Whos At Risk For Hepatitis C
You might be more likely to get it if you:
- Inject or have injected street drugs
- Were born between 1945 and 1965
- Got clotting factor concentrates made before 1987
- Received a blood transfusion or solid organ transplants before July 1992
- Got blood or organs from a donor who tested positive for hepatitis C
- Are on dialysis
Who Is At Risk For Hepatitis C
You are more likely to get hepatitis C if you
- Have injected drugs
If you have chronic hepatitis C, you probably will not have symptoms until it causes complications. This can happen decades after you were infected. For this reason, hepatitis C screening is important, even if you have no symptoms.
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.
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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.
Differences Between Hepatitis A B And C
To recap, hepatitis means inflammation of the liver, and when its followed by A, B or C, it refers to three different viruses that can cause this inflammation. The symptoms, though, are the same regardless of typemainly jaundice, nausea, fatigue and dark urine. Hepatitis A is easily spread through close human contact, as well as contaminated food and drinking water. Hepatitis B is spread through blood and body fluid, while hepatitis C is spread only through blood. And while A and B can be prevented through vaccination, says Dr. Menon, there is no current vaccination for hepatitis C.
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What Does A Reactive Hcv Antibody Test Result Mean
A reactive or positive antibody test means you have been infected with the hepatitis C virus at some point in time.
Once people have been infected, they will always have antibodies in their blood. This is true if they have cleared the virus, have been cured, or still have the virus in their blood.
A reactive antibody test does not necessarily mean that you currently have hepatitis C and a follow-up test is needed.
How Do I Know If I Have Hepatitis C Virus
Diagnosis of hepatitis C virus requires a blood test your doctor can order. Other blood tests can determine which subtype of HCV you have to better target your drug treatment, if needed. Your doctor will also want to know your viral load . In some patients, a liver biopsy is required to determine the level of damage.
Symptoms of chronic HCV may not appear for 2 to 3 decades after infection, so the disease may develop silently in your body for many years. This is the reason you should be tested for HCV infection, to start treatment if needed and to help protect your liver from damage.
The US Centers for Disease Control and Prevention recommends anyone 18 years or older be tested for hepatitis C virus at least once in their lifetime. Women should be tested for hepatitis C testing during each pregnancy. Some high risk groups may need more frequent testing, such as people who share drug preparation equipment and those on hemodialysis.
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Stages Of Hepatitis C
The hepatitis C virus affects people in different ways and has several stages:
- Incubation period. This is the time between first exposure to the start of the disease. It can last anywhere from 14 to 80 days, but the average is 45
- Acute hepatitis C. This is a short-term illness that lasts for the first 6 months after the virus enters your body. After that, some people who have it will get rid of, or clear, the virus on their own.
- Chronic hepatitis C. For most people who get hepatitis C — up to 85% — the illness moves into a long-lasting stage . This is called a chronic hepatitis C infection and can lead to serious health problems like liver cancer or cirrhosis.
- Cirrhosis. This disease leads to inflammation that, over time, replaces your healthy liver cells with scar tissue. It usually takes about 20 to 30 years for this to happen, though it can be faster if you drink alcohol or have HIV.
- Liver cancer. Cirrhosis makes liver cancer more likely. Your doctor will make sure you get regular tests because there are usually no symptoms in the early stages.
Learn more about the stages and progression of hepatitis C.
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.
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What Happens In Your Body With Hep C
Once the virus enters your bloodstream, it heads for your liver. Hepatitis C is a viral infection, and its a virus that lives primarily in the liver, says Dr. Goff. The reason it causes trouble is our immune system tries to get rid of it, but the virus mutates quite quickly, so it keeps alluding being caught. The liver gets caught in the crossfire.
Over time, the chronic infection can lead to serious liver scarring and damage, increasing the risk of life-threatening liver failure and cancer, Dr. Fox says.
Is Liver Transplantation An Option For A Person With Hepatitis C
Hepatitis C is the leading reason for 40% to 45% of liver transplants in the U.S. Hepatitis C usually recurs after transplantation and infects the new liver. Approximately 25% of these patients with recurrent hepatitis will develop cirrhosis within five years of transplantation. Despite this, the five-year survival rate for patients with hepatitis C is similar to that of patients who are transplanted for other types of liver disease.
Most transplant centers delay therapy until recurrent hepatitis C in the transplanted liver is confirmed. Oral, highly effective, direct-acting antivirals have shown encouraging results in patients who have undergone liver transplantation for hepatitis C infection and have recurrent hepatitis C. The choice of therapy needs to be individualized and is rapidly evolving.
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Can You Get Hep C More Than Once
Some people think hepatitis C is a one-and-done viruskind of like the chickenpox. But it is possible to get it more than once in your life, Dr. Fox says. If somebody had the infection, was cured of it, then goes back to the same behavior that got them infected in the first place, they can get re-infected, she explains. The chance of re-infection is lower though, suggesting that you may develop some degree of immunity after your first infection.
Still though, hepatitis C can lead to severe liver damage if left untreated, so if youre engaging in behaviors that put you at risk of getting or transmitting hepatitis C, talk with your doctor. A physician can answer your specific concerns and let you know whether or how often you should get screened. Thankfully, curing hepatitis C is easier than ever thanks to new, highly effective drugsbut better yet, you can avoid getting it in the first place!
