Incomplete Or Failed Response To Treatment
Some people with autoimmune hepatitis have an incomplete response to treatment, meaning that treatment helps but does not lead to remission. If you have an incomplete response to treatment, you may need to take different medicines to help prevent liver damage.
Some people may fail to respond to treatment, meaning that the inflammation and liver damage of autoimmune hepatitis keep getting worse. Your doctor may recommend additional blood tests and higher doses of medicines. If liver damage leads to complications, you may need treatment for complications.
How Can Hepatitis C Affect My Child In The Long Term
Children with hepatitis C can lead completely normal lives, attend school and play sports without any special arrangements.
If left untreated or if treatment fails, chronic hepatitis C can last for decades. During that time, it can progressively damage the liver and lead to such complications as cirrhosis and liver cancer. When they become older, children with hepatitis C should avoid drinking alcohol, as it can make the disease progress more quickly.
If the liver begins to fail because of the hepatitis and its complications, your child may need a liver transplant. While hepatitis C is one of the most common reasons for an adult to receive a liver transplant, it is not a common reason among children.
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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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Why Is It So Important To Take Hepatitis C Drugs Correctly
Taking any medicine correctly is extremely important. Taking medicines correctly means:
For hepatitis C drugs, these issues are especially important because, if a medicine is not taken correctly, it may not kill the virus completely. Then, because the virus has “seen” the drug, it learns how to mutate and change in ways that allow it to escape the drug and avoid getting killed off. This is called drug resistance.
Developing drug resistance is a serious issue. It means that the treatment may not work and that the patient may not respond to future treatments.
To prevent drug resistance, it is important to take any medication correctly, but especially DAAs such as Harvoni, Mavyret, Epclusa, and Zepatier.
Resistance can develop quickly. It is very important to take these new antiviral medications according to instructions, on schedule, and not to skip or reduce doses.
A Healthy Diet Can Help
For some people living with HCV, eating a healthy diet can help manage symptoms. Because the virus causes inflammation, diets that avoid fatty foods, salt, sugar, alcohol, and fried foods may reduce symptoms like nausea and diarrhea. Drinking lots of water to stay hydrated is also a good way to help your body, especially your liver.
I try to eat right without smoking or drinking.
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Side Effects Of Treatment
Treatments with direct acting antivirals have very few side effects. Most people find DAA tablets very easy to take.
You may feel a little sick and have trouble sleeping to begin with, but this should soon settle down.
Your nurse or doctor should be able to suggest things to help ease any discomfort.
You need to complete the full course of treatment to ensure you clear the hepatitis C virus from your body.
If you have any problems with your medicines, speak to your doctor or nurse straight away.
Side effects for each type of treatment can vary from person to person.
For a very small number of people, more severe side effects from hepatitis C treatments may include:
Relation Between Hepatitis C And Hepatocellular Carcinoma
Hepatocellular carcinoma accounts for 85 to 90% of the cases of primary liver cancer. Chronic hepatitis and cirrhosis constitute the major preneoplastic conditions in the majority of HCC. The risk of developing HCC for a patient with HCV-related cirrhosis is approximately 2-6% per year. HCC risk increases to 17-fold in HCV-infected patients compared to HCV-negative subjects. In general, HCC develops only after two or more decades of HCV infection and the increased risk is restricted largely to patients with cirrhosis or advanced fibrosis.
Multiple steps are required in the induction of all cancers it would be mandatory for hepatocarcinogenesis that genetic mutations accumulate in the hepatocytes. In HCV infection, however, some of these steps might be skipped in the development of HCC, in presence of the core protein. The overall effects achieved by the expression of the core protein would be the induction of HCC, even in the absence of a complete set of genetic aberrations, required for carcinogenesis. By considering such a non-Vogelstein type process for the induction of HCC, a plausible explanation might be given for many unusual events happening in HCV carriers.
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.
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.
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There Is No Vaccine For Hepatitis C
But, did you know?
- Hepatitis C can be treated with medication that has cure rates > 90%.
- Earlier diagnosis and treatment lead to better health outcomes.
- Early treatment may even prevent liver disease, liver cancer, or cirrhosis.
Testing is quick and simple with a blood test.
Ask your health care provider for a test if you think you could have hepatitis C.
The best way to know is to get tested.
To learn about how to protect yourself and where you can get tested, visit Canada.ca and search ‘hepatitis C.’
What Does It Mean To Have A Successful Treatment What Is A Sustained Virologic Response
In an untreated state, the hepatitis C virus infects the cells of the liver and then continuously lives there, making copies of itself that circulate in the bloodstream. Antiviral medications can destroy the ability of the virus to reproduce, so the amount of virus in the bloodstream then decreases. The amount of virus in the blood is measured by aviral load.
Treatment is successful when the viral load drops toundetectablelevels, which means the virus cannot be detected in the bloodstream at all. The viral load becomes undetectable during treatment and remains undetected after treatment has ended. If there is still no detectable virus in the blood 12 weeks after the end of the treatment, the treatment was successful. This is called a Sustained Virologic Response .
A patient who has achieved an SVR is considered to be cured of the hepatitis C virus.
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How Can The Spread Of Hepatitis C Be Prevented
People who have had hepatitis C should remain aware that their blood is potentially infectious.
- Do not shoot drugs if you shoot drugs, stop and get into a treatment program if you can’t stop, never share needles, syringes, water or “works”, and get vaccinated against hepatitis A and B.
- Do not share personal care items that might have blood on them .
- If you are a health care or public safety worker, always follow routine barrier precautions and safely handle needles and other sharps get vaccinated against hepatitis B.
