Cases Of Hepatitis C In The United States
The CDC reports that in 2018, a total of 15,713 U.S. death certificates had hepatitis C as an underlying or contributing cause of death. This is likely lower than the actual numbers since so many infections go undocumented.
Studies show that baby boomers are more likely than other groups to have been exposed to HCV. Most of them contracted infections between 1970 and 1990 during a peak of new infections.
And since people with an HCV infection might not show symptoms, they may unknowingly transmit the virus to others.
Today, the most common risk factor for hepatitis C in the United States is injection drug use.
Since an HCV infection can show no symptoms, the number of new cases is likely higher than reported, according to the CDC.
What Medications Cure Hepatitis C Infection
Interferons, for example, Roferon-A and Infergen, and pegylated interferons such as Peg-IntronT, Pegasys, were mainstays of treatment for years. Interferons produced sustained viral response of up to 15%. Later, peglatedll forms produced SVR of 50%-80%. These drugs were injected, had many adverse effects, required frequent monitoring, and were often combined with oral ribavirin, which caused anemia. Treatment durations ranged up to 48 weeks.
Direct-acting anti-viral agents are antiviral drugs that act directly on hepatitis C multiplication.
What Is Hepatitis C Infection How Many People Are Infected
Hepatitis C virus infection is an infection of the liver caused by the hepatitis C virus . It is difficult for the human immune system to eliminate hepatitis C from the body, and infection with hepatitis C usually becomes chronic. Over decades, chronic infection with hepatitis C damages the liver and can cause liver failure. In the U.S., the CDC has estimated that approximately 41,200 new cases of hepatitis C occurred in 2016. When the virus first enters the body there usually are no symptoms, so this number is an estimate. About 75%-85% of newly infected people become chronically infected. In the U.S., more than 2 million people are estimated to be chronically infected with hepatitis C. Infection is most commonly detected among people who are 40 to 60 years of age, reflecting the high rates of infection in the 1970s and 1980s. There are 8,000 to 10,000 deaths each year in the U.S. related to hepatitis C infection. HCV infection is the leading cause of liver transplantation in the U.S. and is a risk factor for liver cancer. In 2016, 18,153 death certificates listed HCV as a contributing cause of death this is believed to be an underestimate.
Those who have cirrhosis from HCV also have a yearly risk of liver cancer of about 1%-5%.
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Could I Give Hepatitis C To Someone Else
Yes, once you have hepatitis C, you can always give it to someone else. If you have hepatitis C, you cannot donate blood. You should avoid sharing personal items like razors and toothbrushes. It is very rare to pass hepatitis C in these ways, but it can happen. Always use a condom when you have sex. If you have hepatitis C, your sexual partners should be tested to see if they also have it.
Talk to your doctor first if you want to have children. The virus isnt spread easily from a mother to her unborn baby. But it is possible, so you need to take precautions. However, if youre trying to have a baby, do not have sex during your menstrual cycle. The hepatitis C virus spreads more easily in menstrual blood.
Sometimes The Infection Goes Away On Its Own
Acute hepatitis is C is a short-term illness that occurs within the first six months after being exposed to the virus. Like the human papillomavirus , early acute hepatitis C can clear on its own without treatment this happens about 25% of the time.
However, it’s more likely that the virus will remain in your body longer than six months, at which point it’s considered to be chronic hepatitis C infection.
“Being younger or a woman tends to be a factor in whether the virus clears on its own, and genetics may play a role,” Reau says. “But we can’t determine with certainty which people are certain to clear the infection and which aren’t.”
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Treatment And Medication For Hepatitis C
If you have acute hepatitis C, there is no recommended treatment. If your hepatitis C turns into a chronic hepatitis C infection, there are several medications available.
Interferon, peginterferon, and ribavirin used to be the main treatments for hepatitis C. They can have side effects like fatigue, flu-like symptoms, anemia, skin rash, mild anxiety, depression, nausea, and diarrhea.