Hepatitis C Transmission: The Centers for Disease Control and Prevention. . Hepatitis C Questions and Answers for the Public. cdc.gov/hepatitis/hcv/cfaq.htm
Hepatitis C Screening: The Centers for Disease Control and Prevention. . Testing Recommendations for Hepatitis C Virus Infection. cdc.gov/hepatitis/hcv/guidelines.htm
How Easy Is It To Transmit Hep C
Heres the good news: Its not easy to transmit hepatitis C without blood exposure, so you really dont have to worry about hugging or sitting close or anything like that, Dr. Fox says. Hepatitis C is in body fluids other than blood, but its harder to pass it without blood exchange.
That said, if you or someone close to you has hepatitis C, certain precautions can keep you extra-safe. For example, if your partner has hep C, its pretty hard to get it while doing normal activities, but you might consider not sharing things that could potentially have blood on it, like nail clippers and toothbrushes, says John Goff, M.D., a clinical professor of medicine at the University of Colorado School of Medicine and member of the American Liver Foundations National Medical Advisory Committee.
Other ways you cant get hep C? Breastfeeding, kissing, coughing, sneezing, eating or drinking, according to the CDC. Whew!
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What Are The Treatment Guidelines For Hepatitis C
Hepatitis C treatment is best discussed with a doctor or specialist familiar with current and developing options as this field is changing, and even major guidelines may become outdated quickly.
The latest treatment guidelines by the American Association for the Study of Liver Disease and Infectious Disease Society of America recommends use of DAAs as first-line treatment for hepatitis C infection. The choice of DAA varies by specific virus genotype, and the presence or absence of cirrhosis. In the U.S., specific insurance providers also might influence the choice due to the high cost of DAAs. Although the individual, public health, and cost benefits of treating all patients with hepatitis C is clear, the most difficult barrier to treating all people with HCV is the very high cost of the drug regimens. Patients are encouraged to discuss options with their health care professional.
Treatment is recommended in all patients with chronic hepatitis C unless they have a short life expectancy that is not related to liver disease. Severe life-threatening liver disease may require liver transplantation. Newer therapies with DAAs have allowed more and more patients to be treated.
What are the goals of therapy for hepatitis C infection?
The ultimate goals of antiviral therapy are to
- prevent transmission of hepatitis C,
- prevent progression to cirrhosis and liver cancer, and
- improve survival and quality of life.
Ways You Wont Spread Hepatitis C
There are some ways in which you wont spread HCV, though. Go ahead and let your significant other have a bite of your sandwich or dessert. According to the CDC, hepatitis C isnt spread by sharing silverware or drinking glasses, or through water or foods. Showing affection by holding hands, hugging, or kissing is also safe, Lee says. And although germs from sneezing or coughing might cause you to get a cold, they wont give you hepatitis C.
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Autoimmune Hepatitis Vs Hepatitis C
Having nothing to do with hepatitis A, B or C, autoimmune hepatitis is caused by an autoimmune reaction that tells the body to attack its liver. Although it is a distinct condition from hepatitis C, people sometimes confuse the two as symptoms do overlap . The causes of the diseases are quite different: AIH may have a genetic component, according to the National Institute of Diabetes and Digestive and Kidney Diseases meanwhile, hepatitis C is caused by a viral infection with no known genetic component.
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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When Should You Call Your Doctor
911 or other emergency services immediately if you have hepatitis C and you:
- Feel extremely confused or are having hallucinations.
- Are bleeding from the rectum or are vomiting blood.
- You think you may have been infected with hepatitis C.
- You have risk factors for hepatitis C, such as IV drug use.
- You have symptoms of hepatitis C and you think you may have been exposed to hepatitis C.
All Adults Pregnant Women And People With Risk Factors Should Get Tested For Hepatitis C
Most people who get infected with hepatitis C virus develop a chronic, or lifelong, infection. Left untreated, chronic hepatitis C can cause serious health problems, including liver damage, cirrhosis, liver cancer, and even death. People can live without symptoms or feeling sick, so testing is the only way to know if you have hepatitis C. Getting tested is important to find out if you are infected so you can get lifesaving treatment that can cure hepatitis C.
If You Are A Baby Boomer Heres Another Item For Your To Do List: Get Tested For Hepatitis C
As the youngest of its generation turns 50 this year, AARP has declared 2014 the Year of the Boomer.
There are many ways in which boomers contributions to society can be recognized and celebrated. But if you are one of the 77 million Americans born after the Second World War, your special year would take on greater meaning if you were to pause and think about your liver health.
Specifically, the American Liver Foundation is appealing to you to take the advice of the Centers for Disease Control and Prevention and get tested for hepatitis C.
Why, you may be thinking, are you being asked to do this? The facts speak for themselves: Anyone can get hepatitis C, but baby boomers are five times more likely to be infected.
Of all the people in the United States who have hepatitis C, more than 75 percent were born between 1945 and 1965.
Over all, considering that an estimated 3.2 million people have hepatitis C in the United States, the disease has been described as an unrecognized health crisis.
There are vaccines available for the hepatitis A and B viruses, but no vaccine is available yet to prevent hepatitis C. So testing for hepatitis C is critical to finding and treating the disease at its earliest stages.
Hepatitis C the silent epidemic
The longer the virus goes undetected, the greater a persons risk of developing serious liver disease, including cirrhosis and liver cancer.
Why is the baby boom generation so susceptible?
What does the test involve?
Hep C 123 Program