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.
Testing For Hepatitis C
Hepatitis C is usually diagnosed using 2 blood tests: the antibody test and the PCR test. These can be as part of a routine blood test or are often combined as a dried blood spot test. The dried blood spot test is similar to a blood sugar test in pricking the finger to get a blood spot that is put on a testing card. This is then sent to a laboratory to be tested.
Another similar test is an antigen test, which if used can often get the results back in 90 minutes. This is very expensive and not many services have access to the machine needed.
Causes Of Hepatitis C
You can become infected with hepatitis C if you come into contact with the blood of an infected person.
Other bodily fluids can also contain the virus, but blood contains the highest level of it. Just a small trace of blood can cause an infection. At room temperature, it’s thought the virus may be able survive outside the body in patches of dried blood on surfaces for up to several weeks.
The main ways you can become infected with the hepatitis C virus are described below.
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Are Alternative Medicines Available
Some people believe certain forms of alternative medicine help cure hepatitis C.
However, the National Center for Complementary and Integrative Health reports that there are no effective, research-proven forms of alternative treatment or complementary medicine for hepatitis C.
Silymarin, also known as milk thistle, is an herb commonly suggested to help cure hepatitis C liver disease. But a rigorous did not find any beneficial effects from this supplement.
Life Expectancy And Prognosis
Can you die from hepatitis? Technically, the complications of chronic hepatitis C are fatal. About 30,000 people in the U.S. die each year from cirrhosis.
How long can you live with untreated hep C? The disease affects everyone differently, so thereâs no rule. But about 70% to 80% of people with will get chronic help C. Within 20 years, about 20% to 30% of those people will get cirrhosis. From there, it depends on what type of cirrhosis you have, your treatment, and if you can get a liver transplant.
Can hepatitis C go away on its own? Yes. From 15% to 20% of people with hep C clear it from their bodies without treatment. Itâs more likely to happen in women and people who have symptoms. But it usually happens between 4 and 18 months after symptoms start.
American Liver Foundation Hep C 123: âFrequently Asked Questions.â
Gastroenterology: âExtrahepatic morbidity and mortality of chronic hepatitis C.â
National Institute of Diabetes and Digestive and Kidney Diseases: âHepatitis C.â
Therapeutic Advances in Infectious Disease: âExtrahepatic Manifestations of Chronic Hepatitis C Virus Infection.â
The Hepatitis C Support Project: âAn Overview of Extrahepatic Manifestations of Hepatitis C.â
BioDrugs: âManagement of hepatitis C virus-related arthritis.â
Frontiers in Endocrinology: âDiabetes and Hepatitis C: A Two-Way Association.â
U.S. National Library of Medicine: âAtherosclerosis,â âPreventing Hepatitis B or C.â
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How Can I Prevent Spreading Hepatitis C To Others
If you have hepatitis C, follow the steps above to avoid spreading the infection. Tell your sex partner you have hepatitis C, and talk with your doctor about safe sex practices. In addition, you can protect others from infection by telling your doctor, dentist, and other health care providers that you have hepatitis C. Dont donate blood or blood products, semen, organs, or tissue.
How Is Hepatitis C Treated
Hepatitis C virus is treated with all-oral medications. These pills, calledantiviral medications, are usually taken once per day. These antiviral medications are extremely good at attacking the virus and preventing it from multiplying.
Antiviral medications were not the original treatment for hepatitis C. Before 2014, the only treatment for hepatitis C was called interferon and ribavirin, taken as weekly injections under the skin, plus pills. Interferon treatment caused many unpleasant side effects and was not usually successful. Then a new generation of medications became available. These antiviral treatments are extremely successful at curing the virus and have very minimal side effects.
Ribavirin is still sometimes prescribed to be taken along with the new antiviral medicines, but it has become more and more uncommon that ribavirin is needed at all. Ribavirin has some mild-moderate side effects. Ribavirin is a pill taken twice per day, as 2 or 3 pills in the morning plus 2 or 3 pills at night, depending on the patient’s body weight. Most patients do not need ribavirin.
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Acute Phase Of Hepatitis C
Acute means ‘new’ or ‘for a short time’. This phase lasts for the first six months. When first infected with the virus, most people have no symptoms, or only mild ones. If symptoms do occur, they develop about 7-8 weeks after being exposed to the virus and may include feeling sick , being sick and feeling generally unwell. Some people go ‘yellow’ . This is due to a build-up of the chemical bilirubin which is made in the liver and spills into the blood in some liver conditions. It is unusual to have severe symptoms.
Following the initial infection:
- In about one quarter to one half of cases the virus is cleared from the body by the immune system within 2-6 months. If this happens then you will have no long-term effects from the virus. Younger people and women are more likely to clear the virus in this way.