- Consider the risks if you are thinking about getting a tattoo or body piercing. You might get infected if the tools have someone else’s blood on them or if the artist or piercer does not follow good health practices.
- HCV can be spread by sex, but this is rare. If you are having sex with more than one steady sex partner, use latex condoms correctly and every time to prevent the spread of sexually transmitted diseases. You should also get vaccinated against hepatitis B.
- If you are infected with HCV, do not donate blood, organs or tissue.
Joint And Muscle Pain
A condition called arthralgia causes joint pain and is common in people with hepatitis C. Itâs different from arthritis, which causes pain and swelling in joints. But infected people can also get hepatitis C-related arthritis.
Fibromyalgia, which causes body aches and muscle pain, is also common in people with hepatitis C.
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How Can I Make A Difference For People With Hepatitis C
Anyone can help raise awareness about this widespread disease. Citizens can write letters to their state representatives or local newspapers and get involved in volunteer efforts with liver disease or Veteran-affiliated organizations . Speaking at support groups and sharing your experience is also a good way to help others with HCV.
Cost Of Hepatitis C Medicines
The newer direct-acting antiviral medicines for hepatitis C can be costly. Most government and private health insurance prescription drug plans provide some coverage for these medicines. Talk with your doctor about your health insurance coverage for hepatitis C medicines.
Drug companies, nonprofit organizations, and some states offer programs that can help pay for hepatitis C medicines. If you need help paying for medicines, talk with your doctor. Learn more about financial help for hepatitis C medicines.
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Awareness Prevention And Early Diagnosis Are Essential
There’s a good reason why hepatitis C is known as a “silent killer.”
According to the U.S. Centers for Disease Control and Prevention, an estimated 3.2 million Americans live with chronic hepatitis C infection, which is transmitted through infected bodily fluids like blood and semen, and causes inflammation of the liver. Yet up to 75% of people who have hepatitis C aren’t aware they have it.
Most of those living with the virus experience only mild symptoms or don’t have any symptoms at all until they develop serious liver damage or another life-threatening liver disease. Unfortunately, that means they aren’t getting diagnosed and treatment is delayed until the later stages when irreversible liver damage has occurred.
Here, hepatologistNancy Reau, MD, associate director of the Solid Organ Transplant Program at Rush University Medical Center, explains who is at risk for hepatitis C and offers advice to help you protect yourself.
Do I Have To Have Drug Treatment
The choice is up to you and your doctor. The decision to use drug therapy can be hard to make because of the potential side effects. Your doctor will closely monitor your symptoms and the amount of the virus in your body. He or she will also consider your overall health. This includes looking at blood test results. All are important factors to consider before you and your doctor start drug treatment for your hepatitis C.
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How Does Hepatitis C Progress
When someone is first infected with hepatitis C, most likely they have no symptoms and are unaware. Occasionally people experience fatigue, loss of appetite, weakness or sometimes having a yellow color in their skin or eyes. Although having any symptoms at all is rare, if they do occur, they usually go away within a few weeks.
Around 15-25% of people who are infected will spontaneously fight off the virus on their own and they will not have a chronic hepatitis C infection and no long term damage occurs.
But around 75-85% of people will develop chronic infection. Most of the time, people with chronic hepatitis C have no symptoms at the time of infection and no symptoms for years or even decades of chronic infection. The virus will be with them until they are successfully treated with hepatitis C medications.
Around 10-20% of people with chronic infection will slowly have gradual damage in the liver over years and will eventually develop cirrhosis . This can take 20 years or more from the time of the initial infection.
Cirrhosis is the replacement of liver cells with permanent scar tissue. Cirrhosis can lead to problems such as bleeding from veins in the esophagus, fluid buildup in the belly, and damaged brain function.Approximately 15% of people with cirrhosis will develop liver cancer during their lifetime. Drinking excessively can double the chance of liver cancer in people infected with HCV.
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.
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What Can I Do To Prevent The Spread Of Germs
- Keep your child away from other people while he or she is sick. This is especially important during the first 3 to 5 days of illness. The virus is most contagious during this time.
- Have your child wash his or her hands often. He or she should wash after using the bathroom and before preparing or eating food. Have your child use soap and water. Show him or her how to rub soapy hands together, lacing the fingers. Wash the front and back of the hands, and in between the fingers. The fingers of one hand can scrub under the fingernails of the other hand. Teach your child to wash for at least 20 seconds. Use a timer, or sing a song that is at least 20 seconds. An example is the happy birthday song 2 times. Have your child rinse with warm, running water for several seconds. Then dry with a clean towel or paper towel. Your older child can use hand sanitizer with alcohol if soap and water are not available.
- Remind your child to cover a sneeze or cough. Show your child how to use a tissue to cover his or her mouth and nose. Have your child throw the tissue away in a trash can right away. Then your child should wash his or her hands well or use a hand sanitizer. Show your child how to use the bend of his or her arm if a tissue is not available.
- Tell your child not to share items. Examples include toys, drinks, and food.
I Have Hepatitis C And I’m Thinking About Having Children What Should I Know
Hepatitis C does not prevent a man or woman from having children.
The hepatitis C virus infection does not cause infertility in either sex–it does not affect a woman’s ovarian or uterine function, or a man’s sperm production or sperm characteristics.
If you are a woman with hepatitis C, talk to your provider about treatment before pregnancy. Treatment before pregnancy can help reduce the risk of hepatitis C transmission to your baby. If you are already pregnant, treatment will usually take place after pregnancy and you may need to be tested for hepatitis C again prior to starting treatment.
If you are a man with hepatitis C, talk to your provider about being treated prior to conceiving. Although the risk of transmission during sex is low, it is still important to treat hepatitis C for your personal health.
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