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.
Antiviral Treatment And Risk Of Hepatocellular Carcinoma Development
At the present time, there are no therapies to eliminate HBV infection. IFN can cure CHB in 315% of patients, but has severe side effects and is rarely used. Nucleoside analogues inhibit reverse transcription and limit HBV replication in more than 95% of treated patients and reduce liver inflammation, disease progression and HCC risk. However, these drugs have no effect on viral cccDNA or integrated copy numbers and require long-term administration. Current guidelines recommend antiviral treatment only when serum HBV-DNA levels are greater than 103 copies ml1 and significant inflammatory activity indicated by increased aminotransferase activity in blood or advanced fibrosis has been diagnosed.
It has, however, become clear that even the successful DAA therapies for CHC will not be able to eliminate the risk of HCC once high-grade fibrosis or cirrhosis has developed. DAA- and IFN-based regimens showed a considerably reduced, but still remaining risk for HCC after HCV cure and highlight the importance of surveillance once liver cirrhosis has developed irrespective of therapy responses . Nevertheless, in countries in which the new DAA therapies are accessible, high rates of SVR and eradication of HCV will have a huge impact on cirrhosis and also HCC incidence in the coming decade.
Liver Cirrhosis And Hepatitis
Hepatitis is a general term meaning inflammation of the liver. Viral hepatitis is hepatitis caused by a virus like the hepatitis B or C virus. Chronic hepatitis C is a common cause of liver cirrhosis. Hepatitis B can also cause cirrhosis. With either of these conditions, you increase your risk of developing cirrhosis if you drink alcohol.
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What Type Of Healthcare Providers Will Treat My Cirrhosis
Depending on the stage of your cirrhosis, different healthcare providers may be involved in your care. Healthcare professionals likely to be part of your care team include:
- Your primary care provider.
- Gastroenterologist .
- Hepatologist .
- Nephrologist .
- Members of a liver transplant team include: hepatologist, transplant surgeon, anesthesiologist, infectious disease specialist, nephrologist, dietitian, transplant pharmacist, physical and occupational therapist, case manager/social worker and nurses.
A note from Cleveland Clinic
Cirrhosis of the liver is a late-stage result of liver disease and its complications. Cirrhosis causes your liver to not function properly. Your liver plays a vital role in many of the processes and functions that keep you alive.
Although scarring from liver disease causes permanent damage, its still possible to live a long life. Depending on the underlying cause, its possible to slow or stop cirrhosis from worsening. Many of the causes and complications that lead to cirrhosis are treatable or manageable. If you drink alcohol, stop. If you have nonalcoholic fatty liver disease, lose weight and control your metabolic risk factors. If you have diabetes, make sure you are following your healthcare providers management recommendations. Take all medications for all your medical conditions as directed by your healthcare team. Get vaccinated for hepatitis A and B.
Last reviewed by a Cleveland Clinic medical professional on 11/01/2020.
Sof Plus Ledipasvir Rbv
Ledipasvir is a NS5A inhibitor with potent antiviral activity against HCV genotype 1a and 1b. Inhibition of NS5A viral phosphoprotein leads to disruption in viral replication, assembly and secretion. Most drug interactions with ledipasvir involve drugs that are Pgp-inducers such as rifampin or St. Johns wort. The following studies evaluated the use of ledipasvir in combination with SOF.
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Hepatitis C Can Be Invisible
There may be few symptoms after initial HCV infection. Many people with hepatitis C dont even know they have the life-threatening disease.
HCV attacks the liver. Many people exposed develop a chronic infection after initial infection with HCV. Chronic HCV infection slowly causes inflammation and damage in the liver. Sometimes the condition may not be diagnosed for 20 or 30 years.
- yellow discoloration in eyes and skin
- swelling in legs
- abnormal blood tests, such as bilirubin, albumin, and coagulation parameters
- enlarged veins in the esophagus and upper stomach that may bleed
- impaired mental function due to buildup of toxins
- infection of the abdominal lining and ascites
- combined kidney and liver failure
A liver biopsy will show scarring, which can confirm the presence of cirrhosis in people with HCV.