- In 5 to 8 out of 10 cases, the virus remains active in the liver and bloodstream long-term. This is called chronic infection with hepatitis C.
How Do My Healthcare Professional And I Decide On Treatment
Your healthcare professional will look at your health history and decide if treatment is right for you. The treatment you receive and the length of treatment may depend on:
- how much virus is in your body
- your genotype of hep C
- whether you have liver damage
- whether or not youve been treated previously
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How Does A Person Get Hepatitis
A person can get hepatitis A through the following sources:
- Food or water contaminated with the fecal matter of an infected person
- Sexual contact
A person can get hepatitis B in many ways, which include:
- Having sexual contact with an infected person
- Sharing needles
- Being in direct contact with an infected persons blood
- Transferred from mother to the fetus
- Getting an infected needle prick
- Being in contact with an infected persons body fluid
A person can get hepatitis C through:
- Sharing infected needles
- Being in direct contact with an infected persons blood
- Getting an infected needle prick
- Having sexual contact with an infected person
Hepatitis D can be spread through:
- Transferred from mother to the fetus
- Being in contact with the infected fluid or blood
- A person can get hepatitis D only if they are infected previously with hepatitis B.
Hepatitis E mainly infects people who eat or drink food or water contaminated with the virus. Under-cooked foods can also spread hepatitis E. It is more dangerous in pregnant women.
The Cost Of Hepatitis C Treatment
Though all of these drugs have been hailed as major medical breakthroughs, much of the discussion around them has focused on their exorbitant price tags. When sofosbuvir was released, it made news because a 12-week round of treatment came in at a total of $84,000. Harvoni cost even more — $94,500 for a 12-week course, though some patients may be cured after only eight weeks, or $63,000. Gilead’s newer offering, Epclusa, goes for just over $74,000. The gamechanger in the market may be Mavyret, which costs $26,500 for treatment. As of January 2019, there are also of some of these drugs available at lower prices.
There have been many arguments about whether these prices may be justified if they actually do provide a permanent cure. Patients with hep C who are not cured often go on to need far more expensive care. One study estimated that yearly care for an HCV patient without liver damage is approximately $5,800. This goes up to over $27,000 each year for an HCV patient with decompensated cirrhosis of the liver, over $43,000 a year for an HCV patient with liver cancer, and over $93,000 a year for a patient who has had a liver transplant.
In the long term, it is likely cheaper for insurers to pay for treatment with a DAA than to wait and pay for ongoing care once the patient gets sicker. Moreover, curing those who have been diagnosed would also prevent the virus from spreading further, which could in turn keep future costs down.
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Can You Drink Alcohol If You Have Hepatitis C
Hepatitis is inflammation of the liver. Hepatitis C viral infection causes this inflammation. There are several risk factors for contracting HCV infection due to the hepatitis C virus. One serious risk factor is drinking alcohol with HCV infection. The combination of HCV and alcohol can cause complications, and may result in more severe and serious liver injury including chronic cirrhosis . It also increases your chances of developing liver cancer having an alcohol induced increase in viral replication and rapid mutation of the hep C virus,which creates complications like:
- Greater viral capacity
Hepatitis refers to any cause of liver inflammation, with or without scarring of the liver . It is contagious, and is spread from person-to-person by blood-to-blood contact. Other viral causes of hepatitis include hepatitis A, B, C, and E. Other types of noninfectious causes of hepatitis include:
- Excessive alcohol intake
- Medications such as some prescription medications or even acetaminophen, for example, Tylenol liver damage and drug induced liver disease.
- Bacteria and viruses other than the hepatitis viruses
How are hepatitis A, B, and E spread?
- Transmission of hepatitis A and E: These forms of the virus are acquired from improper hygiene during food or drink preparation by someone who’s infected.
- Transmission of hepatitis B: This form is spread by blood-to-blood or sexual contact.
How Much Does Hepatitis C Treatment Cost
It is impossible to say what the exact cost is for the various regimens, but it is in the tens of thousands of dollars. In general, out of pocket cost would be very high for the average person, and most people are treated through a health insurer, federal health benefits, or veteran’s benefits. The cost of hepatitis C and the care of its complications, however, is much higher over a person’s lifetime, and the roughly estimated savings is believed to make treatment a good health and financial investment. Liver transplantation alone may cost several hundred thousand dollars for the procedure alone, followed by several hundred thousand for the medications needed in the first 6 months afterward.2 This does not include the many complications of liver transplantation.
