Itching In Liver Disease
Itching secondary to liver diseases, including primary biliary cholangitis, primary sclerosing cholangitis, and hepatitis C, is a very difficult symptom for patients to endure and for physicians to manage. The reason why patients with liver disease itch is not known. It has been thought that some substances accumulate in the blood as a result of liver disease, causing itch.
Although the nature of the substance that cause itch in liver disease is not known, evidence has been accumulating over the past several years to suggest that some substances that are found normally in plasma known as endogenous opioids , contribute, at least in part to the itch secondary to liver disease. It has been proposed that these neurotransmitters cause itch by acting on special areas of the brain. Other substances that also accumulate in the blood in liver disease, including bile acids, may also play a role in this type of itch. There is no strong evidence, however, to support that bile acids cause this type of itch.
Traditionally, the way itch has been studied has been by measuring the concentration of substances known to accumulate in the blood of patients with liver disease who itch. This method, however, has not advanced the understanding of what causes this type of itch.
Keep in mind that itching may be an early symptom of liver disease. If these symptoms develop, you can see a dermatologist, keeping in mind that liver disease may be one of the causes. #liverdisease #pruritis #cirrhosis
How Is It Treated
Experts recommend that nearly everyone who has hepatitis C receive treatment. Talk with your doctor about whether you should get treatment. Current treatments for hepatitis C almost always work.
Taking care of yourself is an important part of the treatment for hepatitis C. Some people with hepatitis C don’t notice a change in the way they feel. Others feel tired, sick, or depressed. You may feel better if you exercise and eat healthy foods. To help prevent further liver damage, avoid alcohol and illegal drugs and certain medicines that can be hard on your liver.
What Do Hepatitis C Symptoms Look Like
Hepatitis C infection can go through two stages: acute and chronic. In the early, or acute stage, most people don’t have symptoms. If they do develop symptoms, these can include:
- flu-like symptoms, tiredness, high temperature and aches and pains
- loss of appetite
- tummy pain
- jaundice, meaning your skin and the whites of your eyes turn yellow
While for some people, the infection will clear without treatment, in most cases, acute infection will develop into long-term chronic infection. Chronic infection may not become apparent for a number of years until the liver displays signs of damage. These symptoms can include:
- mental confusion and depression these are specific to hepatitis C
- constantly feeling tired
- nausea, vomiting or tummy pain
- dark urine
- feeling bloated
- joint and muscle pain
Without treatment, chronic hepatitis C can cause scarring of the liver , which can cause the liver to stop working properly. A small number of people with cirrhosis develop liver cancer and these complications can lead to death. Other than a liver transplant, theres no cure for cirrhosis. However, treatments can help relieve some of the symptoms.
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What Are The Symptoms Of Hepatitis C
You may have hepatitis C and not have any signs or symptoms.
For those who do have symptoms, you may experience:
- nausea and vomiting
Hepatitis C can lead to liver damage, as it causes swelling . This swelling causes scarring of the liver, which affects how the organ functions.
Liver scarring can worsen . This increases your chances of getting liver cancer.
How quickly your liver undergoes damage will depend on if you:
- use alcohol
- get hepatitis C after the age of 40
- have a human immunodeficiency virus co-infection
About 60% to 70% of people with hepatitis C do not develop symptoms until their liver has already been damaged.
Here Are 5 Signs Of Hepatitis C Foot Damage
Would you recognize Hepatitis C foot damage if you were showing symptoms? Well, we hope you would. And were here to help!
As we celebrate World Hepatitis Day this month, we want you to know more about this diseaseand how it impacts your feet. Basically, this form of hepatitis is a virus that causes liver disease. Once you develop liver disease, you may start to notice symptoms in your feet, ranging from minor to severely painful issues. These can include swelling in your feet and ankles, neuropathy, arthritis and more.
