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
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Submission And Collection Notes
Freshly drawn whole blood specimens may be stored and/or transported at 2°C to 25°C for up to 6 hours before centrifugation . Following centrifugation, remove serum from cells immediately. Serum specimens may be stored and/or transported at 2°C to 8°C for up to up to 6 days or at -18°C for up to 12 weeks. If more extended storage of serum specimens is required, it must be frozen at -60°C.
Refer to for collection criteria and instructions for RNA testing using DBS. DBS samples, when prepared appropriately, will be stable at room temperature for up to 30 days.
Do I Need A Hepatitis Panel
Few reasons that have prompted your healthcare provider to order the hepatitis panel for you are: You have exhibited some acute symptoms of hepatitis and the type of virus A, B, or C is not known. You carry an elevated risk of hepatitis infection due to recent exposure and a hepatitis panel may be recommended to determine the type of virus behind the hepatitis infection. Your doctor may ask you to undergo the test even in the absence of symptoms. If you show signs of liver damage, then the hepatitis panel test is a must for you. Some of the overriding symptoms that prompt a hepatitis panel test are: Loss of appetite Illegal drugs
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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.
Monitor Your Liver And Overall Health
Having hepatitis C can be like swimming in murky water: You can’t see if there’s danger ahead. That’s because the virus can live quietly inside the body for years until it causes liver and even kidney damage. Because people can be asymptomatic, testing can be the one method of being sure whether you have hepatitis C. Luckily, with at-home hepatitis C tests, you can ease your mind from the comfort of your own home.
At-home testing allows you to ditch the health clinic lines and get results back quickly from certified labs. If you feel like your body may have been exposed either through drug-injection, sex, unregulated tattoos or body piercings, or sharing personal items, getting tested is recommended as soon as youre aware. Here we rounded up the best at-home hepatitis C tests, so you can start taking care of your health.
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Discussing Screening Results With Clients
The medical personnel who ordered or arranged the screening test, not counselors, usually explain the results. Hepatitis screening should be part of the intake physical examination in an opioid treatment program, and medical personnel may report the results. However, the client may want to discuss the results with the counselor or ask the counselor questions.
Anxiety might interfere with some clients ability to comprehend or retain information, which might need to be repeated.
Suggestions for conversations with clients when the test results are negative include the following:
- Explain results clearly and simply: So the HCV screening result was negative? This means that, as of 6 months ago, you did not have .
- Emphasize that a negative result to an HCV test does not indicate to and that the client should take precautions to avoid . If a relapse to drug use occurs, advise clients to avoid sharing any drug paraphernalia or equipment. Specify that this includes cookers, cotton, water, needles, syringes, pipes, and straws.
- Emphasize the importance of getting HAV and HBV vaccinations. Provide information about the availability of low- or no-cost vaccinations.
Clients whose screening test results are positive for will need additional tests and examinationsusually with doctors who specialize in diseases of the liver to get accurate diagnoses and to determine their health status and the extent of liver damage. These tests are described in .
Appropriate Uses Of The Hcv Rna Test
There are 4 major reasons that HCV RNA tests are used:
More rarely, HCV RNA is used when either very acute HCV infection is suspected or a false HCV Ab is suspected.
It would not be appropriate to repeatedly order HCV RNA viral load screening for a patient who is not on or was recently on HCV treatment, or to use the HCV viral load to determine the severity of the patient’s infection or the patient’s risk of developing significant liver disease.
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Identifying Patterns Of Risky Behavior
Screening is an opportunity to draw attention to the clients behaviors that put him or her at risk for contracting :
- Ask for the clients perception of his or her risk for having contracted : How likely do you think it is that the test will be positive?
- Listen for and identify behaviors that put the client at risk for contracting , B, and C and HIV, especially unprotected sex and sharing injection drug paraphernalia.
- Assess the clients alcohol consumption.
Addressing Hepatitis For The First Time
It is crucial that a treatment counselor or health professional use a nonjudgmental and compassionate tone. Clients need to feel comfortable disclosing information about their health and risky behaviors. The following strategies can help initiate the conversation:
- Display posters, literature, or other -related items that could help prompt the client to ask questions about hepatitis. .
- Assess clients ability to discuss , based on their degree of openness in the counseling session, the amount of detail they provide in their responses, and the length of the therapeutic relationship.
