Higher Rates Of Hepatitis C
Increasingly, in Canada, people living with hepatitis C are disproportionately affected by poverty, substance abuse, racism and limited access to healthcare. People living on the streets often do not have access to sanitary environments for using drugs or getting tattoos and piercings. People in prison often do not have access to new needles, drug use equipment or sterile tattooing equipment and people in prison often must share personal hygiene items. Indigenous people face the challenges of colonization, racism and its impacts, including isolation, poverty and the erosion of culture, which can lead some people to engage in activities that have a higher chance of passing hepatitis C. Medical practices in some countries 20 or 30 years ago exposed numerous people to hepatitis C, some of whom have immigrated to Canada.
Can Hepatitis A Be Treated
There is no drug treatment for hepatitis A. The disease will eventually run its course and an infected person will recover completely although recovery time varies for each person. Recovery from this virus infection means that you are protected for life from getting it again.
The following are some ways of dealing with the symptoms:
- You will feel tired and may have very little energy. You may need to take time off from daily activities, work or school to recover.
- Nausea and vomiting may cause you to lose your appetite. Try to eat small snacks and soft foods such as soup or toast.
- You may look yellow. Once you become yellow, you are no longer infectious. There is no need to isolate yourself. Let people around you know it is OK to be near you.
- Try not to drink alcohol. Your liver may not be able to process alcohol and alcohol may make your symptoms worse.
- Talk to your doctor before taking over-the-counter medications or complementary medicine. None of the alternative therapies have proved helpful in treating hepatitis A.
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
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What Can I Do If I Think I Have Hepatitis C
A doctor or sexual health clinician can test you to see if you have hepatitis C. If you do, effective treatment with fewer side effects than the older medicine is available and you can discuss how to avoid infecting your sexual partners or people you live with.
It can take three to six months before the blood test for hepatitis C will be able to detect signs of infection in your blood. For people with HIV who may be immunocompromised, the antibody may not be detectable and it may be necessary to request an RNA test which detects the virus.
How Is Hepatitis C Spread Will My Loved Ones Catch It From Me
Household transmission of hepatitis C is extremely rare. Here are some ways the virus is transmitted:
The number one risk factor for infection and transmission is sharing needles for intravenous drug use. Most people who use IV drugs become infected with HCV within one year of sharing needles. Learn more.
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What Are The Symptoms
Most people have no symptoms when they are first infected with the hepatitis C virus. If you do develop symptoms, they may include:
- Feeling very tired.
- Sore muscles.
- Dark urine.
- Yellowish eyes and skin . Jaundice usually appears only after other symptoms have started to go away.
Most people go on to develop chronic hepatitis C but still don’t have symptoms. This makes it common for people to have hepatitis C for 15 years or longer before it is diagnosed.
How Does Hepatitis C Spread
Hepatitis C is spread only through exposure to an infected person’s blood.
High-risk activities include:
- Sharing drug use equipment. Anything involved with injecting street drugs, from syringes, to needles, to tourniquets, can have small amounts of blood on it that can transmit hepatitis C. Pipes and straws to smoke or snort drugs can have blood on them from cracked lips or nosebleeds. Get into a treatment program if you can. At the very least, don’t share needles or equipment with anyone else.
- Sharing tattoo or piercing tools. Nonsterile items and ink can spread contaminated blood.
- Blood transfusions in countries that donât screen blood for hepatitis C.
- Nonsterile medical equipment. Tools that arenât cleaned properly between use can spread the virus.
- Blood or cutting rituals. Sharing the tools or exchanging blood can transmit hepatitis C.
Medium-risk activities include:
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What Are The Tests For Hepatitis C
There are two blood tests needed to diagnose hepatitis C:
The antibody test–called HCV antibody, HCV Ab, or anti-HCV–is done first. If this test is positive, it means that you have been infected with hepatitis C at some point in the past. If your antibody test is negative, then you have never been infected with hepatitis C if you were infected within the past month or so, the test may not be accurate you may needed to be retested at a later date.
However, a positive antibody test does not tell you if you still have hepatitis C. For that, you need to have a HCV RNA test, which determines whether the virus itself is in the bloodstream.
If any RNA is present in the blood after 6 months from time of infection, then you have chronic hepatitis C.
If no RNA is detected in the blood after 6 months, you no longer have hepatitis C.
How Can I Avoid Getting Hepatitis A
There is a safe and effective vaccine that can protect you from getting hepatitis A. The vaccine is usually given in two doses six months apart. The vaccine will give you protection for up to 20 years. A combined vaccine for hepatitis A and hepatitis B is also available. Since up to 40% of the reported cases of hepatitis A occur in travellers, it is advisable to protect yourself with a hepatitis A vaccination six weeks before you leave.
Consider these additional safety precautions:
- Wash your hands frequently and thoroughly especially after using the washroom, before preparing food and before eating.
- Avoid raw or undercooked food.
- If you are travelling to countries with high rates of hepatitis A:
- Drink bottled or boiled water and use it for brushing your teeth.
- Drink bottled beverages without ice.
- Avoid uncooked food including salads.
- Avoid food from street vendors.
- Peel and wash fresh fruits and vegetables yourself.
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Hepatitis B: How Does It Spread
You can get it through contact with the blood or body fluids of an infected person. In the U.S., it’s most often spread through unprotected sex. It’s also possible to get hepatitis B by sharing an infected person’s needles, razors, or toothbrush. And an infected mother can pass the virus to their baby during childbirth. Hepatitis B is not spread by hugging, sharing food, or coughing.
