What Is A Hepatitis C Genotype
There are six different types, or strains, of hepatitis C viruses that infect people. These strains are called genotypes.
Genotypes are identified by differences in the genetic code of the viruses. Genotype 1 is the most common hepatitis C strain in the United States, but other strains are also seen in this country.
Your doctor will do a blood test to figure out which genotype you have. Your hepatitis C genotype will help your doctor choose the right medication for you.
What Medications Treat Or Cure Hepatitis C
Hepatitis C treatments once involved months of injected interferons with up to 50% cure rates, and serious side effects. With newer medications, hepatitis C can be treated with oral combinations of medicines for several weeks. These are generally well-tolerated and yield sustained cure of virus from the blood in over 90% of cases.
The goal of treating HCV-infected persons is to reduce the risk of death, end-stage liver disease, and other liver-related adverse events by the achievement of a virologic cure which is determined by the sustained virologic response . Sustained virology response means complete disappearance of the HCV for at least 12 weeks after stopping treatment.
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Sticking To Your Epclusa Treatment Plan
Taking your Epclusa tablets exactly as your doctor prescribes is extremely important. Thats because following your treatment plan increases your chances of curing your hepatitis C . It also helps reduce your risk of long-term effects of HCV, such as cirrhosis and liver cancer.
Missing doses can interfere with how well Epclusa treats your hepatitis C. Following your treatment plan increases your chances of having a level of hepatitis C virus thats so low its no longer detectable in your body. When blood tests cant detect the virus anymore, your infection is considered cured.
Be sure to follow your doctors instructions and take Epclusa every day for 12 weeks. Using a reminder tool can be helpful in making sure you take Epclusa each day.
If you have any questions or concerns about your treatment, talk with your doctor. They can help resolve any issues for you and help you get the most out of your treatment.
The Food and Drug Administration approves prescription drugs such as Epclusa to treat certain conditions.
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Side Effects And Risks
Epclusa and Harvoni belong to the same class of medications, so they have similar effects in the body. Therefore, they cause many of the same side effects. Below are some examples of these side effects.
More common side effects
More common side effects that can occur with both Epclusa and Harvoni include:
Serious side effects
Serious side effects that can occur with both Epclusa and Harvoni include:
- reactivation of the hepatitis B virus, which can lead to liver failure or death
- serious allergic reaction, including angioedema
boxed warnings from the FDA. A boxed warning is the strongest warning from the FDA.
Both drugs have a boxed warning about the risk of reactivation of hepatitis B virus after starting treatment with either drug. Reactivation of HBV can lead to liver failure or death.
Your doctor will test you for HBV before you start taking Epclusa or Harvoni. If the test results show that you have HBV, you may need to take medication to treat it in order to prevent serious liver damage.
What Drugs Cure Hepatitis C Infection
Most hepatitis C is currently treated with all-oral medical regimens of direct-acting antivirals or DAAs. DAAs is a term used to distinguish these hepatitis C drugs from an older generation of injected medicines that act indirectly on the immune response to the hepatitis C virus. DAAs act directly on the virus to block different steps in its life cycle. There are several DAAs that are used in combinations that have been scientifically proven to cure hepatitis C. They are not interchangeable, and some are only available combined in one pill or dose pack as a specific combination. DAAs are not used as single-drug therapy because of the high risk of the virus developing resistance and because they work best in combinations. The choice of which regimen to use depends upon the genotype of the virus, the level of liver fibrosis , and any drug resistancethat may be present .
Examples of combination DAAs with cure rates between 91%-100% include:
Genotype 1a and 1b are the commonest genotypes in the United States. Of all the genotypes, genotype 3 has been the most difficult to treat with DAAs alone and required the use of ribavirin, which has significant side effects. All genotypes can now be treated with oral DAAs without ribavirin. Some genotypes may still require the use of injected pegylated interferon and/or ribavirin if there is no response to DAAs.
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What About Patients With Hepatitis C Who Also Have Hepatitis B
Hepatitis B virus can flare in patients who are co-infected with hepatitis B and hepatitis C and are taking medication for hepatitis C. This has been reported as a potential risk for patients who are taking hepatitis C treatment and have underlying hepatitis B as well. The flare usually occurs within a few weeks after the patient starts taking medication for hepatitis C. Therefore, patients who have both hepatitis B and hepatitis C should be seen by a hepatitis expertbeforestarting treatment of the hepatitis C they may need to start taking hepatitis B treatment to avoid a hepatitis B flare.
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Can I Take Epclusa If I Have Hiv As Well As Hepatitis C
Yes, you can. Epclusa can be safely used to treat hepatitis C in people with an HIV infection.