Lab tests and a physical exam may be enough for your doctor to diagnose advanced liver disease without a biopsy.
Less than a quarter of people with HCV will develop cirrhosis. But, certain factors can increase your risk of cirrhosis, including:
- alcohol use
- infection with HCV and another virus
- high levels of iron in the blood
Anyone with chronic HCV infection should avoid alcohol. Cirrhosis can also accelerate in people older than 45 as fibrosis and scarring increase. Aggressively treating HCV infection in younger people may help prevent progression to cirrhosis.
Its important to stay healthy if you have cirrhosis. Be sure to keep all immunizations up to date, including:
Cirrhosis And Hepatitis C: Their Connection Prognosis And More
Hepatitis C can lead to cirrhosis
Over years, HCV infection can cause major damage to the liver. For every 75 to 85 people who have chronic HCV infection, between
Over time, inflammation in the liver causes scarring and permanent damage . At the point of cirrhosis, the liver is unable to heal itself. Cirrhosis can lead to:
- end-stage liver disease
There are two stages of cirrhosis:
- Compensated cirrhosis means the body still functions despite reduced liver function and scarring.
- means that liver functions are breaking down. Serious symptoms may occur, like kidney failure, variceal hemorrhage, and hepatic encephalopathy.
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Recommended Hcv Treatment With Compensated Cirrhosis
For individuals with compensated cirrhosis , including those with hepatocellular carcinoma, the AASLD-IDSA HCV Guidance provides recommendations for initial treatment and retreatment . Although the treatment recommendations for persons with and without cirrhosis have significant overlap, there are, in some instances, key differences in the recommended regimens, duration of therapy, or inclusion of ribavirin. Thus, when treating HCV in persons with compensated cirrhosis, it should not be assumed the treatment is the same as those without cirrhosis and AASLD-IDSA treatment guidelines should be closely checked and followed.
What Exactly Is Liver Cirrhosis
This is a late-stage liver disease thats very serious and develops over a long period of time. In fact, its possible to have liver cirrhosis for several years without experiencing any symptoms. This is related to how serious your condition is.
The first stages of the liver disease result in something called fatty liver. This involves extra fat in the vital organ. However, over time this condition can develop into more serious stages. The most serious stage is known as live cirrhosis.
Its important to get treatment for the liver condition to help prevent the symptoms from getting worse. Here are some symptoms of liver cirrhosis early stages:
- Black stools
- Uncontrollable shaking.
Liver cirrhosis is often linked to alcoholism. However, there are also non-alcoholic causes of liver disease/cirrhosis. When a person experiences cirrhosis their liver isnt functioning properly. The liver has several functions including producing enzymes for food digestion, removing toxins from the blood, and battling infections.
The liver can normally repair itself and make strong scar tissue. However, when theres a scar tissue buildup the organ is unable to work properly. This results in liver cirrhosis.
Its important to know the main causes of liver cirrhosis. They include obesity, hepatitis B/C infections, and heavy drinking of alcoholic beverages. There are also other conditions that might boost your risk of cirrhosis. They include:
- Iron buildup
- Digestion problems
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What Causes Hepatitis C
The hepatitis C virus causes hepatitis C. The hepatitis C virus spreads through contact with an infected persons blood. Contact can occur by
- sharing drug needles or other drug materials with an infected person
- getting an accidental stick with a needle that was used on an infected person
- being tattooed or pierced with tools or inks that were not kept sterilefree from all viruses and other microorganismsand were used on an infected person before they were used on you
- having contact with the blood or open sores of an infected person
- using an infected persons razor, toothbrush, or nail clippers
- being born to a mother with hepatitis C
- having unprotected sex with an infected person
You cant get hepatitis C from
- being coughed or sneezed on by an infected person
- drinking water or eating food
- hugging an infected person
- shaking hands or holding hands with an infected person
- sharing spoons, forks, and other eating utensils
- sitting next to an infected person
A baby cant get hepatitis C from breast milk.18
What Is Hepatitis Cirrhosis
Hepatitis C is relatively common and affects 1% of the USA population, for example. One possible problem is that many people dont know that they have a serious disease. HCV can do liver damage over the years. In fact, nearly 25% of all people with HCV will get liver cirrhosis. In fact, its the top cause of liver cancer.
