Treatment: Chronic Hepatitis C
The latest drug to be approved by the FDA is glecaprevir and pibrentasvir . This medication offers a shorter treatment cycle of 8 weeks for adult patients with all types of HCV who donât have cirrhosis and who have not been previously treated. The length of treatment is longer for those who are in a different disease stage. The prescribed dosage for this medicine is 3 tablets daily.
There are several other combination drugs available, as well as some single drugs that may be used in combination. Your doctor will choose the right one for you depending on the type of hepatitis C you have, how well your liver is functioning and any other medical problems you may have. Also be sure to discuss your insurance coverage since these medications are expensive.
Questions To Ask Your Doctor
- Do I need treatment?
- What treatment is best for me?
- Will I need be hospitalized?
- Are there any medicines I should avoid taking?
- Are there foods I should avoid eating?
- Can I drink alcohol?
- How can I protect my family from getting hepatitis A?
- If Ive had hepatitis A, am I at higher risk of getting other types of hepatitis?
- Will I have permanent liver damage?
- How soon before I travel should I be vaccinated?
Can Hepatitis B Be Prevented
The hepatitis B vaccine is one of the best ways to control the disease. It is safe, effective and widely available. More than one billion doses of the vaccine have been administered globally since 1982. The World Health Organization says the vaccine is 98-100% effective in guarding against the virus. Newborns should be vaccinated.
The disease has also been more widely prevented thanks to:
- Widespread global adoption of safe blood-handling practices. WHO says 97% of the blood donated around the world is now screened for HBV and other diseases.
- Safer blood injection practices, using clean needles.
- Safe-sex practices.
You can help prevent hepatitis B infections by:
- Practicing safe sex .
- Never sharing personal care items like toothbrushes or razors.
- Getting tattoos or piercings only at shops that employ safe hygiene practices.
- Not sharing needles to use drugs.
- Asking your healthcare provider for blood tests to determine if you have HBV or if you are immune.
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Who Should Be Vaccinated For Hepatitis B
All newborns should be vaccinated. Also, people who are under 18 who were not vaccinated at birth should also get the vaccine. Other groups who should be sure to be vaccinated are those in certain high-risk categories, such as:
- People who have more than one sexual partner.
- Men who have sex with men.
- Adults with diabetes.
- Sexual partners of infected people and people who share households with infected individuals.
- People who are exposed to blood and other bodily fluids, including healthcare and public safety professionals, and people who work in jails and other places taking care of people who cant take care of themselves.
Should You Get Screened For Hepatitis C
Its important that the hepatitis C virus be detected early and that people who have it get treatment. Every person born between 1945 and 1965 the baby boomers should be tested for hepatitis C at least once, the CDC advises baby boomers are five times more likely to have this virus than other adults.
But since any signs and symptoms of this illness vary widely, and can change with the stage of disease involved, its also important to know your risk factors, which can include:
- Getting a tattoo or body piercing from someone who didnt use properly sterilized equipment
- Using intravenous drugs by means of a shared needle, or sharing a straw to inhale drugs
- Being a healthcare worker or working in another environment in which you could have come into contact with needles or blood infected with hepatitis C
- Having unprotected sex with multiple sex partners, having HIV , or having another sexually transmitted disease
- Being born to a mother who had hepatitis C when she was pregnant
- Undergoing hemodialysis for an extended period of time
- Receiving an organ transplant or blood transfusion before July 1992
- Receiving a blood clotting product made before 1987
Its simple to get screened for hepatitis C, says Dr. Hanje, and the treatment for this damaging liver disease is safe and effective. And if any concern about possible exposure to hepatitis C, he says, contact your doctor immediately for testing.
Additional reporting by Andrea Peirce
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Hepatitis C And Injecting Drugs
If you inject drugs, avoid sharing needles, syringes or other equipment such as tourniquets, spoons, swabs or water.
Where possible, always use sterile needles and syringes. These are available free of charge from needle and syringe programs and some pharmacists. To find out where you can obtain free needles, syringes and other injecting equipment, contact DirectLine
Try to wash your hands before and after injecting. If you cant do this, use hand sanitiser or alcohol swabs from a needle and syringe program service.
Blood Tests To Check For Liver Damage
Blood tests may be done to help find out if your liver has been damaged. They include:
- Bilirubin, albumin, and prothrombin time. These help show how well your liver is working. Cholesterol testing also may be done.
- Alanine aminotransferase , aspartate aminotransferase , alkaline phosphatase, and lactic dehydrogenase . These show whether your liver is damaged or inflamed.
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Treatment: Chronic Hepatitis B
The goal of treating chronic hepatitis B is to control the virus and keep it from damaging the liver. This begins with regular monitoring for signs of liver disease. Antiviral medications may help, but not everyone can take them or needs to be on medication. Be sure to discuss the risks and benefits of antiviral therapy with your doctor.
How Can I Make A Difference For People With Hepatitis C
Anyone can help raise awareness about this widespread disease. Citizens can write letters to their state representatives or local newspapers and get involved in volunteer efforts with liver disease or Veteran-affiliated organizations . Speaking at support groups and sharing your experience is also a good way to help others with HCV.
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Should I Be Screened For Hepatitis B
Screening is testing for a disease in people who have no symptoms. Doctors use blood tests to screen for hepatitis B. Many people who have hepatitis B dont have symptoms and dont know they are infected with hepatitis B. Screening tests can help doctors diagnose and treat hepatitis B, which can lower your chances of developing serious health problems.
