What Are The Treatments For Hepatitis C
Treatment for hepatitis C is with antiviral medicines. They can cure the disease in most cases.
If you have acute hepatitis C, your health care provider may wait to see if your infection becomes chronic before starting treatment.
If your hepatitis C causes cirrhosis, you should see a doctor who specializes in liver diseases. Treatments for health problems related to cirrhosis include medicines, surgery, and other medical procedures. If your hepatitis C leads to liver failure or liver cancer, you may need a liver transplant.
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.
Causes And Risk Factors
HCV causes hepatitis C. People contract the virus through blood-to-blood contact with contaminated blood. For transmission to occur, blood containing HCV must enter the body of a person without HCV.
A speck of blood, invisible to the naked eye, can carry hundreds of hepatitis C virus particles, and the virus is not easy to kill.
The report the following risk factors for developing hepatitis C:
- using or having used injectable drugs, which is currently the most common route in the U.S.
- receiving transfusions or organ transplants before 1992, which is before blood screening became available
- having exposure to a needle stick, which is most common in people who work in healthcare
- being born to a mother who has hepatitis C
The CDC offer advice on cleaning syringes if it is not possible to use clean and sterile ones. Although bleach can kill the HCV in syringes, it may not have the same effect on other equipment. Boiling, burning and using alcohol, peroxide, or other common cleaning fluids to wash equipment can reduce the amount of HCV but might not stop a person from contracting the infection.
It is extremely dangerous to inject bleach, disinfectant, or other cleaning products, so people should make sure they rinse the syringe thoroughly. A person should only ever use bleach to clean equipment if new, sterile syringes and equipment are not available.
People who are at risk due to these factors can have screening to rule out HCV.
- peginterferon alfa-2a
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Italian Restaurant In Philadelphia Suburb Is Shut Down After Hepatitis A Outbreak Kills At Least One Person And Infects Nearly A Dozen
- Gino’s Ristorante and Pizzeria in West Norriton may be the epicenter of a hepatitis A outbreak that killed one person after infected eleven
- Two additional infections and a second death connected to the virus are still under investigation, the Montgomery County Officer of Public Health said Friday
- The restaurant’s attorney said that allegations of the virus at the neighborhood haunt were ‘unfounded lies’ and that no violations were found upon inspection
- ‘We cannot and will not be held responsible for something we did not do’
- The well-reviewed restaurant received two ‘Out of Compliance’ ratings from the Health Department in 2020, including violations for ‘mouse-like droppings’
- Employees handled food for customers with their hands at one inspection, and ‘fly-like insects’ were spotted by an inspector in July of that year
Risk Factors For Disease Progression
Factors that could conceivably play a role in progression of chronic hepatitis C include features of the virus, the host or items of environmental or extraneous origin .
Regarding the virus, attention has been focused on viral concentration and viral genotype, but there is little definitive evidence that these factors affect liver disease progression.
Regarding extraneous issues, by far the most significant impact on disease progression is the cofactor of associated alcoholism , although the exact extent of alcohol intake likely to add to the injury is uncertain . Similarly, smoking has been reported to be associated with increased fibrosis progression to both cirrhosis and HCC .
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Can Hepatitis C Be Prevented
There is no vaccine for hepatitis C. But you can help protect yourself from hepatitis C infection by:
- Not sharing drug needles or other drug materials
- Wearing gloves if you have to touch another person’s blood or open sores
- Making sure your tattoo artist or body piercer uses sterile tools and unopened ink
- Not sharing personal items such toothbrushes, razors, or nail clippers
- Using a latex condom during sex. If your or your partner is allergic to latex, you can use polyurethane condoms.
NIH: National Institute of Diabetes and Digestive and Kidney Diseases
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Progression Based On Disease Severity
Two groups that represent opposite ends of the disease spectrum progress at differing rates, namely those who are immune suppressed and those who are HCV infected but who have persistently normal aminotransferase levels.
Hepatitis C virus-infected persons who are immunocompromised, either because of HIV co-infection or through immunosuppressive treatments , have a higher rate of progression to a more serious outcome than do those who are mono-infected. Relative to immunocompetent infected persons, immune suppressed persons have an approximately two-fold increase in the frequency and rate of development of cirrhosis.
Medications For Hepatitis C
Medications called direct-acting antivirals work to fully remove the hepatitis C virus from your body while helping prevent liver damage at the same time.
A few brand names of these medications include:
Researchers have identified 6 different genotypes, or strains, of hepatitis C.
Once your doctor or other healthcare professional knows your genotype, theyll have a better idea of which medication will work best for you. Some strains have developed a resistance to some medications, so your genotype can affect your treatment options.