In a clinical trial involving people who had both hepatitis C and HIV, up to 95% of people who received Epclusa were cured of hepatitis C. Importantly, treatment with Epclusa didnt cause worsening of HIV.
boxed warning . This is the most serious warning from the Food and Drug Administration . A boxed warning alerts doctors and patients about drug effects that may be dangerous.
Reactivation of hepatitis B virus can occur in people with both hepatitis C virus and HBV infections. This can happen during or after treatment with Epclusa. Your doctor will do blood tests for HBV before you start taking Epclusa. If you currently have HBV or have had it in the past, you may need to take medication for HBV.
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How Long Does It Take To Recover From Hepatitis C Treatment
The recovery period depends on the type of symptoms you have and how advanced the hepatitis virus is in your system. A combination of antiviral medications can prevent liver problems, and they might have to be taken for a longer period. You would be required to take periodic tests with your doctor to check how well your liver is performing.
Side Effects Of Hepatitis C Treatment: What To Expect
Articles On Side Effects of Hep C Medications
Hepatitis C can be treated and even cured. And treatment is important. Hepatitis C, caused by a virus, can permanently damage your liver if you don’t get treatment for it.
Treatment for hepatitis C keeps changing quickly. The standard treatment was typically interferon along with other drugs — usually ribavirin and either boceprevir or telaprevir .
But many people have a hard time with interferons side effects, which include fatigue, fever, chills, and depression. Treatment now involves direct-acting antiviral drugs . These medicines are highly effective for most people with hepatitis C and are interferon-free and often ribavirin-free. This means they typically have fewer side effects. The treatments are often simpler, using fewer pills for a shorter amount of time. DAAs are available as either single drugs or combined with other medicines in one pill.
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Elbasvir-grazoprevir , ledipasvir-sofosbuvir , and sofosbuvir-velpatasvir are once daily combination pills. Depending on the type of hepatitis C infection, these can often cure the disease in 8 to 12 weeks. Other treatment options include: daclatasvir ombitasvir- paritaprevir-ritonavir or some combinations of simeprevir sofosbuvir peginterferon or ribavirin.
Ask your doctor what’s best for you, based on your medical needs.
What Are the Some of the Most Common Side Effects of Hepatitis C Medications?
What to Avoid
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Side Effects After Treatment
Side effects after Epclusa treatment ends havent been reported in clinical trials.
There have been reports of people experiencing flu-like symptoms, such as fatigue, muscle aches, trouble sleeping, and chills, after treatment with Epclusa. However, these side effects are likely caused by your body recovering from the hepatitis C virus.
If you have flu-like symptoms after your Epclusa treatment ends, talk with your doctor.
The Benefits Of Subduing Side Effects
The goal here is to create an approach that will allow you to benefit from your drugs while avoiding the side effects that can make taking them difficult. There are two potentially huge benefits to this approach:
First, you are much more likely to properly adhere to your antiretroviral therapy, which means sticking to your drug schedule and taking your drugs exactly as prescribed and directed. Always taking your drugs as directed means youre much less likely to experience drug resistance. That means the ability of your drugs to keep you healthy can remain effective for years.
And last, but most assuredly not least, your quality of life can be immensely improved when difficult side effects are eliminated or lessened. Its all about living well with HIV, not just longer.
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Why Does It Matter That I Have Genotype 2
Knowing that you have genotype 2 offers important information about your treatment options and how likely they are to be effective.
Based on the genotype, doctors can narrow down which treatments are most likely to be effective and how long you should take them. This can prevent you from wasting time on the wrong therapy or taking medications longer than you have to.
Some genotypes respond differently to treatment than others. And how long you need to take medicine can differ based on your genotype.
However, the genotype cant tell doctors how quickly the condition will progress, how severe your symptoms might get, or if an acute infection will become chronic.
15 to 25 percent of people clear the hepatitis C infection without any treatment. Since there isnt a way of knowing who falls into this category, in an acute infection, your doctor will recommend waiting for 6 months to treat the virus, since it may clear spontaneously.
Hepatitis C is treated with antiviral drugs that clear your body of the virus and prevent or lessen damage to your liver. Often, youll take a combination of two antiviral drugs for 8 weeks or longer.
Theres a good chance youll have a sustained virologic response to oral drug therapy. In other words, its highly curable. The SVR rate for many of the new hepatitis C drug combinations is as high as 99 percent.
