How Do Doctors Treat Autoimmune Hepatitis
Doctors treat autoimmune hepatitis with medicines that suppress, or decrease the activity of, your immune system, reducing your immune systems attack on your liver. The medicines doctors most often prescribe are corticosteroidsprednisone or prednisolonewith or without another medicine called azathioprine.
Doctors typically start with a relatively high dose of corticosteroids and then gradually lower the dose. Your doctor will try to find the lowest dose that works for you. Your doctor will use blood tests to find out how you are responding to the treatment. A decrease in levels of the liver enzymes alanine transaminase and aspartate transaminase shows a response to treatment. ALT and AST falling to normal levels shows a full response. In some cases, a doctor may repeat a liver biopsy to confirm the response to treatment and find out whether the damage has resolved.
Treatment can relieve symptoms and prevent or reverse liver damage in many people with autoimmune hepatitis. Early treatment of autoimmune hepatitis can lower the chances of developing cirrhosis and other complications. A minority of people who have no symptoms or only a mild form of the disease may or may not need medicines.
Are There Ways To Cure Hepatitis C Other Than With Medications
Patients sometimes ask whether there are ways to treat hepatitis C other than taking medicines. Currently, there are no vaccines to prevent hepatitis C. Once a person is infected, the only way to treat it is with prescribed antiviral medications.
Some patients worry that having hepatitis C means they will need a liver transplant. Only a very small fraction of people with hepatitis C require a liver transplant. By far, most people with hepatitis C never need a liver transplant. A transplant is performedonlywhen damage to the liver is extremely advanced and the liver is unable to perform its basic functions. A transplant provides a new working liver, but a transplant does not get rid of the hepatitis C virus in the patient. Patients with a liver transplant still need antiviral medication to cure their virus.
How Do Doctors Treat The Complications Of Hepatitis C
If hepatitis C leads to cirrhosis, you should see a doctor who specializes in liver diseases. Doctors can treat the health problems related to cirrhosis with medicines, surgery, and other medical procedures. If you have cirrhosis, you have an increased chance of liver cancer. Your doctor may order an ultrasound test to check for liver cancer.
If hepatitis C leads to liver failure or liver cancer, you may need a liver transplant.
Also Check: How Does Someone Catch Hepatitis C
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
Pregnancy And Hepatitis C
The new hepatitis C medicines have not been tested in pregnancy.
You should not become pregnant while taking treatment as it could be harmful to unborn babies.
If you’re pregnant, you must delay treatment until after your baby is born.
Speak to your doctor before starting hepatitis C treatment if you’re planning to become pregnant in the near future.
You’ll need to wait several weeks after treatment has ended before trying to get pregnant.
Women taking ribavirin should use contraception during treatment and for another 4 months after the end of treatment.
Men taking ribavirin should use a condom during treatment and for another 7 months after the end of treatment. This is because semen can contain ribavirin.
If you become pregnant during treatment, speak to your doctor as soon as possible to discuss your treatment options.
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How Much Do The New Hep C Treatments Cost
The new hep C drugs are expensive. So expensive, that two of them make it onto our list of the 11 Most Expensive Drugs in the U.S.A. This is because they are still patented .
Luckily, hep C treatment is covered by most insurance plans, so for many people, the cheapest way of getting it will be through insurance .
If your hep C treatment is not covered by your insurance, ask your doctor about an appeal. The exact process will depend on your insurance provider but often requires that you work with your doctor to submit an appeal letter.
Other savings tips worth checking out:
Manufacturers $5 copay cards can make treatment more affordable :
What Can People Do To Help The Medications Work Best
- Take the medications every day
- Stay in touch with pharmacy to be sure that all refills are ready on time
- Take the medications exactly as prescribed
- Do not skip doses
- Get all blood tests done on time
- Go to all visits with providers as recommended
- Tell the provider about all other medications that are being taken – including over-the-counter medicines, vitamins, herbs, and supplements
- Complete the entire course of medication
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How Can I Get Free Medication For Hepatitis C
Its possible to get free hep C medication through a patient assistance program. But you must meet specific requirements. Its also important to check what additional costs you might be responsible for when enrolling in this type of program.
Eligibility requirements differ by the pharmaceutical company. They determine eligibility based on your income from the previous year and household size.
Typically, those with incomes below the federal poverty line qualify. For example, a two-person household earning $17,420 a year or less might qualify for free medication, as well as a four-person household with an income of $26,500 a year or less.
Be prepared to provide proof of income before receiving free or discounted medication. The company will verify your current income and review your most recent federal tax return.