Symptoms alone generally dont offer enough information for a doctor to diagnose hepatitis C. Whats more, you might not have symptoms or notice any signs of the condition.
Thats why its so important to connect with a doctor or other healthcare professional and ask about getting tested if youve been exposed to the hepatitis C virus.
The Centers for Disease Control and Prevention also recommend hepatitis C testing for people who have abnormal liver tests, along with those who are:
A healthcare professional can order a few different tests to help diagnose hepatitis C. These include:
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Hcv Telemedicine Program Satisfying Cost
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SAN FRANCISCO A telemedicine program brought high levels of satisfaction and proved cost effective in patients with hepatitis C in a Spanish prison, according to data presented at The Liver Meeting 2018.
Susana Llerena, MD, of the Hepatology Unit at Marques De Valdecilla University Hospital in Spain, and colleagues aimed to assess whether a telemedicine program could be useful in eliminating HCV in the El Dueso Penitentiary Center in Cantabria, Spain.
In prisons, there is a high concentration of comorbidities, Llerena said. This is a population at risk for the spread of new infections. The use of telemedicine allows us to improve access to specialized care for isolated populations, such as inmates.
Llerena suggested that this is the first study to look at telemedicine in a prison population. Our aim was to evaluate the effectiveness of telemedicine from two points of view: we carried out a satisfaction assessment, and a cost-effectiveness assessment, she said. The full cohort included 847 patients, of whom 69 had HCV.
The intervention included a universal test-and-treat strategy conducted between 2016 and 2017. The study had multiple phases, from defining the work team, to acquiring informed consent, to setting up the telemedicine program. Ultimately, in the key phase, universal treatment of inmates was initiated.
Additional Tests You Might Need
Once youve been diagnosed with Hepatitis C, your doctor will likely order a number of tests to find out about the health of your liver and decide on a treatment plan thats most appropriate for you.
Hepatitis C genotype
The Hepatitis C genotype refers to a specific strain or type of the Hepatitis C virus. There are six major types of Hepatitis C around the world: genotypes 1, 2, 3, 4, 5 and 6. In the United States, genotypes 1, 2, and 3 are common:
- Genotype 1: Most Americans with Hepatitis C have this type
- Genotype 2: About 10% of Americans with Hepatitis C have this type
- Genotype 3: About 6% of Americans with Hepatitis C have this type
The genotype of Hepatitis C does not change over time, so you only need to get tested once.
Genotype tests are done before a person starts treatment. Hepatitis C treatment works differently for different genotypes, so knowing your genotype helps your doctor choose the best treatment for you.
Testing for Hepatitis A and Hepatitis B
Your doctor may test to see if your body is immune to Hepatitis A and Hepatitis B. If these tests show no prior exposure or protection, he or she will recommend that you be vaccinated against these two viruses to eliminate the chance of becoming infected.
Liver function tests or liver enzymes
Liver function tests also include ALP and total bilirubin, among other things.
Tests to measure liver scarring or fibrosis
- Liver Biopsy
- Serum markers
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How Is A Person Tested For Hepatitis C
A viral-load test is used to check for hepatitis C in the bloodstream. Usually, hepatitis C virus can be found in a persons bloodstream two weeks after he or she becomes infected.
*Except in case of recent risk or in people with a weakened immune system**During the first six months after HCV infection, a person may spontaneously clear the virus if there was a recent risk, repeat viral-load testing to confirm chronic hepatitis C infection
Hcv Core Antigen Testing
The hepatitis C core antigen is a viral protein. Since the core antigen is part of hepatitis C virus, it can usually be found in the bloodstream two weeks after infection.
Since HCV core antigen testing is simpler and less expensive than viral-load testing, some experts suggest using it in resource-limited settings. Core antigen testing can be usedoften with HCV antibody testingto detect acute HCV or to confirm chronic HCV infection. HCV core antigen testing can also be used to measure treatment outcome. Although it does not detect low levels of HCV , usually the hepatitis C viral load is much higher in people who relapse after HCV treatment.
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What Does A Negative Hcv Antibody Test Result Mean
A negative antibody test result usually means that the person has not been infected with hepatitis C .
The body needs at least two months to make antibodies. People with weakened immune systems are not always able to produce antibodies. This might happen in people with autoimmune disorders , HIV-positive people with a CD4 cell count below < 200 cells/mm3, and people taking immunosuppressants.
Items Requiring Consideration For Evaluating The Natural History
As knowledge of hepatitis C began to grow, it became clear that in order to better understand the process of evolution of hepatitis C, consideration must be directed at the very least towards the following four questions:
What is the rate of spontaneous resolution of acute hepatitis C that brings the disease to an end, thus confining progression only to those in whom the virus persists?
Among those who do not spontaneously recover, what outcomes can be anticipated, with what frequency and over what duration of time?