- Raise the subject in a way that avoids making clients feel defensive or afraid. Consider introducing the subject by making parallels with other conditions that have been discussed. Say, for example, You said you were tested for HIV several times. Were you ever tested for viral ? or You mentioned that your friend is sick with HIV. Have you been tested for HCV or HIV? Tell me about those tests.
- Be patient and allow time for multiple, short conversations about the subject. This might ease feelings of fear, anxiety, or shame.
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Getting Tested For Hepatitis C
A blood test, called an HCV antibody test, is used to find out if someone has ever been infected with the hepatitis C virus. The HCV antibody test, sometimes called the anti-HCV test, looks for antibodies to the hepatitis C virus in blood. Antibodies are chemicals released into the bloodstream when someone gets infected.
Test results can take anywhere from a few days to a few weeks to come back. Rapid anti-HCV tests are available in some health clinics and the results of these tests are available in 20 to 30 minutes.
Can Hepatitis C Be Treated
Yes, since 2010 enormous progress has been made in the treatment of chronic hepatitis C. New therapies called direct-acting antivirals are pills that act on the virus itself to eradicate it from the body, unlike older medicines like interferon injections which work by stimulating an immune response. These new treatments are very effective and can achieve cure rates of over 90%. In most situations now, there is no need for interferon, which was responsible for many of the side effects previously associated with HCV treatment. The new treatment combinations require shorter treatment durations , have reduced side effects and appear to be effective at all stages of the disease.
Because these new therapies are very new, they remain very expensive. As such, drug coverage from both government and private companies may require that your liver disease has progressed to a certain stage before they are willing to cover the cost of these drugs.
Your primary care physician may refer you to a specialist to determine whether you are eligible for treatment. A specialist will help you decide which drug therapy is best for you based on the severity of your liver disease, your virus genotype and whether or not you have been treated in the past.
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What Is Hepatitis C
Hepatitis C is a bloodborne virus that is spread when blood from an infected individual enters the body of someone who is not infected. The HCV infection can cause both chronic and acute hepatitis in an individual. Acute hepatitis describes individuals who have only had the hepatitis C virus infection for 6 months or less, which is considered an acute infection. In chronic hepatitis cases, the infection is long-term. A chronic infection is a significant risk factor for liver disease and liver cancer, and is potentially life-threatening if left untreated.
If you think you may be at risk, taking our hep C test kit can help you check if you have this infection. Our HCV test is quick and easy to take , and you can conveniently view your results on our secure, online platform.
Diagnosing Hepatitis A B & C
At NYU Langone, hepatologists, or liver specialists, and infectious disease specialists use blood tests to diagnose hepatitis A, B, and C. These viral infections cause inflammation of the liver.
If the results of a blood test confirm a diagnosis of viral hepatitis, your doctor may recommend imaging tests or a liver biopsy to determine the extent of liver disease.
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Potential Sites For Screening For Hepatitis C
Screening for hepatitis C can be offered in several venues the most likely are primary care offices, emergency rooms, urgent care clinics, and public health fairs.
Following the CDC recommendation, 3 studies were presented at the 2013 meeting of the American Association for the Study of Liver Diseases in Washington, DC. One study was conducted in an emergency department, the second in the outpatient clinics of the US Department of Veterans Affairs, and the third involved individuals undergoing screening colonoscopies for colorectal cancer at a community hospital.- All 3 studies confirmed the higher prevalence of positive serum anti-HCV in individuals born in the years 1945-1965.
Do I Need To Be Tested For Hepatitis C
People with hepatitis C may not show symptoms until liver problems show up, underscoring the importance of getting tested. The Centers for Disease Control and Prevention recommends all adults aged 18 years and older to get tested at least once in their lifetime. For those who have HIV, injected drugs or shared needles and syringes, or received a transfusion or organ transplant, testing is recommended regardless of age.
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Hepatitis C Screening: Questions For The Doctor
Hepatitis C is a serious liver disease caused by the hepatitis C virus . The most common way to get hepatitis C is by coming into contact with the blood of someone who has it.
Everyone ages 18 to 79 needs to get tested for hepatitis C at least once.
Many people who have hepatitis C live for years without feeling sick. But the virus can still damage your liver even when there arent any symptoms. You could also spread the virus to others without knowing it.