Contagious And Incubation Periods
The incubation periodthe time it takes for symptoms to appear after the hepatitis C virus has entered your bodyis from 2 weeks to 6 months. But not all people have symptoms when they are first infected.
You can spread the virus to someone else at any time after you are infected, even if you don’t have symptoms.
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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.
Why Getting Tested Is Important
A blood test is one of the only ways to confirm a diagnosis of hepatitis C. Additionally, hepatitis C often has no visible symptoms for many years.
Because of this, its important to be tested if you believe youve been exposed to the virus. Getting a timely diagnosis can help ensure you receive treatment before permanent liver damage occurs.
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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.”
Cases Of Hepatitis C In The United States
The CDC reports that in 2018, a total of 15,713 U.S. death certificates had hepatitis C as an underlying or contributing cause of death. This is likely lower than the actual numbers since so many infections go undocumented.
Studies show that baby boomers are more likely than other groups to have been exposed to HCV. Most of them contracted infections between 1970 and 1990 during a peak of new infections.
And since people with an HCV infection might not show symptoms, they may unknowingly transmit the virus to others.
Today, the most common risk factor for hepatitis C in the United States is injection drug use.
Since an HCV infection can show no symptoms, the number of new cases is likely higher than reported, according to the CDC.
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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.
What Are The Side Effects Of Treatments For Hepatitis C Infection
Side effects of interferon or pegylated interferon
- The most common side effects of interferon or pegylated interferon include fever, flu-like symptoms, and depression. Patients must be monitored closely for depression. Risk of suicide is a reason to avoid interferons.
- Interferons also reduce white blood cell and/or red blood cell counts . This may cause increased susceptibility to infection. Interferons also increase the risk of certain cancers. Death rarely occurs as a result of therapy, but may occur from progression of liver failure in patients with advanced cirrhosis.
Side effects of ribavirin
- Ribavirin most commonly causes anemia due to destruction of red blood cells . This can be severe enough that people with heart disease may suffer a heart attack from insufficient blood flow, so people with heart disease should not receive this drug. Anemia improves with a reduction in the dose of ribavirin. Injected growth factor that stimulates the production of red blood cells often is used to improve the anemia associated with ribavirin. Ribavirin also accumulates in the testicles and ovaries and causes birth defects in animals. Although no birth defects have been reported in humans, both men and women should use contraceptive measures to avoid pregnancy during and for at least six months after ribavirin treatment.
Side effects of DAAs
- The most common and significant side effects of boceprevir , sofosbuvir , and ledipasvir/sofosbuvir include
- fatigue ,
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Can You Have Hep C And Not Know It
We said this illness is sneaky, and in fact, most people with hepatitis C dont have any symptoms at the time they are diagnosed, says Dr. Goff. That makes it difficult to trace exactly where and when someone contracted the virus. Unfortunately, it also gives the virus time to wreak havoc on the liver before you feel sick enough to seek treatment.
Until we started actively screening the population, patients could be infected with hepatitis C and have absolutely no idea they had it, Dr. Fox says. Weve had to change our screening recommendations over time so that were not only testing people who self-report a history of a risk factor.
Currently, the CDC recommends all adults get screened for hepatitis C at least once in their lifetime, and pregnant women should be screened during each pregnancy. For people with ongoing risk factorsfor example, for people who regularly inject drugs or share needlesmore frequent testing is recommended.
How It’s Passed On
The hepatitis C virus is found in blood and is passed on when infected blood gets into another persons bloodstream. Its seen as unlikely that it can be passed on in semen.
Most people get the virus from sharing drug injecting equipment such as needles, syringes, water cups, tourniquets, spoons, filters and swabs. Sharing things like straws and banknotes that are used for snorting drugs might pass the virus on, as can sharing pipes.
In the UK piercing and tattooing should be safe but unsterilised equipment abroad can spread the virus.
An infected person risks infecting others if they share anything that might have blood on it like a toothbrush or razor. A pregnant woman with the virus can give it to her baby during pregnancy or childbirth.
Blood transfusions in the UK are safe as blood is screened.
You can also potentially get it from medical or dental treatment abroad in countries where hepatitis C is common and infection control is inadequate.
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Treatment: Chronic Hepatitis B
The goal of treating chronic hepatitis B is to control the virus and keep it from damaging the liver. This begins with regular monitoring for signs of liver disease. Antiviral medications may help, but not everyone can take them or needs to be on medication. Be sure to discuss the risks and benefits of antiviral therapy with your doctor.
What Drugs Treat And Cure Hepatitis C
The treatment of chronic hepatitis C has gone through several generations of medications. Not long ago, treatment was limited to interferon alpha-2b or pegylated interferon alpha-2b , and ribavirin . Interferon and pegylated interferon need to be injected under the skin , while ribavirin is taken by mouth. This combination therapy is infrequently used today, being recommended for only the least common genotypes of hepatitis C virus .
Since 2010, direct-acting antiviral drugs have been in use. The second generation of antivirals for HCV was the protease inhibitors telaprevir and boceprevir , both taken by mouth. These were used in combination with the earlier drugs to increase effectiveness . These drugs are also no longer in common use, and have been replaced by better options.
As more has been learned about how hepatitis C virus multiplies within the liver cells, new drugs continue to be developed to interfere with this multiplication at different stages. As such, we no longer think in terms of generations of drugs, but rather categories of action. Research and development of these direct-acting antivirals continue, with new agents coming to market every few months. Each category is improved and expanded by the addition of new drugs, which are safer and more effective.
Currently available and commonly used direct-acting antiviral drugs include:
- simeprevir
- Muscle aches
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