypes better than those infected by others.
Aside from genotype, there are many variables that can affect the likelihood of treatment success. Some of the more significant ones include:
- amount of HCV virus in your blood
- severity of liver damage before treatment
- the condition of your immune system
- ongoing alcohol misuse
- response to prior therapies
Certain human genes can also predict how well treatment may work. The human gene known as IL28B is one of the strongest predictors of response to PEG/ribavirin treatment in people with HCV genotype 1.
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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Is Screening For Hepatitis C Recommended During Pregnancy
There is a 4%-7% risk of transmitting HCV from mother to infant with each pregnancy. Currently, there is no CDC recommendation for routine hepatitis C screening during pregnancy, and there is no currently recommended medicine to prevent transmission from mother to infant . However, CDC is monitoring research findings and may make recommendations in the future as evidence arises.
While data is still limited, a recent study of over 1,000 cases in the United Kingdom found that 11% of infants had been infected at birth, and that these infants were likely to develop cirrhosis in their early 30s. The case for screening for HCV during pregnancy includes the potential to safely treat mothers during pregnancy with direct-acting antiviral agents to treat the mother before cirrhosis develops, prevent infant transmission, and prevent transmission to others. Children born to HCV-infected mothers may also be offered treatment at an early age to prevent cirrhosis, as well as transmission to others. Coordination of care between multiple specialists will be important to accomplish these goals.
Children of HCV-infected mothers may be screened for hepatitis C as early as 1-2 months of age using hepatitis C viral load or PCR testing . Antibodies to hepatitis C passed from the mother to child will be present for up to 18 months, so children should be tested for HCV antibody no earlier than this.
What Are The Risk Factors For Hepatitis C
In the United States, having been born between 1945 and 1965, and the use of illicit injection drugs are the two most common factors associated with hepatitis C. Other risk factors include:
- having received blood transfusions prior to 1990,
- hemodialysis, and
- having greater than 10-lifetime sex partners.
Population studies show that hepatitis C is more common among males, non-Hispanic blacks, those with low income, and those with less than a high school education.
People who have HIV/AIDS have an increased risk for hepatitis C, because both these diseases are transmitted in the same ways, through blood and body fluids. If someone has both infections, that person is said to be co-infected with HIV and HCV.
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How Is Hepatitis C Spread
Hepatitis C spreads through contact with the blood of someone who has HCV. This contact may be through:
- Sharing drug needles or other drug materials with someone who has HCV. In the United States, this is the most common way that people get hepatitis C.
- Getting an accidental stick with a needle that was used on someone who has HCV. This can happen in health care settings.
- Being tattooed or pierced with tools or inks that were not sterilized after being used on someone who has HCV
- Having contact with the blood or open sores of someone who has HCV
- Sharing personal care items that may have come in contact with another person’s blood, such as razors or toothbrushes
- Being born to a mother with HCV
- Having unprotected sex with someone who has HCV
Before 1992, hepatitis C was also commonly spread through blood transfusions and organ transplants. Since then, there has been routine testing of the U.S. blood supply for HCV. It is now very rare for someone to get HCV this way.