What are the variables and risk factors that help predict that progression of chronic hepatitis is likely to occur?
What is the pathogenesis of disease persistence and progression?
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Hepatitis C Patients Protest Limited Access To Sofosbuvir
Hundreds of hepatitis C patients and respective supporters protested in Madrid last December, complaining about the cuts in public spending that have significantly reduced public access to Sovaldi , a novel drug that could treat and cure this deadly liver disease for hundreds of Spanish citizens. Those infected with the virus occupied a Hospital in Southern Madrid for a week, where they demanded the government to authorize physicians to prescribe the drug more commonly.
Hundreds of patients and supporters were yelling and waving banners while they took the protest to the health ministry gate. Protesters accused the agency of not spending enough money on making these crucial, life-saving drugs available to patients that actually need them.
Antonio Fernandez, 59, a patient suffering from hepatitis C, even said, If they do not give us the latest generation medicines, we will die. The group of protesters say that everyday, 12 people in Spain lose their lives to hepatitis C and its many life-altering and costly complications.
Sovaldi was originally approved for commercial purposes in Spain last November but, according to the lobbying group, the authorities only spent enough money to make the drug accessible to no more than 5,000 patients. Fernandez adds: It is trickling through.
What It Is Symptoms How You Get It & More
Hepatitis C, an inflammation of the liver, develops after you contract the hepatitis C virus.
This virus is bloodborne, which means you can only transmit or contract it through blood that carries the virus.
- Acute hepatitis C often involves no symptoms at all. Any symptoms you do experience may appear within a week or two after exposure, and they could clear up on their own in just a few weeks.
- Chronic hepatitis C symptoms, on the other hand, can develop over a period of months or even years. You might not notice any symptoms until they become severe.
The World Health Organization estimates around 58 million people around the world have chronic hepatitis C.
In the United States, hepatitis C numbers among the most common types of hepatitis, along with hepatitis A and B. Unlike hepatitis A and B, however, a vaccine to prevent hepatitis C doesnt yet exist.
Left untreated, hepatitis C can cause serious, even life-threatening health complications, including:
But most of the time, hepatitis C can be cured. Getting tested and treated promptly can help reduce your chances of severe symptoms and liver failure.
Read on to get the details on hepatitis C symptoms, complications, and treatment, plus a few tips on prevention.
Not everyone with hepatitis C virus experiences symptoms. In fact, about 80 percent of people dont notice any signs of illness when they first contract the virus.
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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 Is Hepatitis C Spread
Hepatitis C spreads through contact with the blood of someone who has HCV. This contact may be through:
- Sharing drug needles or other drug materials with someone who has HCV. In the United States, this is the most common way that people get hepatitis C.
- Getting an accidental stick with a needle that was used on someone who has HCV. This can happen in health care settings.
- Being tattooed or pierced with tools or inks that were not sterilized after being used on someone who has HCV
- Having contact with the blood or open sores of someone who has HCV
- Sharing personal care items that may have come in contact with another person’s blood, such as razors or toothbrushes
- Being born to a mother with HCV
- Having unprotected sex with someone who has HCV
Before 1992, hepatitis C was also commonly spread through blood transfusions and organ transplants. Since then, there has been routine testing of the U.S. blood supply for HCV. It is now very rare for someone to get HCV this way.
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Pathogenesis Of Chronic Hepatitis C
An extensive discussion of the mechanisms responsible for recovery from HCV infection is beyond the scope of this article. Control of HCV infection is clearly immunologically mediated as is evident by the appearance of virus-specific T cells with the occurrence of clinically apparent hepatitis C . Persistence of HCV infection results when innate responses are blunted, thus diminishing the direct antiviral effects and dampening the priming of adaptive responses . T-cell induction of interferon – clears HCV infection, while a poor response to IFN- permits continued viral replication with its effects on cytokine release.
What Are Antibodies
Antibodies are Y-shaped proteins made by a persons immune system. They are part of the immune systems response to viruses, bacteria, and other harmful substances .
Antibodies attach themselves to antigens or infected cells and tag them so that other immune cells can find and disable them. Antibodies stay in a persons body long after the antigen that triggered them disappears . If the same antigen enters a persons body again, even years later, the immune system will remember itand send antibodies to destroy it.
When HCV enters a persons bloodstream, it triggers an immune response. The immune system makes HCV-fighting antibodies. Sometimes, the immune system gets rid of hepatitis C virus by itself . About a quarter of people with hepatitis C will spontaneously clear the virus. This is more likely in young people , people who do not have HIV, and people with the IL28B CC genotype .
Even when a person has cleared HCV or been cured by treatment, HCV antibodies remain in a persons blood for years.
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