The only way to know for sure if you have hepatitis C is to get a blood test. Medicine can cure most cases of hepatitis C.
Enzyme Immunoassays For Detection Of Hepatitis C Antibody
The HCV Ab test is used for initial screening for hepatitis C. The test is performed by enzyme immunoassays , which detect the presence of hepatitis C antibodies in serum. The result of the test is reported as positive or negative. Third-generation EIAs have a sensitivity/specificity of approximately 99%. However, the presence of HCV Ab does not indicate whether the infection is acute, chronic, or resolved. A positive antibody test result should be followed up with an HCV RNA test to confirm that viremia is present.
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Taking A Hepatitis C Test
Hepatitis C testing is conducted on a sample of blood. Blood samples can be collected by a doctor, nurse, technician, or other health care provider from an adult patients vein using a small needle or a skin prick on a childs heel.
For an at-home hepatitis C test, patients collect a blood sample according to the manufacturers directions. Instructions provided in the test kit detail the steps to obtain a small sample of blood and mail it for testing.
When Should I Test For Hep C
Many people dont feel sick when they first get hep C. If you are exposed to hep C, your body will try and fight the virus for 6 months. 1 in 4 people will clear hep C in those first 6 months.
People who dont clear their hep C will have whats called chronic hep C. You can get tested for hep C straight after you think you have been exposed, but you will need to go back for another test after 12 weeks and possibly again at 6 months.
You might be able to access testing and healthcare via your computer or phone.
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Preparation Prior To Transport
Label the specimen container with the patients full name, date of collection and one other unique identifier such as the patients date of birth or Health Card Number. Failure to provide this information may result in rejection or testing delay.
Centrifuge if using SST. Place specimen in biohazard bag and seal. Specimens should be stored at 2-8°C following collection.
Specimens more than 7 days post collection will not be tested.
Requisitions And Kit Ordering
| < 1.50E+01 IU/mL | < 1.00E+03 IU/mL | HCV RNA detected below the lower limit of quantitation. Unable to quantify. or 1000 IU/mL .) |
| 1.50 E+01 to 1.00 E+08 IU/mL | 1.00 E+03 to 1.00 E+08 IU/mL | Viral load will be reported in IU/mL. |
| > 1.00E+08 IU/mL | > 1.00E+08 IU/mL | HCV RNA detected above the upper limit of quantitation. Unable to quantify. |
1Based on internal validation studies performed at PHO Laboratory, HCV RNA testing conducted on DBS is less sensitive than venous-collected samples. The lower limit of detection of HCV RNA using two DBS per test is approximately 1.6 to 2.0 logs higher than a concomitantly tested EDTA plasma or serum sample thus, DBS samples should NOT be used to rule out active HCV infection or to determine whether a patient on treatment has achieved an undetectable HCV RNA level.
No additional sample is usually required for HCV genotyping, provided there is sufficient volume. The first pre-treatment sample submitted for HCV RNA viral load testing will be used to automatically perform HCV genotyping if the HCV viral load is 500 IU/mL. Below this level, HCV genotyping cannot be performed.
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What Does The Test Measure
Hepatitis C testing identifies antibodies to the hepatitis C virus, detects viral RNA, and/or determines the strain of hepatitis C. Hepatitis C testing may involve several different tests:
- Hepatitis C antibody test: Antibodies are a part of the bodys response to an infection. Testing for hepatitis C antibodies determines whether or not a patient has been exposed to the hepatitis C virus at some point in their life. If this test is positive, the next step is to test for hepatitis C RNA which can tell you if you have a current infection.
- Hepatitis C RNA test: RNA is a type of genetic material from the hepatitis C virus that can be detected in the blood. If test results are positive after a hepatitis C antibody test, doctors use a hepatitis C RNA test to look for and/or measure the amount of the virus in the blood. Qualitative HCV RNA tests can detect the presence of HCV RNA, while quantitative HCV RNA tests measure the amount of HCV RNA. Understanding the amount of HCV in the blood helps to monitor response to treatment.
- Genotype test: There are at least six types of hepatitis C, which are also called strains or genotypes. Treatment for hepatitis C depends on the strain, so genotype testing to guide treatment is performed in patients who are diagnosed with an HCV infection.