Because negotiations are confidential business contracts, little is known about how much is actually paid for medical treatments by these drugs. One example is the medication sofosbuvir. Estimated costs for a standard 12-week treatment with sosobuvir was $84,000 in the US. Actual costs to individuals depend upon price contracts between pharmaceutical companies and health insurers, as well as government and private organizations. Thus, an individual with healthcare coverage may only pay a monthly co-pay.4
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Is There A Hepatitis C Vaccine
Prevention truly is your best medicine for hepatitis C because unlike its cousins, hepatitis A and B, hepatitis C has no vaccine. Thats not for lack of trying: There are currently clinical trials underway to find a vaccine, and in a study published last year in Science Advances, scientists at the Scripps Research Institute in La Jolla, California, showed proof of concept for the development of a vaccine. But despite this progress, not every expert is convinced a vaccine is in the near offing. There are people who have tried to make a hepatitis C vaccine for 20 years and couldnt do it, says Dr. Dieterich. This is a virus that mutates a lot.
In other words, going on the offense with a commitment to healthy behaviors is going to be your best defense against hepatitis C. You can set yourself up for a healthy future, too, by taking advantage of the May 19 National Hepatitis Testing Day and getting yourself checked. Remember, the disease is curablebut only if you know you have it. Go get tested for free today: You literally have nothing to lose.
Lagging on important health checkups? Let this Checklist of Annual Physical Exams for Women be your cheat sheet.
We Now Have The Cure For Hepatitis C But Can We Afford It
A long, difficult and costly research effort gives doctors a new cure for hepatitis C
A decades-long search for better treatments for a debilitating liver disorder is finally coming to fruition. Later this year the U.S. Food and Drug Administration is expected to approve a new pill that can cure hepatitis Ca chronic infection that afflicts about 170 million people worldwide and annually kills 350,000 people, including 15,000 in the U.S.faster and with fewer side effects than current remedies.
The breakthrough treatment comes, however, at a price that may place it out of reach for all but the wealthiest or best-insured patients. It will contain two drugs, one of which is already available at $1,000 per dose, or $84,000 for a complete 12-week course. The dual-drug combination will likely cost even more, which has prompted outrage from physicians and patient advocates alike, as well as plans from insurers to ration the combination when it becomes commercially available.
Over the coming months, physicians, patients, economists and insurance companies will no doubt hotly debate whether the treatment is worth the full asking price. There is little doubt, however, that the medication’s effectiveness is unprecedented and that its development is a significant achievement. A closer look at the complex chemical problems that needed to be solved to develop the cure shows why.
doi:10.1038/scientificamerican0914-32
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Tests To Diagnose Hepatitis C
How is Hepatitis C diagnosed?
There are two main blood tests typically used to diagnose Hepatitis C. First, youll have a screening test that shows if youve ever had Hepatitis C at some point in your life. If this test is positive, youll have a second test to see if you have Hepatitis C now. These blood tests are described below:
Hepatitis C antibody test
This is the screening test used by doctors to show whether or not you have ever been exposed to Hepatitis C at some time in your life, by detecting antibodies in your blood. Antibodies are substances your body makes to fight off all kinds of infections. If you were ever infected with Hepatitis C, your body would have made antibodies to fight the virus.
If the test result is:
- Negative, it means you have not been exposed to Hepatitis C and further testing is usually not needed.
- Positive, you have had Hepatitis C at some point. However, it does not tell you whether you have it now. Youll need to see your doctor for another test the Hepatitis C RNA test to determine if the virus is still active and present in your blood.
Hepatitis C RNA Qualitative Test
This test will determine whether or not you are currently infected with Hepatitis C. It is often called the PCR test because of the process used . It looks for the genetic material of the Hepatitis C virus in your blood.
If the test result is:
Hepatitis C RNA Quantitative Test
How Can You Get Hepatitis C
Hepatitis C is a blood-borne disease. The main source of infection is from blood from an infected person.
- Most cases are caused by using contaminated needles or injecting equipment to inject drugs . Even a tiny amount of an infected person’s blood left on a needle is enough to cause spread to others.
- Some people who received blood transfusions or blood prior to 1991 were infected with hepatitis C from some donor blood. Since 1991 all blood and blood products donated in the UK are screened for HCV.
- There is also a risk of contracting hepatitis C from needlestick accidents, or other injuries involving blood spillage from infected people.
- There is a small risk of contracting the virus from sharing toothbrushes, razors and other such items which may be contaminated with infected blood.
- There is even a small risk from inhaling drugs like cocaine, as these can make the inside of your nose bleed. If that happens, tiny spots of blood can fall on to the note you are using and, if that is used by someone else, your blood can travel up their nose and into their bloodstream.
- There is also a small risk from re-used equipment used for tattooing, body piercing, acupuncture, etc.
- There is a small risk that an infected mother can pass on the infection to her baby.
- There is a small risk that an infected person can pass on the virus whilst having sex.
The virus is not passed on during normal social contact, such as holding hands, hugging, or sharing cups or crockery.
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