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.
Natural History And Clinical Manifestations
Patients with hepatitis C are usually recognized when they already have chronic disease, because in most cases acute hepatitis C lacks clinical manifestations. However, acute hepatitis C may be diagnosed serologically in patients presenting with signs and symptoms of acute liver disease, such as malaise, anorexia, nausea, upper abdominal discomfort, and jaundice, as well as in individuals undergoing serologic testing after a suspect contact, such as a needlestick accident. Acute hepatitis C is believed to represent approximately 20% of cases of acute hepatitis.1 Fulminant hepatic failure caused by acute HCV infection is considered to be an extremely rare event. The diagnosis of acute hepatitis C is based on laboratory findings, including elevated transaminase values, as well as detection of HCV RNA and antibodies in the serum.10 HCV RNA is detectable within 1 to 2 weeks of exposure to the virus, whereas antibodies to viral proteins appear from 2 weeks to 6 months after exposure.1,14
Roger Y. Dodd, in, 2007
What Is The Treatment For Hepatitis C
The treatment for hepatitis C has advanced in recent years which has greatly improved the outlook for people with hepatitis C. The main aim of treatment is to clear HCV from the body and so prevent severe liver damage leading to cirrhosis.
If you have acute hepatitis C, you may not need treatment, but will be monitored carefully to see if your body clears the virus on its own, and to keep an eye out for liver damage. Treatment with medicines is advised for most people with chronic hepatitis C. The type of treatment will depend on various factors, including the type of HCV, the severity of the infection and your own health. The treatments recommended are changing all the time as the treatment of hepatitis C is a developing area of medicine. New treatments continue to be developed. The specialist who knows your case can give more accurate information about the outlook for your particular situation. They can also advise on the side-effects you can expect with each individual treatment. Treatment length varies, depending on your situation, and can last from two months to nearly a year.
However, newer treatment combinations have been found to be more effective in many cases. Sometimes these are used along with ribavirin. There are quite a few different medicines used and recommendations change frequently in this rapidly developing field.
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What Laboratory Tests Diagnose Hepatitis C
Laboratory blood tests will be done to evaluate the patient’s liver function and to look for hepatitis C antibodies . If these tests indicate that the person has hepatitis C, a hepatitis C “viral load” test will be done. This looks for genetic material from the hepatitis C virus and measures the quantity of hepatitis C virus that is circulating in the patient’s blood. This is helpful in determining if treatment is appropriate and to monitor the success of the treatment .
Individuals who had hepatitis C in the past and cleared the virus on their own will have a positive HCV antibody test, but there will be no hepatitis C virus genetic material in the blood. If a person is immunosuppressed due to an immunological condition, cancer chemotherapy, immunotherapy or HIV/AIDS, the test results may be different and need to be evaluated accordingly.
Easy Bleeding And Bruising
Your liver makes the things that help your blood clot. When itâs damaged, it canât make enough. You might start to bleed easily and have trouble stopping it. Or you might bruise easily.
Tell your dentist or other doctors before you have any medical procedure. Treat cuts with pressure bandages and get to the doctor right away. In an emergency, youâll get platelets to replace what you lost and Vitamin K to help your blood clot. View a slideshow on the basics of bruises.
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Limitations Of Screening For Hepatitis C
Barriers to screening for hepatitis C include limited access to healthcare, inadequate health insurance coverage, individuals’ decreasing recall of past risky behaviors, lack of knowledge of hepatitis C prevalence, natural history, and available tests and treatments for hepatitis C at the provider level.- Moreover, nearly 42% of primary care physicians reported being unfamiliar with the CDC guidelines in a survey of community-based physicians.
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.
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Evaluation Of Individuals With Positive Screening Test
Patients with a positive screening test for anti-HCV antibody should be tested for serum HCV RNA. Serum HCV RNA quantifies the amount of viral RNA in serum and indicates ongoing infection. If HCV RNA is detectable, tests should be performed to determine the extent of hepatic fibrosis. These tests typically include liver biopsy or noninvasive measures, such as biochemical markers of fibrosis or transient elastography., An ultrasound of the abdomen should also be performed to identify the possible presence of cirrhosis and focal lesions in the liver suspicious for hepatic malignancy.
Patients who have a positive anti-HCV on a screening test but have no detectable HCV RNA should have a confirmatory HCV RNA test a few months later. If HCV RNA remains undetectable, these individuals should be reassured that they do not have hepatitis C infection and that the anti-HCV may remain persistently positive. Such individuals have either cleared the virus or the true specificity of the test is lower than the reported 100%, and the test result was a false positive.
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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What Are The Signs & Symptoms Of Hcv Infection
Most people with HCV have no symptoms. But even without symptoms, they can develop health problems decades later and can still pass the disease to others.
If symptoms do happen, it’s usually when the disease is very advanced. Symptoms can be similar to those of hepatitis A and hepatitis B and include:
- jaundice
- fever
- darker than usual urine or gray-colored stools
How Can You Get Hepatitis C
Hepatitis C is a blood-borne disease. The main source of infection is from blood from an infected person.
- Most cases are caused by using contaminated needles or injecting equipment to inject drugs . Even a tiny amount of an infected person’s blood left on a needle is enough to cause spread to others.
- Some people who received blood transfusions or blood prior to 1991 were infected with hepatitis C from some donor blood. Since 1991 all blood and blood products donated in the UK are screened for HCV.
- There is also a risk of contracting hepatitis C from needlestick accidents, or other injuries involving blood spillage from infected people.
- There is a small risk of contracting the virus from sharing toothbrushes, razors and other such items which may be contaminated with infected blood.
