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.
Who Should Get Testing
Screening tests for hepatitis B and C attempt to find these infections early, before symptoms develop and when theyre easier to treat. Screening for viral hepatitis helps to reduce damage to the liver and prevent patients from knowingly spreading hepatitis to others. A patients doctor can help determine the need for screening tests, as recommendations vary based on a patients age, sex, family history, and other risk factors. Screening recommendations include:
- Screening for hepatitis B: Hepatitis B screening is recommended for people at an increased risk of contracting HBV. Groups that may benefit from screening include pregnant people, people born in parts of the world where hepatitis B is more common, people who didnt receive a hepatitis B vaccine as an infant, HIV-positive people, users of injectable drugs, and people at risk of HBV infection due to certain sexual practices.
- Screening for hepatitis C: All adults over age 18 should be screened for hepatitis C at least once, except in areas with very low prevalence of HCV. Screening is also recommended during each pregnancy and periodically for patients with risk factors for HCV infection. Risk factors for HCV include current or past injectable drug use, having a blood transfusion or organ transplant before July 1992, being on kidney dialysis, having contact with needles at work, working or living in a prison, being born to a mother with hepatitis C, having an HIV infection, and engaging in certain sexual practices.
The Treatment Programs Role In The Screening Process
Medical staff members at substance abuse treatment programs might assume the primary role for screening individuals for and explaining the screening process and test results. Opioid treatment programs with medical staff members should screen for and C at intake and periodically as indicated. In programs without onsite medical staff, clients may be referred elsewhere for screening with minimal involvement of the substance abuse treatment program.
Regardless of the type of program, counselors should have a basic understanding of the importance of screening, the screening process, and the meaning of the results. Counselors can encourage clients referred for screening to follow through and complete the screening and evaluation process . Clients might feel anxious about being diagnosed with hepatitis, and they might delay or avoid getting screened.
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Who Should Get Tested For Hepatitis C
Hepatitis C is transmitted mostly when the blood of an infected person gets into an uninfected person’s body, such as from sharing needles for intravenous drug use . Less commonly, a person can also get hepatitis C virus through sexual contact with someone who is infected.
You should get tested for hepatitis C if you:
- Are age 18 or older
- Currently use intravenous drugs or have in the past
- Received a blood transfusion or organ transplant before July 1992, when routine blood screenings became available
- Received a clotting factor concentrate made before 1987
- Are a hemodialysis patient or ever spent many years on dialysis for kidney failure
- Were born to an HCV-positive mother
- Had tattoos or piercings done at an unlicensed or unregulated establishment
- Are a healthcare worker who has ever been injured by a needle at work
Why Is This Important
Hepatitis can cause severe liver damage if left untreated. It can be fatal. But, as with many conditions, early diagnosis and treatment can result in a good recovery.
With many sufferers unaware that they have early stage hepatitis, the opportunity to pick it up from routine blood tests in A& E departments could be crucial in helping identify sufferers.
In turn, this will reduce the risk of the disease becoming more severe and requiring more expensive treatments. This will enable patients to lead a normal healthy life. It will also reduce the risk of a carrier transmitting hepatitis to others.
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How Do I Know If I Have Hepatitis
Viral hepatitis, such as hepatitis A , hepatitis B and hepatitis C , is diagnosed by your symptoms, a physical exam and blood tests. Sometimes imaging studies such as a sonogram or CAT scan and a liver biopsy are also used.
What are the types of Hepatitis?
There are several types of hepatitis, but the three most common in the U.S. are:
- Hepatitis A â It is considered highly contagious but is not a long-term infection and usually has no complications. Your liver usually heals within two months. Preventable with a vaccination, it can be spread by eating or drinking something that has been contaminated with the stool of a person who has the virus.
- Hepatitis B â While it can lead to long-term liver damage, most children and adults recover within 6 months. You can spread the virus even though you show no symptoms. Pregnant women who are infected by the virus can pass it along to their newborn. Also, preventable through vaccine, hepatitis B is spread by:
- Having sex with someone who’s infected
- Sharing dirty needles
- Having direct contact with infected blood or the body fluids of someone who’s got the disease
Who’s at Risk for Hepatitis Infection?
