Should I Be Screened For Hepatitis C
Doctors usually recommend one-time screening of all adults ages 18 to 79 for hepatitis C. Screening is testing for a disease in people who have no symptoms. Doctors use blood tests to screen for hepatitis C. Many people who have hepatitis C dont have symptoms and dont know they have hepatitis C. Screening tests can help doctors diagnose and treat hepatitis C before it causes serious health problems.
Lipids Apolipoproteins And Hcv Pathogenesis
The viral effect on patient serum lipid profile has recently been confirmed in a large scale study in China including 11,000 patients that reported HCV viremia statistically associating with lower serum cholesterol and TG levels . This pathology can also be observed in transgenic mice expressing the HCV polyprotein . Diminished triglyceride levels may also play an important role in the severity of the infection, since an Egyptian study highlighted that high circulating TG levels during acute infection associates with spontaneous clearance of HCV . Moreover, the VLDL-TG to non-VLDL-TG ratio, a measure of the proportion of large TRLs, negatively associated with disease progression patients with more advanced fibrosis were lacking in large TRLs .
Rowell et al. investigated these links clinically by measuring several lipid and lipoprotein parameters including total cholesterol, triglyceride, low-density lipoprotein cholesterol , high-density lipoprotein cholesterol , apoA-I, -B, -CIII, and -E in the sera of patients who both did or did not clear chronic HCV infection. Interestingly, multiple logistic regression analysis revealed diminished serum apoC-III levels to be the factor that most strongly associated with both chronic infection and the increasing severity of hepatic fibrosis. The authors of this study propose that apoC-III levels may potentially act as a possible marker of HCV disease progression .
How Is Hepatitis C Infection Prevented
Unfortunately, there is no vaccine to prevent hepatitis C. To reduce your risk of getting hepatitis C:
- Injection drug use is the most common way people get hepatitis C. Avoid injecting drugs to reduce your risk. If you do inject drugs, use sterile injection equipment. Avoid reusing or sharing.
- Avoid sharing personal care items that might have blood on them
- If you are a health care or public safety worker, follow universal blood/body fluid precautions and safely handle needles and other sharps
- Consider the risks if you are thinking about tattooing, body piercing, or acupuncture are the instruments properly sterilized?
- If youre having sex with more than one partner, use latex condoms correctly and every time to prevent the spread of sexually transmitted diseases, including hepatitis C.
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Treatments For Hepatitis C
Hepatitis C can be treated with medicines that stop the virus multiplying inside the body. These usually need to be taken for several weeks.
Until recently, most people would have taken 2 main medicines called pegylated interferon and ribavirin .
Tablet-only treatments are now available.
These new hepatitis C medicines have been found to make treatment more effective, are easier to tolerate, and have shorter treatment courses.
They include simeprevir, sofosbuvir and daclatasvir.
Using the latest medications, more than 90% of people with hepatitis C may be cured.
But it’s important to be aware that you will not be immune to the infection and should take steps to reduce your risk of becoming infected again.
Limit Your Alcohol Intake
Drinking alcohol can negatively affect an already damaged liver. Its important to decrease the amount of alcohol you consume on a regular basis. Your doctor may even recommend that you refrain from alcohol altogether.
Your liver is the primary organ responsible for metabolizing nutrients and other substances you ingest. If theres too much alcohol in your system, your liver enzymes may be ill-equipped to process it. In turn, the excess alcohol circulates through the rest of your body.
As a rule of thumb, its important to drink in moderation. This equates to two drinks a day for men, and one a day for women .
Still, moderate alcohol consumption can be dangerous when youre living with hepatitis C. Ask your doctor for specific recommendations.
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What Are The Other Health Challenges For People With Hepatitis Who Inject Drugs
People with hepatitis who inject drugs often have several other health conditions at the same time, including mental illness and HIV/AIDS, thus requiring care from multiple health care providers. This is sometimes referred to as co-occurring disorders. Substance use disorder treatment is critical for PWID, as it can reduce risky behaviors that increase the chance of transmitting hepatitis. Research has shown that patients with hepatitis receiving medication-assisted treatment for their opioid addiction can be safely treated with antiviral medications.5
To enhance HCV care, NIDA is examining coordinated care models that utilize case managers to integrate HCV specialty care with primary care, substance use disorder treatment, and mental health services so that these patients get treatment regimens that address all of their health care needs. The Health Resources and Services Administrations Ryan White HIV/AIDS Program developed a free, online curriculum about HIV/hepatitis C for healthcare providers and healthcare staff to increase knowledge about co-infection among people of color in the United States.
Can You Prevent Hepatitis C Infection
Thereâs no vaccine to prevent hepatitis C. To avoid getting the virus:
- Use a latex condom every time you have sex.
- Don’t share personal items like razors.
- Don’t share needles, syringes, or other equipment when injecting drugs.
- Be careful if you get a tattoo, body piercing, or manicure. The equipment may have someone else’s blood on it.
