How Soon Can You Detect Hepatitis C

How About Monitoring Aminotransferase Levels

What is usually most helpful is serial testing of AST and ALT over time to determine whether the levels are going up, staying stable, or going down. For example, patients undergoing treatment for chronic hepatitis C should be monitored with serial liver enzyme tests. Those responding to treatment will experience lowering of liver enzyme levels to normal or near normal levels. Those who develop relapse of hepatitis C after completion of treatment will usually develop abnormal liver enzyme levels again.

Do Medical Conditions Outside The Liver Occur In Persons With Chronic Hepatitis C

A small percentage of persons with chronic hepatitis C develop medical conditions outside the liver . These conditions are thought to occur due to the body’s natural immune system fighting against itself. Such conditions include: glomerulonephritis associated with kidney disease, essential mixed cryoglobulinemia, and porphyria cutanea tarda-a skin condition.

Why It Is Done

Hepatitis C virus testing is done to:

• Find out if a hepatitis C infection is the cause of abnormal liver function tests.
• Screen people who have an increased chance of getting or spreading a hepatitis C infection.
• Screen potential blood donors and donor organs to prevent the spread of hepatitis C.
• Screen people born from 1945 to 1975. People in this age group are more likely to have hepatitis C and not know it.
• Identify the type of hepatitis C virus causing the infection.

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How Is Hepatitis C Diagnosed

Hepatitis C viruses are so small that they can only been seen with the most powerful electron microscopes. Yet simple tests can reliably tell whether someone has been exposed to the virus. Other tests can show if someone still has an active infection. Still other tests are able to gauge the extent of damage to the liver.

Often the first sign that something is wrong comes from a standard blood test, which includes a test for enzymes associated with liver function. An abnormal reading alerts doctors to the possibility of liver disease. Several other tests performed by analyzing blood can verify the presence of the hepatitis C virus. One simple test measures signs of antibodies to hepatitis C, small molecules produced by the immune system when it detects a virus. Other tests measure the level of viruses found in the blood and identify precisely which type of hepatitis C is present. The most common tests for hepatitis C include the following:

Enzyme immunoassay

HCV RNA

The HCV RNA test looks for the presence of the genetic material that makes up the hepatitis C virus, called RNA. One of two different kinds of methods may be used: polymerase chain reaction or transcription mediated amplification . Unlike an antibody test, which looks for signs that the immune system has responded to hepatitis C, the RNA test looks for the presence of the virus itself. Finding HCV RNA is a reliable way to demonstrate that HCV infection is present.

Recombinant immunoblot assay

Normally Where Are The Aminotransferases

AST is normally found in a diversity of tissues including liver, heart, muscle, kidney, and brain. It is released into serum when any one of these tissues is damaged. For example, its level in serum rises with heart attacks and with muscle disorders. It is therefore not a highly specific indicator of liver injury.

ALT is, by contrast, normally found largely in the liver. This is not to say that it is exclusively located in liver but that is where it is most concentrated. It is released into the bloodstream as the result of liver injury. It therefore serves as a fairly specific indicator of liver status.

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Determining The Stage Of Fibrosis

Noninvasive methods of assessing fibrosis are used to predict the severity of fibrosis. Similar to liver biopsy, these noninvasive techniques use scoring systems such as the 5-point Metavir scoring system to determine the stage of fibrosis. A Metavir score of 2 or greater is indicates significant fibrosis.1

Should I Be Tested For Hep C

As a result of so many people undiagnosed and untreated for hepatitis C, the Centers for Disease Control and Prevention recommends that all adults be tested at least once, with more frequent testing for those who fall into high-risk categories including: anyone with an abnormal liver test or an unexplained liver disease, people who received a blood transfusion before 1992, past or present injection drug users, people who have received kidney dialysis, anyone who has had multiple sex partners, people who have had a tattoo or body piercing, veterans , people with a history of heavy alcohol use, medical workers who handle blood, anyone who has received a clotting agent before 1987, and people who have tested positive for HIV.

Testing is simple and done through a blood test that looks for hepatitis C antibodies. If someone tests positive for hepatitis C antibodies, typically, a follow-up test is done to look for the hepatitis C virus in the blood stream, called a viral load test .

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Is It Necessary To Do Genotyping When Managing A Person With Chronic Hepatitis C

Yes, as there are 6 known genotypes and more than 50 subtypes of HCV, and genotype information is helpful in defining the epidemiology of hepatitis C. Knowing the genotype or serotype of HCV is helpful in making recommendations and counseling regarding therapy. Based on your genotype, the length of treatment, as well as the combination of medication will be determined. The good new now, is that the current HCV therapies are “pan-genotypic”, meaning they work equally well with all of the genotypes. This is great news.27. What is the risk for HCV infection from a needle-stick exposure to HCV contaminated blood?