You are at increases risk hepatis A if you meet one or more of these criteria:
- Children born to mothers who have HBV
- People with certain high liver function blood tests
- Feeling sick to the stomach
Counseling Practices That Educate Support And Motivate Clients Undergoing Screening
Clients might need help deciding whether to get screened, understanding the test results, and determining their next steps. Even when services offered through the substance abuse treatment program are limited, discussing testing with clients presents an opportunity for counselors to motivate clients for change by confronting substance use and by making choices that improve their overall health. However, this may also be true when services are offered on-site through substance abuse treatment programs. A study at one methadone clinic that offered hepatitis screening and vaccination revealed that although the majority of clients completed screening , only 54.7 percent of clients who lacked for hepatitis A received vaccinations and only 2.9 percent of clients who lacked immunity for received vaccinations .
The Consensus Panel makes the following general recommendations while recognizing that, in some programs, the counselors role may be limited:
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Preparing Clients For Screening
Once clients are comfortable talking about viral , they might be more willing to undergo screening. However, clients might be anxious about the test itself a reassurance that testing is a simple procedure can help allay these concerns. Many substance use treatment facilities do not offer screening, and clients might need to be referred elsewhere. The following strategies can enhance the discussion of the hepatitis screening process and hepatitis prevention:
What Do I Ask The Doctor
When you visit the doctor, it helps to have questions written down ahead of time. You can also ask a family member or friend to go with you to take notes.
Print this list of questions and take it to your next appointment.
- Do I need to get tested for hepatitis C?
- What puts me at risk for hepatitis C?
- How will you test me for hepatitis C?
- How long will it take to get my test results?
- How will I find out my test results?
- If I have hepatitis C, what will happen next?
- Can you give me some information about hepatitis C to take home with me?
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What Are The Treatments For Viral Hepatitis
The treatment for viral hepatitis depends on the type and stage of the infection. Over the last several years, excellent treatments for both hepatitis B and C have become available. More and improved treatments are being evaluated all the time.
Your primary care doctor should be able to provide adequate care of your hepatitis. However, if you have severe hepatitis, you may require treatment by a hepatologist or gastroenterologist — specialists in diseases of the liver. Hospitalization is normally unnecessary unless you cannot eat or drink or are vomiting.
Hepatitis A usually requires minimal treatment and your liver usually heals within 2 months. Make sure you stay hydrated and well-nourished. While a vaccination can prevent you from getting hepatitis A, once you have had it, you cannot be re-infected.
Doctors sometimes recommend drug therapy for people with hepatitis B and C. Antiviral medication for hepatitis B includes adefovir , entecavir , interferon, lamivudine , peginterferon , telbivudine , and tenofovir.
Until recently, the standard treatment for chronic hepatitis C was a course of peginterferon plus ribavirin for people with genotype 2 and 3, and peginterferon plus ribavirin plus a protease inhibitor for people with genotype 1. These treatments had been shown to be effective in from 50% to 80% of those infected with hepatitis C but the side effects were very difficult for people to tolerate.
Hepatitis in Pregnant Women
Other Points to Consider
Types Of Hepatitis Tests
Hepatitis testing often begins with preliminary tests to evaluate the liver and detect evidence of hepatitis. Depending on the patients symptoms, medical history, and the results of a physical exam, a patients doctor may order individual tests or broad test panels such as a comprehensive metabolic panel and a liver panel. These tests may be used to evaluate the liver, detect evidence of hepatitis, and begin to narrow down the underlying cause of a patients condition.
Tests used to diagnose, evaluate, and guide treatment for viral hepatitis may be performed individually when a person has a known or suspected exposure to a specific type of viral hepatitis. In patients without a known or expected exposure, tests may be performed together as part of an acute viral hepatitis panel. An acute viral hepatitis panel detects evidence of the three most common types of hepatitis in the United States: hepatitis A, B, and C.
Viral hepatitis testing detects antibodies, antigens, or the genetic material of a hepatitis virus. Antigens are substances from the virus that produce an immune response, while antibodies are produced by the immune system after an infection. Tests related to viral hepatitis include:
|Tests Related to Viral Hepatitis|
|Blood||Antibodies present in primary biliary cholangitis, a type of liver disease|
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How To Prevent An Infection
You contract hepatitis C when you come into contact with the blood of a person who has a hepatitis C infection.
Hepatitis C can be transmitted from mother to baby during childbirth. It can be transmitted from a needle stick in a medical setting too.
Its not common, but hepatitis C can also be transmitted when you share personal items or during sexual contact with a person who has the infection.
Here are some ways to lower your risk of hepatitis infection:
- Do not share needles, syringes, or other injection equipment.
- Do not share razors, toothbrushes, or other personal care items.
- When getting a tattoo or body piercing, use only licensed facilities that prioritize and implement infection-control practices.