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How Common Is Hepatitis C In The United States
In the United States, hepatitis C is the most common chronic viral infection found in blood and spread through contact with blood.14
Researchers estimate that about 2.7 million to 3.9 million people in the United States have chronic hepatitis C.13 Many people who have hepatitis C dont have symptoms and dont know they have this infection.
Since 2006, the number of new hepatitis C infections has been rising, especially among people younger than age 30 who inject heroin or misuse prescription opioids and inject them.15,16
New screening efforts and more effective hepatitis C treatments are helping doctors identify and cure more people with the disease. With more screening and treatment, hepatitis C may become less common in the future. Researchers estimate that hepatitis C could be a rare disease in the United States by 2036.17
Is Hepatitis Testing Recommended For People With Hiv
Yes. Everyone living with HIV should be tested for HBV and HCV when they are first diagnosed with HIV and begin treatment. People living with HIV who have ongoing risk factors for getting hepatitis B or hepatitis C should be tested annually.
In addition, new HCV screening recommendations from the Centers for Disease Control and Prevention call for:
- One-time screening for all adults 18 years and older
- Screening of all pregnant women during every pregnancy
- Testing for all persons with risk factors, with testing continued periodic testing those with ongoing risk.
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How Does Hepatitis Affect The Body
Typically, symptoms for all types of hepatitis occur once the infection begins causing damage to the liver. In acute cases, symptoms develop quickly and in chronic instances, signs may take up to 6 months to begin showing concern.
General signs and symptoms for acute and chronic hepatitis
All hepatitis types will have the following signs and symptoms in common:
- Flu-like symptoms
- Abdominal pain
- Loss of appetite and unexplained weight loss
- Dark urine
Other signs and symptoms for hepatitis A
- Muscle aches
- Clay-coloured stools
Other signs and symptoms for hepatitis B and D
- Abdominal discomfort
- Tan-coloured stools
All symptom for hepatitis B must be assessed and treated by a medical professional as quickly as possible to prevent an infection developing into HDV and further health complications. If you are exposed to the virus and can seek treatment within the first 24 hours following exposure, an infection can be prevented with prompt medical attention.
A HDV infection may not always display obvious symptoms but when they do, they are very similar to those of hepatitis B. Symptoms of HDV can often make those of HBV worse, which can make diagnosis a little trickier.
Other signs and symptoms for hepatitis C
- Abdominal discomfort
- Itching skin
If there are already signs of damage to your liver, you will display the following symptoms:
Other signs and symptoms for hepatitis E
- Liver enlargement
- Nausea and vomiting
Non-viral hepatitis signs and symptoms
Complications Of Hepatitis C
If the infection is left untreated for many years, some people with hepatitis C will develop scarring of the liver .
Over time, this can cause the liver to stop working properly.
In severe cases, life-threatening problems, such as liver failure, where the liver loses most or all of its functions, or liver cancer, can eventually develop.
Treating hepatitis C as early as possible can help reduce the risk of these problems happening.
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How Does Hepatitis C Affect Your Body
Hepatitis C is an inflammation of the liver. The hepatitis C virus is most often transmitted through infected blood, such as by sharing needles, says Alexander Kuo, MD, medical director of liver transplantation at Cedars-Sinai in Los Angeles.
Sexual transmission is very uncommon, he says. In healthy adults, youre more likely to catch HCV by sharing a toothbrush or razor than through sexual contact. Using barrier methods during sex decreases the risk further.
People who contract HCV often dont realize they have it. During the early stages of infection, the vast majority of people are symptom free, Dr. Kuo says, so it can be difficult to diagnose before it has already done lasting damage to your liver.
People who may have been exposed children of women who have hepatitis C people who have gotten at-home tattoos and those whove used intravenous drugs should get a onetime blood test to screen for HCV even before they experience symptoms, according to the Centers for Disease Control and Prevention . People who actively inject drugs should have routine screenings.
Over time, the chronic inflammation from untreated hepatitis C can lead to fibrosis, or scarring, in the liver. Kuo cautions that if this continues for 20 or more years, there is a risk that the liver can become hard from severe fibrosis, resulting in a condition called cirrhosis.
How Is Hepatitis C Treated
Significant progress has been made in treating and even curing hepatitis C. Older hepatitis C treatments usually required weekly injections, had serious side effects, and often were not effective.
New and better oral medicines now can cure HCV for many people within 3 months. The new medicines were very expensive at first, but their prices have come down, a trend that health experts hope will continue as the incidence of HCV rises and increased screening brings more cases to light.
These medicines successfully cure about 90% of HCV patients. A new oral medicine under development looks promising for the 10% who don’t respond to the standard treatment. This new antiviral combination pill is currently under review by the U.S. Food and Drug Administration .
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Whats The Best Way To Stop The Spread Of Hepatitis A
Hepatitis A vaccination is the best way to prevent hepatitis A. The hepatitis A vaccine is given in 2 doses, usually about 6 months apart.