Potential Complications Of Hepatitis C
Chronic hepatitis C infection is a long-lasting illness with potentially serious complications. About 75% to 85% of those with acute hepatitis C infection go on to develop chronic illness. Of those in the chronic illness group, more than two-thirds will develop liver disease. Up to 20% will develop cirrhosis, or scarring of the liver, within 20 to 30 years. Cirrhosis affects liver function and causes elevated blood liver enzymes. Up to 5% of people with chronic hepatitis C infection will die from liver cancer or cirrhosis. Chronic hepatitis C infection is the most common reason for liver transplantation in the U.S.
Also Check: What Does Hepatic Steatosis Mean
Consider Applying For Disability Benefits
If complications of liver disease have made it hard for you to meet your responsibilities at work, you might qualify for disability benefits through the Social Security Administration. If you receive Social Security disability benefits for two years, you will also be enrolled in Medicare.
It can be challenging to navigate the disability benefits application process. Consider visiting a community legal services center in your area to learn if there are disability rights advocates or other professionals who can guide you through the process.
How Do You Get Hepatitis C
Hepatitis C is a blood-borne illness, meaning it is transmitted via contact with infected blood. Usually the virus enters the body through a puncture wound on the skin. The most common way hepatitis C is transmitted is via injection drug use. Sharing dirty needles with someone who is infected can transmit hepatitis C. Health care professionals may contract the virus via needlestick injury. Prior to 1992, the U.S. blood supply was not screened the way it is today, so some people contracted hepatitis C from infected blood transfusions. Rarely, babies born to hepatitis C-infected mothers acquire the virus. Hepatitis C can also be spread by having sex with an infected person or sharing personal items with someone who has the virus, but these cases are rare.
Read Also: How Do Doctors Test For Hepatitis C
What If I Am Pregnant Or Want To Have A Baby
The hepatitis C medicine ribavirin can cause severe birth defects and must not be taken during pregnancy. Both partners should not use ribavirin at least six months before trying to get pregnant. There is not a lot of information yet about the safety of newer treatments during pregnancy. Talk to your doctor or nurse about the best treatment options for you.
Edema Symptoms Lead To Diagnosis
The Baltimore resident found out he had the disease in 2018 after his feet swelled up. My feet were so bad, I had to take the shoestrings out of my shoes so I could walk, he says.
I couldnt believe I tested positive, says Pannell, 64. I was mad, but I figured that I probably got the disease from sharing needles because I was an addict at one time. Today, Im going on 17 years clean.
After completing eight weeks of antivirals, Pannell was retested. He still had hepatitis C. I was frustrated and discouraged that it didnt work, says Pannell, but my care provider said lets try it again.
After a second round of therapy, Pannell was cured.
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Your Insurance Company Could Say No
Some insurance companies try to combat the high cost of hepatitis C drugs by rejecting coverage for them. More than one-third of people were denied coverage for these drugs by their insurance company, according to a 2018 study in Open Forum Infectious Diseases. Private insurance companies rejected more claims for these drugs over 52 percent than Medicare or Medicaid.
Medicare and Medicaid are more likely to approve hepatitis C drug coverage. But with Medicaid, you might have to meet certain requirements to receive these drugs, such as:
- getting a referral from a specialist
- having signs of liver scarring
- showing proof that you have stopped using alcohol or illicit drugs, if this is a problem
Burden On Medicaid Populations
Although cost issues present challenges for all diagnosed patients, they are especially relevant for Medicaid beneficiaries, a low socioeconomic group with particularly high HCV disease burden compared with the general population. Prevalence of HCV in some Medicaid populations has been estimated at 7.5 times that of commercially insured populations, with the homeless and incarcerated representing another fraction of infected beneficiaries. In 2014, demand for new HCV medications in Medicaid populations helped drive a historic 13.1% surge in national prescription drug spending, the largest increase observed since 2001.
At the programmatic level, state Medicaid programs also face more substantial budget constraints than do other insurers, which can particularly limit their ability to manage the use of sofosbuvir and other new HCV medications among large populations of patients clinically eligible to receive them. Initially, some programs approved sofosbuvir for use whereas others chose not to add it to their formularies, prompting some physicians to obtain direct subsidies from the drug manufacturer. By report, others pursued alternative strategies, including convincing their state to renegotiate or carve out sofosbuvir coverage through direct payment outside capitation.
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What Is Hepatitis C
Hepatitis C is a viral infection that causes liver inflammation and damage. Inflammation is swelling that occurs when tissues of the body become injured or infected. Inflammation can damage organs.
Viruses invade normal cells in your body. Many viruses cause infections that can be spread from person to person. The hepatitis C virus spreads through contact with an infected persons blood.
Hepatitis C can cause an acute or chronic infection.