The human liver has important functions like making nutrients and blood detox. Various things can damage the liver including heavy alcohol drinking, hepatitis, and parasites.
As time passes liver inflammation can cause various issues like major scarring . There are 4 stages of this condition and it can cause various health issues like liver failure and liver cancer.
The good news is under one-quarter of HCV patients will get cirrhosis. However, there are various factors that can boost your cirrhosis risk including alcohol use, HCV virus, and high iron in the blood.
If you have liver cirrhosis there are four different stages. The first stage doesnt include complications. However, Stages 2, 3, 4 includes more tissue scarring and can result in different complications including diabetes, gum disease, and medication processing.
During the early stages, you can use prescription medicines to treat cirrhosis. They might slow down the speed of liver disease/failure. However, if the disease becomes more advanced then treatment becomes tougher due to various complications including anemia , ascites , and HE .
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How Is Cirrhosis Treated
- Medicines may be used to treat high blood pressure in the portal vein . You may also need medicine to decrease extra fluid that collects in an area such as your legs or abdomen. Medicines may be used to decrease itching, or to treat a bacterial or viral infection.
- Surgery may be used to create a channel inside your liver to increase blood flow. This will help decrease swelling in your abdomen and lower blood pressure in the portal vein. Your risk for bleeding in your esophagus and stomach will also be decreased. You may need a liver transplant if your liver fails.
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:
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What Are The Symptoms Of Cirrhosis
The symptoms of cirrhosis depend on the stage of your disease. In the beginning stages, you may not have any symptoms. If you do have symptoms, some are general and could easily be mistaken for symptoms of many other diseases and illnesses.
Early symptoms and signs of cirrhosis include:
- Loss of appetite.
- Redness in the palms of your hands.
- Spider-like blood vessels that surround small, red spots on your skin .
- In men: loss of sex drive, enlarged breasts , shrunken testicles.
- In women: premature menopause .
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.
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When Should I Call 911 Or Go To The Emergency Room
If you have cirrhosis and experience the following, call 911:
- Your poop are black and tarry or contain blood .
- You are vomiting blood.
- You have muscle tremors or shakiness.
- You are confused, irritable, disoriented, sleepy, forgetful or foggy.
- You have a change in your level of consciousness or alertness you pass out.
Cirrhosis Of The Liver
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How Do You Get Hepatitis C
Hepatitis C spreads when blood or body fluids contaminated with the hepatitis C virus get into your bloodstream through contact with an infected person.
You can be exposed to the virus from:
- Sharing injection drugs and needles
- Having sex, especially if you have HIV, another STD, several partners, or have rough sex
- Being stuck by infected needles
- Birth — a mother can pass it to a child
- Sharing personal care items like toothbrushes, razor blades, and nail clippers
- Getting a tattoo or piercing with unclean equipment
You canât catch hepatitis C through:
- Casual contact
- Have been on long-term kidney dialysis
- Have abnormal liver tests or liver disease
- Have HIV
- Were born to a mother with hepatitis C
Since July 1992, all blood and organ donations in the U.S. are tested for the hepatitis C virus. The CDC says it is now rare that someone getting blood products or an organ would get hepatitis C. That said, The CDC recommends that anyone over the age of 18 get tested for Hepatitis C. If you haven’t been screened, you should consider having it done.
Learn more about the risk factors for hepatitis C.
Can Hepatitis C Infection Be Spread By Sexual Contact
Yes, but the risk of getting HCV from sexual contact is believed to be low. The risk increases for those who have multiple sex partners, have a sexually transmitted infection, engage in rough sex or other activities that might cause bleeding, or are infected with HIV. More research is needed to understand how and when HCV can be spread by sexual contact.
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