Now, these are all areas where our highly trained Spring TX podiatrists can help. That was certainly the case for our patient Judy M, who recently shared this review:
When I first came to Dr. Walsh I was in terrible foot pain that was affecting my daily activities. I was tired of a swollen ankle and constant foot pain. Dr. Walsh performed a complete flat foot reconstruction which was an extensive surgery. Throughout my recovery, Dr. Walsh was wonderful-informative, responsive, encouraging and caring. She also educated/advised me on the right types of shoes to wear, Once recovered, I was able to return back to my normal activitiesI highly recommend Dr Walsh!
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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.
What Else Causes Itching When You Have Hepatitis
In some cases hepatitis C can cause you to have elevated bilirubin levels, due to the damaged liver having difficulty removing bilirubin from the body. When bilirubin levels become high the skin becomes yellowish and itchy .
When you have itchy skin while taking Mavyret it is important to check with your doctor so they can determine whether the itchy skin is
- a side effect of Mavyret or
- jaundice due to liver damage from hepatitis C
To determine the cause of the itchy skin your doctor may need to do further investigations or tests, and the results of these will decide what treatment options are best for you.
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Blood And Vessel Problems
People with hepatitis C often get a condition called cryoglobulinemia. This happens when certain proteins in your blood stick together in cold weather. They can build up in vessels and block blood flow, which causes swelling and damage. The condition can affect your skin, organs, nerves, and joints.
Hepatitis C also can cause problems with blood itself. You may not make enough white blood cells, which fight infections, or platelets, which help your blood clot.
The infection can also make you bruise easily or get red or purple spots under your skin. Those are signs of a bleeding disorder called immune thrombocytopenic purpura.
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.
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What To Think About
Researchers are working to develop other treatments, including gene therapy and medicines that help control the immune system.
Rashes From Hcv Treatment
While some skin rashes are caused by HCV, treatment for the infection can cause rashes, too. This is most common when anti-hepatitis medications are injected. In such cases, rashes may develop at the injection site as a sign of irritation.
Cold packs and hydrocortisone cream may alleviate itchiness and discomfort as the rash heals. If you experience rashes that are not at the injection site, this can be a sign of a rare reaction to the medication. Call your doctor right away.
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Can Hepatitis C Be Prevented
There is no vaccine against hepatitis C. The only way to prevent infection is to avoid contact with infected blood.
Hepatitis C cannot be spread by coughing, sneezing or sharing eating utensils. People should not be kept away from school, work, or other social settings because they have hepatitis C.
Here are some precautions that may prevent the spread of hepatitis C:
- Do not share personal care items, such as toothbrushes or razors, with others.
- Practice safe sex by using condoms.
- Dont share needles or syringes.
- Wear gloves when handling another persons blood.
- Use sterile equipment for body piercings or tattoos.
- If you are a healthcare worker, follow recommended safety measures.
People who are at greater risk for contracting hepatitis C should have their blood tested. The Centers for Disease Control recommends that Americans born between 1945 and 1965 be screened at least once for the disease.
What Causes Hepatitis C
Hepatitis C is caused when blood from an infected person enters the body of an uninfected person. These are the most common methods of infection:
- An infected person shares needles or syringes for injecting intravenous drugs. Even people who have used IV drugs infrequently may be at risk for infection.
- Healthcare workers who accidentally stick themselves with needles used on infected patients are at risk of getting hepatitis C.
- Patients who received donated blood or blood products or who had organ transplants before 1992 are at higher risk for hepatitis C.
Less common ways of spreading hepatitis C include the following:
- Sexual contact with an infected person. Although the risk of getting hepatitis C through sexual intercourse is low, the risk increases for people who have several sex partners or those with HIV infections.
- Sharing a razor, toothbrush or other personal item that may have come into contact with the blood of an infected person.
- Becoming infected through body piercing or tattooing, if the facility does not use sterile equipment or does not follow infection control practices.
Babies born to mothers who have hepatitis C might become infected, although this is not common. In addition, baby boomers are at increased risk of having hepatitis C and should be screened for it.
Hepatitis C cannot be spread by simple contact or by coughing or sneezing.