Now youâre more likely to get one of these medications:
Find out more on treatment options for hepatitis C.
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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Can You Get A Vaccine To Prevent Hepatitis C
Vaccines are a way to expose your body to a virus before you encounter the live virus naturally. A vaccine contains traces of a dead virus, so your body can form a memory of the virus. Your body then remembers how to attack and destroy the virus if you ever come into contact with it.
There isnt a vaccine for hepatitis C at this time. Hepatitis C has many different subtypes and strains, so creating a vaccine that protects against all the different types is complicated. Vaccines are available for both hepatitis A and B, but one for hepatitis C hasnt been approved.
If you have hepatitis C, your doctor may suggest you get the vaccine for both hepatitis A and B. These two types of viruses cause liver damage, so the added protection is a smart idea.
What Are The Side Effects Of Treatments For Hepatitis C Infection
Side effects of interferon or pegylated interferon
- The most common side effects of interferon or pegylated interferon include fever, flu-like symptoms, and depression. Patients must be monitored closely for depression. Risk of suicide is a reason to avoid interferons.
- Interferons also reduce white blood cell and/or red blood cell counts . This may cause increased susceptibility to infection. Interferons also increase the risk of certain cancers. Death rarely occurs as a result of therapy, but may occur from progression of liver failure in patients with advanced cirrhosis.
Side effects of ribavirin
- Ribavirin most commonly causes anemia due to destruction of red blood cells . This can be severe enough that people with heart disease may suffer a heart attack from insufficient blood flow, so people with heart disease should not receive this drug. Anemia improves with a reduction in the dose of ribavirin. Injected growth factor that stimulates the production of red blood cells often is used to improve the anemia associated with ribavirin. Ribavirin also accumulates in the testicles and ovaries and causes birth defects in animals. Although no birth defects have been reported in humans, both men and women should use contraceptive measures to avoid pregnancy during and for at least six months after ribavirin treatment.
Side effects of DAAs
- The most common and significant side effects of boceprevir , sofosbuvir , and ledipasvir/sofosbuvir include
- fatigue ,
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What Are The Names Of The Medications For Treating Hepatitis C
Since 2014, multiple different antiviral treatments for hepatitis C have been developed. With the many options now available, often there is more than one good choice for a patient. Some of the treatments are recommended as first-line options, some are second-line options, and others are used less commonly in light of all the available choices.
- Elbasvir/Grazoprevir
Second line hepatitis C medications:
- Sofosbuvir/Velpatasvir/Voxelaprevir
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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How Effective Is Treatment
Direct acting antivirals cure 9 out of 10 patients with hepatitis C.
Successful treatment does not give you any protection against another hepatitis C infection. You can still catch it again.
There’s no vaccine for hepatitis C.
If treatment does not work, it may be repeated, extended, or a different combination of medicines may be tried.
Your doctor or nurse will be able to advise you.
What Occupations Have Increased Risk Of Hepatitis C
The risk of acquiring hepatitis C from the workplace depends on the amount of exposure to human blood or blood products and needlestick injuries. In general, occupational groups with increased risk include workers such as healthcare workers, dentists, and laboratory personnel who are repeatedly exposed to human blood and who are at risk of needlestick injuries.
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Immunogenicity Efficacy And Effectiveness
Immunogenicity
Protective concentrations of antibody against HA develop in 95% to 100% of vaccine recipients after 1 dose of HA vaccine, and nearly 100% seroconvert after receiving 2 doses of vaccine.
Pre-exposure
HA vaccines are at least 90% to 97% effective in preventing clinical HA illness.
Post-exposure
The use of HA vaccine in susceptible populations interrupts HA outbreaks. The protective efficacy of HA vaccine when used within 1 week of exposure is approximately 80%.
What Are The Symptoms Of Hepatitis C
Most people infected with hepatitis C have no symptoms. Some people with an acute hepatitis C infection may have symptoms within 1 to 3 months after they are exposed to the virus. These symptoms may include
If you have chronic hepatitis C, you most likely will have no symptoms until complications develop, which could be decades after you were infected. For this reason, hepatitis C screening is important, even if you have no symptoms.