After needle stick or sharps exposure to HCV positive blood , about 2 healthcare workers out of 100 will get infected with HCV.

How Soon Do Std Symptoms Appear

How long it takes for an STD to show up in testing is entirely dependent on the STD itself, how long its own incubation period is, and your own bodys immune response. You can test for some STDs, like chlamydia, only a day after potential exposure. Meanwhile, HIV and syphilis can take a month or more before you can accurately test for them. Its all pretty confusing but lucky for you, we created a nifty little chart that breaks down each STDs average incubation period.

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Lifestyle And Home Remedies For Hepatitis C Infection

If you receive a diagnosis of hepatitis C, your doctor will likely recommend certain lifestyle changes. These measures will help keep you healthy longer and protect the health of others as well:

• Stop drinking alcohol. Alcohol speeds the progression of liver disease.
• Avoid medications that may cause liver damage. Review your medications with your doctor, including over-the-counter medications you take as well as herbal preparations and dietary supplements. Your doctor may recommend avoiding certain medications.
• Help prevent others from coming in contact with your blood. Cover any wounds you have and dont share razors or toothbrushes. Dont donate blood, body organs or semen, and advise health care workers that you have the virus. Also tell your partner about your infection before you have sex, and always use condoms during intercourse.

What should I eat and drink if I have hepatitis C?

If you have hepatitis C, you should eat a balanced, healthy diet. Talk with your doctor about healthy eating. You should also avoid alcohol because it can cause more liver damage.

How To Get Tested

Hepatitis C testing is performed by a doctor. Testing requires a blood sample, which can be collected in a hospital, lab, or other medical setting. Blood is often drawn from a vein in the arm or, in children, taken by pricking the skin. After blood is collected, the sample is sent to a laboratory for analysis.

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What Are The Chances Of Someone With Hepatitis C Virus Infection Developing Cirrhosis Or Liver Cancer

Of every 100 people infected with hepatitis C virus, approximately 525 will develop cirrhosis within 1020 years. Patients who develop cirrhosis have a 1%4% annual risk of developing hepatocellular carcinoma and a 3%6% annual risk of hepatic decompensation for patients with liver failure, the risk of death in the following year is 15%20% 22).

What Do Elevated Ast And Alt Mean

AST and ALT are sensitive indicators of liver damage from different types of disease. But it must be emphasized that higher-than-normal levels of these liver enzymes should not be automatically equated with liver disease. They may mean liver problems or they may not. The interpretation of elevated AST and ALT levels depends upon the whole clinical picture and so it is best done by doctors experienced in evaluating liver disease.

The precise levels of these enzymes do not correlate well with the extent of liver damage or the prognosis . Thus, the exact levels of AST and ALT cannot be used to determine the degree of liver disease or predict the future. For example, patients with acute viral hepatitis A may develop very high AST and ALT levels . But most patients with acute viral hepatitis A recover fully without residual liver disease. For a contrasting example, patients with chronic hepatitis C infection typically have only a little elevation in their AST and ALT levels. Some of these patients may have quietly developed chronic liver disease such as chronic hepatitis and cirrhosis .

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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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Meaning Of Hcv Viral Load

The number of HCV RNA international units per milliliter of blood must be measured before treatment and during the course of treatment, to assess response. Before treatment, however, the HCV viral load is not related to the patient’s liver disease severity or HCV prognosis. This is important for patients and providers to understand.

Note: In hepatitis B, unlike hepatitis C, a higher HBV DNA viral load does correlate with increased disease severity and increased likelihood of outcomes such as hepatocellular carcinoma.

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How Much Does The Test Cost

The cost of hepatitis C testing depends on the tests that are performed, where the test is conducted, and a patients health insurance coverage. When testing is ordered by a doctor, patients with health insurance may find it helpful to discuss the cost of hepatitis C testing with their insurance company. In addition to the cost of testing, there may be other out-of-pocket costs such as copays and deductibles.

For patients without health insurance, or for whom insurance doesnt cover the cost of testing, it may be helpful to discuss the cost of hepatitis C testing with a doctor or hospital administrator.

At-home hepatitis C testing starts around $49. Some at-home kits test for multiple types of viral hepatitis at once, with the cost of these panels starting around $80.