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Who Is At High Risk And Should Be Tested For Hepatitis C Infection
The U.S. Preventive Health Services task force recommends that all adults born between 1945 and 1965 be tested once routinely for hepatitis C, regardless of whether risk factors for hepatitis C are present. One-time testing also is recommended for:
- People who currently inject drugs or snort drugs, or ever did so, even once many years previously
- People with persistently elevated alanine aminotransferase level, a liver enzyme found in blood
- People who have HIV infection
- Children born to HCV- or HIV-infected mothers
- People who were ever on long-term hemodialysis
- People who got a tattoo in an unregulated setting, such as prison or by an unlicensed person
- People who received clotting factor produced before 1987
- People who received transfusions or organ transplants before July 1992, or who were notified that they received blood from a donor who later tested positive for hepatitis C infection
- Health care, emergency medical, and public safety workers after a needlestick, eye or mouth exposure to hepatitis C-infected blood
People who may have been exposed to hepatitis C in the previous 6 months should be tested for viral RNA load rather than anti-HCV antibody, because antibody may not be present for up to 12 weeks or longer after infection, although HCV RNA may be detectable in blood as soon as 2-3 weeks after infection.
How Do You Test For Hepatitis C
A simple blood test carried out by a healthcare professional will show whether you have the virus. You may also be given an extra test to see if your liver is damaged.
If youve got hepatitis C you should be tested for other STIs. It’s important that you tell your recent sexual partner/s so they can also get tested and treated. Many people who have hepatitis C do not notice anything wrong, and by telling them you can help to stop the virus being passed on. It can also stop you from getting the infection again.
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Eat Regular Nutritious Meals
Sometimes people with hepatitis C have a hard time eating. You may have no appetite, feel nauseated, or have different tastes than you are used to. Even if you don’t feel like eating, it’s very important to eat small meals throughout the day. Some people have nausea in the afternoon. If this happens to you, try to eat a big, nutritious meal in the morning.
If you have cirrhosis, it may not be a good idea to eat salty foods or foods that are high in protein. If you want to know more about which foods to avoid and which foods are good to eat, ask your doctor about meeting with a registered dietitian to discuss a healthy eating plan.
Ask Your Doctor About Skin Symptoms
First, consider scheduling an appointment with your doctor or dermatologist. Not every skin rash is indicative of a hepatitis C infection or of liver damage. Your physician will be able to identify your rash and either explain why it is occurring or order tests to verify or rule out other illnesses, including hepatitis C. If you are diagnosed with hepatitis C, your physician will be able to provide you with both the test results and the information so you can begin to understand what happens next to rid your body of the virus. Together, you and your doctor will plan a course of action that fits with your insurance, your budget, and your individual medical needs.
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Treatment Of Relapse Or Non
Sometimes you may need to take a different combination of medicines if your first round of treatment didn’t work very well. If it was not done before, your doctor may do a test to find out which genotype caused the infection. This may help the doctor choose a medicine that is more likely to cure the infection.
You Have Slurred Speech And Confusion
When your liver isnt working to its full capacity, ammonia that isnt being processed begins circulating in your blood. When ammonia heads into the brain, this can lead to a serious condition called hepatic encephalopathy. Symptoms of this complication include slurred speech and confusion.
The bodys liver is the organ responsible for absorbing, transporting, and storing iron. If your liver is damaged and these processes are interrupted, you can become iron deficient.
Common symptoms of anemias seen with liver damage include:
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Skin Rash During Chronic Hepatitis C Therapy
Hepatitis C virus infection remains a significant clinical and public health challenge, with approximately 4.1 million individuals infected in the United States. The World Health Organization estimates that 34 million individuals are infected each year worldwide, with a global 170 million chronic HCV carriers at risk of developing liver cirrhosis and/or liver cancer. Various types of skin rash have been reported due to HCV infection, as well as anti-HCV treatment. Some skin rashes improve with anti-HCV treatment, whereas others worsen, necessitating the discontinuation of the treatment and the initiation of therapy targeted toward the rash itself. We describe 3 cases that illustrate the therapeutic dilemmas that can arise when a patient develops a skin rash during treatment with pegylated interferon alfa-2a with ribavirin.
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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