When choosing drugs and deciding how long you should take them, your doctor will usually consider the following factors:
Treatment After Liver Transplantation
After liver transplantation reinfection of the graft leads to fast development of liver fibrosis, and consequently the risks of organ dysfunction and graft loss are significantly increased . Thus, antiviral treatment is essential to preserve liver function and ensure transplant survival . Severe post-transplantation cholestatic hepatitis and patients with moderate to severe fibrosis need urgent initiation of antiviral treatment to prevent graft loss . In the SOLAR-1 and -2 trials patients after liver transplantation show similar SVR rates compared to nontransplanted patients with the treatment of sofosbuvir/ledipasvir plus RBV . Comparable results were achieved by the combination of sofosbuvir/velpatasvir . These results are supported by data from several real-world studies confirming the efficacy and safety of DAA treatment in the post-transplantation setting. Potential DDI between DAA and immunosuppressive drugs require special attention, in particular when using protease inhibitors. However, the combination of glecaprevir/pibrentasvir is certainly a valuable pangenotypic alternative to sofosbuvir-containing regimens, in particular for patients with impaired kidney function after liver transplantation . During DAA treatment serum levels of immunosuppressant drugs have to be closely monitored.
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Daa Treatment And Hepatocellular Carcinoma
The impact of DAA treatment on hepatocellular carcinoma incidence, recurrence and tumor aggressiveness in patients with chronic HCV infection has been intensively discussed over the last 2 years. Shortly after DAA approval, an observed increase in early occurrence or recurrence of HCC after HCV eradication with DAA has been reported .
However, the higher incidence of de novo HCC compared to historical data was most likely related to a significantly higher proportion of older patients as well as those with end-stage liver disease certainly ineligible for IFN-based regimens. Later on, further data analysis revealed that HCV eradication due to DAA treatment reduces the risk of HCC development to a comparable level as with IFN-based therapies . These findings were supported by results from prospective studies showing a reduction of HCC incidence in patients with HCV-related liver cirrhosis . Nevertheless, the absolute risk of HCC development remains high in patients with established cirrhosis. Ongoing HCC surveillance is mandatory despite HCV clearance .
How Long Does It Take To Work
You may start to feel better days to weeks after you start taking Epclusa, but youll still need to take the full 12 weeks of treatment. Its important to both take the full treatment and avoid missing any doses. These steps help the medication clear the HCV from your body.
In clinical trials, more than 89% of people who took Epclusa were cleared of the virus after three months of treatment. Your doctor will test you before and during treatment with Epclusa, and again 12 weeks after you finish taking Epclusa. This last test will determine if you have achieved sustained virologic response , which means the virus is no longer detectable in your blood. This means your hepatitis C infection is considered cured.
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Can Hepatitis C Be Treated
Yes, since 2010 enormous progress has been made in the treatment of chronic hepatitis C. New therapies called direct-acting antivirals are pills that act on the virus itself to eradicate it from the body, unlike older medicines like interferon injections which work by stimulating an immune response. These new treatments are very effective and can achieve cure rates of over 90%. In most situations now, there is no need for interferon, which was responsible for many of the side effects previously associated with HCV treatment. The new treatment combinations require shorter treatment durations , have reduced side effects and appear to be effective at all stages of the disease.
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.
Your primary care physician may refer you to a specialist to determine whether you are eligible for treatment. A specialist will help you decide which drug therapy is best for you based on the severity of your liver disease, your virus genotype and whether or not you have been treated in the past.
Preventing The Spread Of Hepatitis C
There is no vaccine available to prevent a person from being infected with hepatitis C. Recommended behaviours to prevent the spread of the virus include:
- Always use sterile injecting equipment. This can be accessed from your local needle and syringe program service.
- Avoid sharing personal items such as toothbrushes, razors, nail files or nail scissors, which can draw blood.
- If you are involved in body piercing, tattooing, electrolysis or acupuncture, always ensure that any instrument that pierces the skin is either single use or has been cleaned, disinfected and sterilised since it was last used.
- If you are a healthcare worker, follow standard precautions at all times.
- Wherever possible, wear single-use gloves if you give someone first aid or clean up blood or body fluids.
- Although hepatitis C is not generally considered to be a sexually transmissible infection in Australia, you may wish to consider safe sex practices if blood is going to be present, or if your partner has HIV infection. You may wish to further discuss this issue and personal risks with your doctor.
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How Do You Prevent Hepatitis C From Spreading
- Avoid sharing the same needles: People who are intravenous drug users are at the risk of getting it because they may use the same needle many times. If the person snorts drugs cocaine this can also transmit the disease if the same straw is being used by another user.
- Direct exposure to blood and blood products should not be done: If a person is a doctor or medical worker then they can get transmitted with infection if they come in direct contact of the blood. Therefore the equipment that is being used must be sterilized properly to prevent direct contact with blood and stop spreading it.
- No sharing of personal care items: People must not share items of personal care with other people because they can be exposed to blood while shaving, or normal cuts thus it increases the danger of spreading it. If a person is already suffering from then they must take care that they do not spread it to other people by sharing the items.
- Practising safe sex: It can be spread or transmitted through sexual activities or intercourse. The chance of getting hepatitis increases if you have HIV, multiple sex partners, or if you are engaged in rough sex. Therefore while having sex person must stay cautious and practice safe sex.
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