Should Pregnant Women Be Routinely Tested For Anti

No. Since pregnant women have no greater risk of being infected with hepatitis C virus than non-pregnant women and interventions to prevent mother-to-child transmission are lacking, routine anti-hepatitis C virus testing of pregnant women is not recommended. Pregnant women should be tested for anti-hepatitis C virus only if they have risk factors for hepatitis C virus infection.

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How Do You Get Tested For Hepatitis C

Several testing procedures are available to accurately diagnose hepatitis C infection.

Masterfile

Hepatitis C, an inflammation of the liver caused by the hepatitis C virus , often goes undiagnosed until serious liver problems develop decades after contracting the virus. This is because the illness is asymptomatic for most people, according to the Centers for Disease Control and Prevention .

For these asymptomatic people, hepatitis C is generally detected when blood screenings show they are HCV-positive, or routine examinations show they have elevated levels of the liver enzyme alanine aminotransferase , an indication of liver cell damage.

Spread Of Hepatitis C

Hepatitis C is spread through blood-to-blood contact. The most common way people become infected with hepatitis C in Australia is by sharing drug-injection equipment such as needles, syringes, spoons and tourniquets.

Hepatitis C may also be spread through:

• tattooing and body piercing using equipment that has not been properly cleaned, disinfected or sterilised
• sharing toothbrushes, razor blades or other similar personal items that could have small amounts of blood on them
• one persons blood coming into contact with open cuts on another person
• needlestick injuries in a healthcare setting
• receiving blood transfusions in Australia prior to February 1990, when hepatitis C virus testing of blood donations was introduced
• unsterile medical procedures, blood transfusions or blood products and mass immunisation programs provided in a country other than Australia
• pregnancy or childbirth there is a five per cent chance of a mother with chronic hepatitis C infection passing on the virus to her baby during pregnancy or childbirth.
• Breastfeeding is safe unless nipples are cracked or bleeding
• sexual transmission rates of hepatitis C are very low, however the risk is increased with certain sexual practices or circumstances where there is the possibility of blood-to-blood or anorectal fluid-to-blood contact that can lead to tears in the mucosal membrane or exposure of open cuts or wounds on the skin to hepatitis C in anorectal fluid.

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Who Is More Likely To Get Hepatitis C

People more likely to get hepatitis C are those who

• have injected drugs
• had a blood transfusion or organ transplant before July 1992
• have hemophilia and received clotting factor before 1987
• have been on kidney dialysis
• have been in contact with blood or infected needles at work
• have had tattoos or body piercings
• have worked or lived in a prison
• were born to a mother with hepatitis C
• are infected with HIV
• have had more than one sex partner in the last 6 months or have a history of sexually transmitted disease
• are men who have or had sex with men

In the United States, injecting drugs is the most common way that people get hepatitis C.13

What About Other Liver Enzymes

Aside from AST and ALT, there are other enzymes including alkaline phosphatase, 5-nucleotidase , and gamma-glutamyltranspeptidase that are often tested for liver disease.

We have restricted this consideration of liver enzymes to AST and ALT because they are biochemically related to each other and, more importantly, they are the two most useful liver enzymes.

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Interpreting Hcv Rna Test Results

It is essential that the provider understands how to interpret HCV RNA test results, especially during the course of HCV treatment.

What Is The Risk That An Hepatitis C Virus

Approximately 6 of every 100 infants born to hepatitis C virus-infected mothers become infected with the virus. Transmission occurs at the time of birth, and no prophylaxis is available to prevent it. The risk is increased by the presence of maternal hepatitis C virus viremia at delivery and also is 23 times greater if the woman is coinfected with HIV. Most infants infected with hepatitis C virus at birth have no symptoms and do well during childhood. More research is needed to find out the long-term effects of perinatal hepatitis C virus infection.

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How Can I Protect Myself From Hepatitis C Infection

If you dont have hepatitis C, 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 persons 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

Hepatitis C can spread from person to person during sex, but the chances are low. People who have multiple sex partners, have HIV or other sexually transmitted diseases, or who engage in rough or anal sex have a higher chance of getting hepatitis C. Talk with your doctor about your risk of getting hepatitis C through sex and about safe sex practices, such as using a latex or polyurethane condom to help prevent the spread of hepatitis C.

If you had hepatitis C in the past and your body fought off the infection or medicines cured the infection, you can get hepatitis C again. Follow the steps above, and talk with your doctor about how to protect yourself from another hepatitis C infection.

If you think you may have been exposed to the hepatitis C virus, see your doctor as soon as possible. Early diagnosis and treatment can help prevent liver damage.