- Be very careful when cleaning up blood spills and be sure to wear gloves. The hepatitis C virus can live up to 6 weeks on surfaces.
Causes Of Noninfectious Hepatitis
Although hepatitis is most commonly the result of an infection, other factors can cause the condition.
Alcohol and other toxins
The alcohol directly injures the cells of your liver. Over time, it can cause permanent damage and lead to thickening or scarring of liver tissue and liver failure.
Other toxic causes of hepatitis include misuse of medications and exposure to toxins.
Autoimmune system response
In some cases, the immune system mistakes the liver as harmful and attacks it. This causes ongoing inflammation that can range from mild to severe, often hindering liver function. Itâs three times more common in women than in men.
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Testing For Hepatitis C
Two tests need to be done to discover if you have hepatitis C:
- Antibody test: Which establishes whether you have ever been exposed to the hepatitis C virus.
- PCR test: Which establishes whether the virus is still active and needs treating.
The two tests can often be done from one sample of blood which means you may only need to provide the sample once. Both tests can then be done on your sample at the laboratory. However, some services will perform one test and then call you back for a further blood sample to perform the second test.
A hepatitis C antibody test is the first test undertaken. This is to determine whether you have ever been exposed to the hepatitis C virus. It works by testing for the presence of antibodies to the virus generated by your immune system. If you receive a negative hepatitis C antibody test but have been experiencing symptoms or have been recently exposed to hepatitis C, then you are likely to be advised to have a second test.
It is important to remember that there is a ‘window period’. This is the short period of time when your immune system may not have had time to produce antibodies. It usually takes between six and twelve weeks for these antibodies to develop. However, in a few people it can take up to six months. So if you have the test within this window period and the result is negative, it does not necessarily mean that you don’t have the virus.
Who Should Get Tested
You should consider getting tested for hepatitis C if you’re worried you could have been infected or you fall into one of the groups at an increased risk of being infected.
Hepatitis C often has no symptoms, so you may still be infected if you feel healthy.
Some groups of people are at an increased risk of hepatitis C, including:
- ex-drug users and current drug users, particularly users of injected drugs
- people who received blood transfusions before September 1991 or blood products before 1986 in the UK
- UK recipients of organ or tissue transplants before 1992
- people who have lived or had medical treatment in an area where hepatitis C is common high-risk areas include Africa, the Middle East and central Asia
- babies and children whose mothers have hepatitis C
- anyone accidentally exposed to the virus, such as health workers
- people who have received a tattoo or piercing where equipment may not have been properly sterilised
- sexual partners, family members and close contacts of people with hepatitis C
If you continue to engage in high-risk activities, such as injecting drugs frequently, regular testing may be recommended. Your doctor will be able to advise you about this.
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Symptoms Of Hepatitis C
Many people dont experience any symptoms when they get infected with Hepatitis C. Others might face vague flu-like symptoms, joint aches, tiredness, nausea and pains.
Some infected people stay well and their liver do not get affected. However, others might develop health complications for a long term that require ongoing treatment.
How Hepatitis A Is Spread
It can be spread by two routes. The first route is it may spread sexually where sex involves any contact with the anus or faeces of an infectious person. Penetrative sex such as oral sex, without a condom may further spread Hepatitis A.
The other route is through foods that have been contaminated by faeces or by someone who is suffering from Hepatitis A who has not washed their hands properly before preparing food.
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Why The Test Is Performed
Your provider may order this test if you have signs of hepatitis. It is used to:
- Detect current or previous hepatitis infection
- Determine how contagious a person with hepatitis is
- Monitor a person who is being treated for hepatitis
The test may be performed for other conditions, such as:
- Chronic persistent hepatitis
Prior To Vaccination: Pre
- Some patients should be tested for existing immunity to hepatitis A, before vaccination these patients should be tested only for Hep A IgG
- Patients who should be tested prior to vaccination are those who have a reasonable likelihood of previous hepatitis A infection, such as:
- People born in geographic areas with high or intermediate prevalence of hepatitis A
- Native Americans
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What To Expect From Your Doctor
Hep B can be very complex and not every doctor has a good understanding of it. You can check our directoryfor a hep B specialist doctor or use our resources to help you and your doctor through hep B testing.
Your doctor might ask you about your family history of hep B or liver disease, where you were born, and any other possible exposures to hep B such as unprotected sex or injecting drug use.
You can tell your doctor as much or as little as you feel comfortable with. More information can help your doctor make the best decisions for your health, but what you share with them is up to you.
You might be able to access healthcare via your computer or phone.