Although no vaccine for hepatitis C is available, you can take steps to protect yourself from hepatitis C. If you have hepatitis C, talk with your doctor about treatment. Medicines can cure most cases of hepatitis C.
Medicines Used To Treat Hepatitis C
Hepatitis C treatments come in pill form, have few side effects and are usually taken for eight or 12 weeks. For most people, treatment means taking one to three pills once a day.
Hepatitis C treatments stop the virus from being able to make copies of itself. Over the weeks of treatment, the virus is cleared from the body. In some cases, like severe liver injury, a medicine called ribavirin may be added to hepatitis C treatment.
For more information about hepatitis C drugs, please see Chronic hepatitis C treatment combinations.
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Look Into Assistance Programs From Drug Manufacturers
Many drug manufacturers operate patient assistance programs to help uninsured and underinsured patients afford the costs of medication. Consider contacting the manufacturer of your prescribed medication to learn if you qualify for financial assistance.
You can also use the Partnership for Prescription Assistance or RxAssist database to learn more about these programs. The American Liver Foundation also maintains a helpful list of pharmaceutical patient assistance programs specifically for hepatitis C.
Some nonprofit organizations and charitable foundations offer financial support to help people cope with the costs of hepatitis C. For example, you might qualify for one or more of the following:
- copay, coinsurance, premium, or deductible assistance, if you have insurance
- discounts on medication, with or without insurance coverage
- travel support, to help cover the costs of traveling for treatment
- other types of financial support
To learn about some of the organizations that offer support to people with liver disease or hepatitis C, download a copy of the American Liver Foundations Financial Assistance Resources.
It’s Different Than Hepatitis A And B
Each form of hepatitis has its own specific virus that spreads and is treated differently. “Hepatitis simply means inflammation of the liver, or that the virus has an affinity for hurting the liver,” Reau says.
- Hepatitis A is an acute, short-term infection that often does not require treatment.
- Hepatitis B hides deep in the body and, like hepatitis C, is treated in a variety of ways, from antiviral medications to liver transplants.
“The viruses are different, but all of them should be taken very seriously since they can lead to significant liver disease and even death,” she adds.
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Who Should Get Tested
You should consider getting tested for hepatitis C if you’re worried you could have been infected or you fall into one of the groups at an increased risk of being infected.
- Hepatitis C often has no symptoms, so you may still be infected if you feel healthy.
- The following groups of people are at an increased risk of hepatitis C:
- ex-drug users and current drug users, particularly users of injected drugs
- people who received blood transfusions before September 1991
- recipients of organ or tissue transplants before 1992
- people who have lived or had medical treatment in an area where hepatitis C is common high risk areas include North Africa, the Middle East and Central and East Asia
- babies and children whose mothers have hepatitis C
- anyone accidentally exposed to the virus, such as health workers
- people who have received a tattoo or piercing where equipment may not have been properly sterilised
- sexual partners of people with hepatitis C
If you continue to engage in high-risk activities, such as injecting drugs frequently, regular testing may be recommended. Your doctor will be able to advise you about this.
What If I Use Street Drugs
You can get treated and cured for hepatitis C while still using drugs. Treatments work just as well to cure hepatitis C if you are using drugs. You deserve respectful care by doctors, nurses and other health workers. Talk about your situation with a health worker you trust.
Some hepatitis C medicines can change the effects of the drugs you use, which can contribute to an overdose. The first time you use drugs after you start treatment, start slowly, use with someone you trust and keep Naloxone nearby.
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Indias Efforts To Help End Hepatitis C Starts With Prison Population
A global nonprofit is leading an effort to help eliminate the hepatitis C virus among people who are incarcerated in India. Over the last two years, the Foundation for Innovative New Diagnostics has been targeting the highly vulnerable group of prison inmates in the northern states of Punjab and Haryana where HCV is particularly prevalent.
By eliminating the virus in prisons, you can prevent transmission within both the prisons and the general population and ultimately slow the spread of the virus, explains Sanjay Sarin, Vice President of Access at FIND.
An estimated 1% of the population, or as many as 14 million people, are believed to be living with HCV in India. Much like HIV, it is spread through contact with infected blood or body fluids. A large percentage of inmates in Punjab, for instance, are people who use drugs and have contracted the virus by sharing needles.
FIND, which focuses on diagnostics for neglected diseases, aims to stop the spread of the virus by testing and treating inmates in these two states, as well as those in the adjacent territory of Chandigarh. This is the first time a program of this kind has been implemented anywhere in India. Although the Indian government has long-established programs to combat HIV and TB, it only recently began to focus on HCV, launching a national initiative in 2018.
Thus far, FIND has screened about 30,000 inmates with about 2,700 testing positive for HCV in the designated prisons.