- There is even a small risk from inhaling drugs like cocaine, as these can make the inside of your nose bleed. If that happens, tiny spots of blood can fall on to the note you are using and, if that is used by someone else, your blood can travel up their nose and into their bloodstream.
- There is also a small risk from re-used equipment used for tattooing, body piercing, acupuncture, etc.
- There is a small risk that an infected mother can pass on the infection to her baby.
- There is a small risk that an infected person can pass on the virus whilst having sex.
The virus is not passed on during normal social contact, such as holding hands, hugging, or sharing cups or crockery.
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What Are The Symptoms Of Hepatitis C In Women
What is hepatitis C?
Hepatitis C is an infection caused by the hepatitis C virus . There are different types of hepatitis viruses, including hepatitis A, B, D, and E. Among the different viruses, hepatitis C is the most serious because it can be chronic and cause severe liver damage.
The virus spreads through contact with infected blood, so certain people have a higher risk of infection. This includes healthcare workers exposed to blood and drug users. Getting a tattoo or piercing with unsterilized equipment also increases the risk of infection.
Hepatitis C affects both men and women. As a whole, the symptoms and complications of the disease are the same for both sexes. But the virus can affect women differently.
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:
- Breastfeeding
- 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.
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Hepatitis C Testing And Diagnosis
Doctors will start by checking your blood for:
Anti-HCV antibodies: These are proteins your body makes when it finds the hep C virus in your blood. They usually show up about 12 weeks after infection.
It usually takes a few days to a week to get results, though a rapid test is available in some places.
The results can be:
- Nonreactive, or negative:
- That may mean you donât have hep C.
- If youâve been exposed in the last 6 months, youâll need to be retested.
If your antibody test is positive, youâll get this test:
HCV RNA: It measures the number of viral RNA particles in your blood. They usually show up 1-2 weeks after youâre infected.
- The results can be:
- Negative: You donât have hep C.
- Positive: You currently have hep C.
You might also get:
Liver function tests: They measure proteins and enzyme levels, which usually rise 7 to 8 weeks after youâre infected. As your liver gets damaged, enzymes leak into your bloodstream. But you can have normal enzyme levels and still have hepatitis C. Learn the reasons why you should get tested for hepatitis C.
Enhancing Healthcare Team Outcomes
Hepatitis C is a serious infection that has high morbidity and mortality. The management of HCV is prohibitively expensive, and newer antivirals offer a potential cure for the disorder. The infection is best managed by an interprofessional team that also includes nurses and pharmacists. All clinicians who see patients with HCV should educate them and advise them against the use of alcohol, which is known to accelerate the progression of the infection. Also, the infectious disease nurse should provide basic sex education and inform these patients that they may transmit the virus to their partners during sexual intercourse. Additionally, these patients should avoid sharing personal care products with others. The patients should be told not to donate blood or any organs as the risk of transmission is high.
The key is that many advances have taken place in the treatment of hepatitis C, which can eradicate the virus, shorten the duration of treatment, and hopefully prevent hepatocellular cancer. The board-certified infectious disease pharmacist should educate the patients about the newer antiviral drugs which are effective in eradicating the virus. Following treatment with the newer drugs, monitoring is still necessary to ensure compliance here again is where nursing can step to the front, alerting the clinician of any issues. Current short term data indicate that the drugs can eliminate the virus from the bloodstream.
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Sometimes The Infection Goes Away On Its Own
Acute hepatitis is C is a short-term illness that occurs within the first six months after being exposed to the virus. Like the human papillomavirus , early acute hepatitis C can clear on its own without treatment this happens about 25% of the time.
However, it’s more likely that the virus will remain in your body longer than six months, at which point it’s considered to be chronic hepatitis C infection.
“Being younger or a woman tends to be a factor in whether the virus clears on its own, and genetics may play a role,” Reau says. “But we can’t determine with certainty which people are certain to clear the infection and which aren’t.”
What Are The Symptoms Of Chronic Hepatitis B
About 1 in 20 people who get hepatitis B as adults become carriers, which means they have a chronic hepatitis B infection. Carriers are more likely to pass hepatitis B to other people. Most carriers are contagious meaning they can spread hepatitis B for the rest of their lives.
Hepatitis B infections that last a long time may lead to serious liver diseases like cirrhosis and liver cancer. About 1 in 5 people with chronic hepatitis B die from it. There are medicines that can help treat chronic hepatitis B infections.
Most babies who get hepatitis B develop chronic infection, unless they get treated right away. But treatments almost always work if your baby gets them quickly. Thats why its important for pregnant people to get tested for hepatitis B.
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Spread Of Hepatitis C
Hepatitis C is spread through blood-to-blood contact when blood from a person with hepatitis C enters another persons bloodstream.
The most common way people become infected with hepatitis C in Australia is by sharing injecting equipment such as needles, syringes, spoons and tourniquets. It is possible to be infected with hepatitis C after only one risk event.
Hepatitis C may also be spread through:
- tattooing and body piercing with equipment that has not been properly cleaned, disinfected or sterilised such as backyard tattoos’. Registered parlours with appropriate infection control procedures are not a risk
- needlestick injuries in a healthcare setting
- receiving blood transfusions in Australia prior to 1990 before hepatitis C virus testing of blood donations was introduced
- medical procedures, blood transfusions or blood products and mass immunisation programs provided in a country other than Australia
- pregnancy or childbirth there is a 5% chance of a mother with chronic hepatitis C infection passing on the virus to her baby during pregnancy or childbirth.
Breastfeeding is safe, however if nipples are cracked or bleeding cease breastfeeding until they have healed.
Less likely possible routes of transmission of hepatitis C include:
Hepatitis C cannot be transmitted by:
- kissing
- sharing food, cups or cutlery
- shaking hands or day-to-day physical contact.