Other ways to stop the spread of HAV are:
- Always washing your hands with soap and warm water immediately after using the bathroom or changing a diaper
- Always washing your hands with soap and warm water before preparing or eating food
How Should I Take Care Of Myself If I Have Hepatitis C
Good health habits are essential for those who have hepatitis C. You should especially avoid alcohol and medicines and drugs that can put stress on the liver. You should eat a healthy diet and start exercising regularly. Your family doctor can help you plan a diet that is healthy and practical.
Talk to your doctor about any medicines that you are taking, including over-the-counter medicine. Many medicines, including acetaminophen , are broken down by the liver. Because of this, they may increase the speed of liver damage. You should also limit alcohol use. It speeds the progression of liver diseases like hepatitis C. An occasional alcoholic drink may be okay, but check with your doctor first.
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Hepatitis C And Cancer: What To Know
Hepatitis C is one of the leading causes of liver cancer. Its also linked to non-Hodgkins lymphoma, cancer in the bile ducts, and possibly pancreatic and head and neck cancers. And if you already have any other type of cancer, it can cause additional complications. Thats why MD Anderson tests all new patients for hepatitis C.
The good news is that if its found early and treated, hepatitis C can be cured, reducing your risk for cancer and other complications. Thats why hepatitis C screening and treatment is so important.
Unfortunately, an estimated 3.2 million people in the U.S. living with a chronic hepatitis C infection and dont know theyre infected. In many cases, thats because chronic hepatitis C doesnt any symptoms until the liver shows signs of damage.
We talked to Harrys Torres, M.D., associate professor of Infection Diseases and founding director of the hepatitis C clinic at MD Anderson, about what you should know about hepatitis C. Heres what he had to say.
Whats the link between hepatitis C and cancer?
There are two types of hepatitis C:
- acute or short-term hepatitis C, which goes away on its own in less than six months
- chronic hepatitis C, which requires treatment
The reason chronic hepatitis C causes multiple types of cancer is complex and not fully understood. The good news is that in most cases, hepatitis C infection can be cured with medication, and treatment can prevent many associated cancers.
Who is at risk for hepatitis C?
Hepatitis C And Blood Spills
When cleaning and removing blood spills, use standard infection control precautions at all times:
- Cover any cuts or wounds with a waterproof dressing.
- Wear single-use gloves and use paper towel to mop up blood spills.
- Clean the area with warm water and detergent, then rinse and dry.
- Place used gloves and paper towels into a plastic bag, then seal and dispose of them in a rubbish bin.
- Wash your hands in warm, soapy water then dry them thoroughly.
- Put bloodstained tissues, sanitary towels or dressings in a plastic bag before throwing them away.
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Diagnosis Of Hepatitis C
If you are at risk of hepatitis C infection, or think you may have been exposed to hepatitis C in the past, see your doctor for an assessment of your liver health. This will include blood tests and possibly a non-invasive test for liver damage .
There are 2 blood tests used to diagnose hepatitis C. Usually these can be done at the same time but sometimes they will be done separately.
The first test known as a hepatitis C antibody test can tell you whether you have ever been exposed to hepatitis C.
It may take 2 to 3 months from the time of infection until a blood test can detect antibodies to hepatitis C, so there is a window period during which you cannot tell if you are or have been infected. In this time, take precautions to prevent the potential spread of the virus.
The second test is called hepatitis C PCR, which will be done if the antibody test is positive. This determines if the virus is still present in your blood or liver or if you have already cleared the infection.
If you have cleared the virus or had successful treatment to cure it, the PCR test will be negative.
A liver ultrasound or Fibroscan can also be performed to assess if you have any liver damage.
If your doctor is inexperienced in diagnosing hepatitis C you can call the LiverLine on for information, and to find a GP who can help you.
How Can I Cover Medication Costs
New therapies called direct-acting antivirals are effective and can achieve cures of over 90%. 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.
Talk with your healthcare provider about financial support that may be available.
Below are useful resources when looking for financial assistance:Private health insurance or drug plansIf you have private health insurance or a drug plan at work, you may be able to have the medication paid through your plan. Please consult your private health insurance or drug plan provider to see if your drug is covered.
Publicly funded plansEach provincial and territorial government offers a drug benefit plan for eligible groups. Some are income-based universal programs. Most have specific programs for population groups that may require more enhanced coverage for high drug costs. These groups include seniors, recipients of social assistance, and individuals with diseases or conditions that are associated with high drug costs. For more details, please contact your provincial or territorial health care ministry, or click on the appropriate link below.
Available Patient Assistance Programs for Hepatitis C treatment Holkira Pak Maviret
MerckCare Hepatitis C Program 1 872-5773 Zepatier
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How Can I Prevent Spreading Hepatitis C To Others
If you have hepatitis C, follow the steps above to avoid spreading the infection. Tell your sex partner you have hepatitis C, and talk with your doctor about safe sex practices. In addition, you can protect others from infection by telling your doctor, dentist, and other health care providers that you have hepatitis C. Dont donate blood or blood products, semen, organs, or tissue.