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Hepatitis C Testing And Diagnosis
Doctors will start by checking your blood for:
Anti-HCV antibodies: These are proteins your body makes when it finds the hep C virus in your blood. They usually show up about 12 weeks after infection.
It usually takes a few days to a week to get results, though a rapid test is available in some places.
The results can be:
- Nonreactive, or negative:
- That may mean you donât have hep C.
- If youâve been exposed in the last 6 months, youâll need to be retested.
If your antibody test is positive, youâll get this test:
HCV RNA: It measures the number of viral RNA particles in your blood. They usually show up 1-2 weeks after youâre infected.
- The results can be:
- Negative: You donât have hep C.
- Positive: You currently have hep C.
You might also get:
Liver function tests: They measure proteins and enzyme levels, which usually rise 7 to 8 weeks after youâre infected. As your liver gets damaged, enzymes leak into your bloodstream. But you can have normal enzyme levels and still have hepatitis C. Learn the reasons why you should get tested for hepatitis C.
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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Test Frequency And Turnaround Time
Hepatitis C Serology testing is performed daily Monday to Friday.
Turnaround time is up to 3 days from receipt by PHO laboratory for Non-reactive antibody results. Reactive and Indeterminate HCV antibody results are available and reported within 6 days.
Repeat testing may be indicated in those with ongoing risk factors for the acquisition of HCV.
Once a patient tests positive for HCV antibodies, other than in cases of maternal antibody transfer, there is no value in repeating the test as they will remain antibody positive for life regardless of whether they have cleared the virus or are chronic carriers.
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.
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Are There Ways To Cure Hepatitis C Other Than With Medications
Patients sometimes ask whether there are ways to treat hepatitis C other than taking medicines. Currently, there are no vaccines to prevent hepatitis C. Once a person is infected, the only way to treat it is with prescribed antiviral medications.
Some patients worry that having hepatitis C means they will need a liver transplant. Only a very small fraction of people with hepatitis C require a liver transplant. By far, most people with hepatitis C never need a liver transplant. A transplant is performedonlywhen damage to the liver is extremely advanced and the liver is unable to perform its basic functions. A transplant provides a new working liver, but a transplant does not get rid of the hepatitis C virus in the patient. Patients with a liver transplant still need antiviral medication to cure their virus.
Questions To Ask Your Doctor
- Do I need treatment?
- What treatment is best for me?
- What medicines should I take?
- Are there any medicines I should avoid?
- How can I cope with the side effects of treatment?
- Is there a therapist I can talk to?
- How long will my treatment last?
- Can hepatitis C be cured?
- Are organ transplants and blood transfusions safe?
- Is it safe for me to get pregnant?
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What Are The Symptoms And Consequences Of Infection
Approximately 20 percent of persons exposed to the virus develop symptoms which may include jaundice , fatigue, dark-colored urine, stomach pain, loss of appetite and nausea. After the initial infection, 15-25 percent will recover and 75-85 percent will become chronically infected . Approximately 70 percent of persons chronically infected may develop liver disease, sometimes decades after initial infection.
Does Treatment For Hepatitis C Always Work
Treatments for this virus have improved dramatically in recent decades. Older treatments relied on strengthening the bodys immune system and not attacking the virus directly. Newer medicines, however, work directly on the viruss cells.
Todays treatments can virtually cure hepatitis C. Once you complete treatment, your viral load will be checked regularly. If the virus is still undetectable in your blood after three months, youre considered cured of hepatitis C.
15 to 25 percent of people who get hepatitis C will eventually clear the virus from their body entirely. This can be done through treatment, or the body can spontaneously eliminate the virus.
Having the hepatitis C virus once doesnt protect you against contracting it again. However, if you encounter the virus in the future, your risk for infected again is dramatically lower because of your previous infection. The best way to avoid being infected again is to reduce behaviors that put you at risk.
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