Your doctor may recommend screening for hepatitis B if you9,14
- are pregnant
- were born in an area of the world where 2 percent or more of the population has hepatitis B infection, which includes Africa, Asia, and parts of the Middle East, Eastern Europe, and South America
- didnt receive the hepatitis B vaccine as an infant and have parents who were born in an area where 8 percent or more of the population had hepatitis B infection, which includes sub-Saharan Africa and parts of Asia
- are HIV-positive
- are a man who has sex with men
- have lived with or had sex with a person who has hepatitis B
- have an increased chance of infection due to other factors
Will The Baby Be Infected If The Mother Or Father Has Hepatitis C
The baby’s risk of becoming infected with hepatitis C in the womb varies, depending on whether the parent with hepatitis C is the father or the mother.
If the mother is infected, whether or not the father is infected, there is a 5% chance that the baby will be born with hepatitis C. The risk is the same regardless of whether the birth occurs by vaginal delivery or by cesarean section. The risk is higher if the mother is also living with HIV.
If the father has hepatitis C but the mother does not, the baby cannot become infected because a father cannot pass the virus directly to a baby. If the father first passes the virus to the mother through sex, then the baby possibly could be infected by the mother. However, the chance of the virus being transmitted both from father to mother and then from mother to baby is almost zero.
All children born to HCV-infected women should be tested for HCV infection. Testing is recommended using an antibody-based test at or after 18 months of age. Approximately 25-50 % infants with hepatitis C will clear the infection without any medical help by age 4. For those who become chronically infected, most have no symptoms .
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What Is The Difference Between Relapse And Nonresponse
The goal of treating chronic hepatitis C is to completely clear the virus. This means that your “viral load” is zero or so low that the virus can’t be detected with standard blood tests.
Without treatment, the hepatitis C virus in liver cells constantly makes copies of itself, and the virus ends up not just in liver cells but also in the bloodstream. Treatment is intended to completely stop reproduction of the virus so that it doesn’t continue to enter the bloodstream or cause any more injury to liver cells.
Successful treatment results in a “sustained virological response.” This means the virus becomes completely undetectable before the treatment is finished, and it remains undetectable for 6 months after treatment is stopped.
A “relapse” means the viral load drops to an undetectable level before treatment is completed, but becomes detectable again within 6 months after treatment is stopped. Even if the virus returns at a level that is lower than it was before treatment, a relapse is still considered to have occurred. A relapse can be determined if the viral load starts to rise during treatment, or at any time after the virus becomes undetectable.
A “nonresponse” means the viral load never drops significantly and the virus remains detectable throughout the course of treatment.
You Can Have It And Not Know It
What is hepatitis B?
Hepatitis B is a liver disease caused by the hepatitis B virus . HBV is far more infectious than HIV and can be prevented by a vaccine. People who have not been vaccinated may be at risk of getting infected.
About 95 percent of adults will recover within 6 months of becoming infected and as a result will develop lifelong protection against it. The remaining 5 percent are unable to clear the virus and will become chronically infected. Chronic hepatitis B infection is treatable.
It is estimated that less than 1 percent of Canada’s population is infected with either acute or chronic HBV. People who are infected before the age of 7 are at a higher risk of developing chronic infection. In 2011, the overall reported rate of acute hepatitis B infection in Canada was 0.6 reported cases per 100,000 people living in Canada.
Why is hepatitis B a health concern?
Many people infected with HBV do not know they have the virus because symptoms can take two to six months to appear and only about 50 percent of people develop symptoms. During this time, they can spread the infection to others. You may not know you have this infection until damage has already been done to your liver. Potential complications from chronic HBV infection include cirrhosis of the liver, liver failure, liver cancer and premature death.
Why do I need my liver?
How is hepatitis B spread?
HBV is spread through contact with infected blood and body fluids including semen and vaginal fluid.
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Treatment For Chronic Hepatitis B
If blood tests show that you still have hepatitis B after 6 months, your doctor may recommend medication to reduce the risk of complications of hepatitis B and regular tests to assess the health of your liver.
Treatment is usually offered if:
- your immune system is unable to control the hepatitis B by itself
- there’s evidence of ongoing liver damage
Hepatitis B medications can help keep the virus under control and stop it damaging your liver, although they won’t necessarily cure the infection and some people need lifelong treatment.
The main medicines for chronic hepatitis B are outlined below.
Is There A Cure For Chronic Hepatitis B
Currently, there is no complete cure for hepatitis B. But when managed properly, those living with the virus can expect to live a normal life. Maintaining a healthy diet and avoiding alcoholic beverages and tobacco products are crucial components in managing the disease.
You should also visit a doctor familiar with hepatitis B at least annuallythough twice a year might be best to monitor your liver through blood tests and medical imaging. As with most diseases, detecting it early leads to a better outcome. If youre exposed to the virus, you should get an antibody injection within 12 hours of exposure.
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How Is Hepatitis C Spread Will My Loved Ones Catch It From Me
Household transmission of hepatitis C is extremely rare. Here are some ways the virus is transmitted:
The number one risk factor for infection and transmission is sharing needles for intravenous drug use. Most people who use IV drugs become infected with HCV within one year of sharing needles. Learn more.
What Does It Mean When Different Types Of Blood Tests For Hepatitis C Give Different Results
The first test your provider probably will perform is called an “antibody” test. A positive result means that you were exposed to the hepatitis C virus at some point in your life.
If the result is positive, your provider will perform a second test called hepatitis C virus RNA to see if the virus is still in your body. If the RNA test result is positive, then you have chronic hepatitis C infection.
So what does it mean if you have a positive result for the first test but a negative result for the second?
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If I Have No Symptoms How Would I Know If I Have Hepatitis B
To confirm whether or not you have hepatitis B, you will need blood tests.
If you have at least one risk factor , you should ask your health care provider to be tested for hepatitis B. Also, you should be tested for hepatitis B if:
- you were born in a region where hepatitis B is more common, including Asia, Africa, southern and eastern Europe, the Pacific Islands, the Middle East, and the Arctic
- one or both of your parents immigrated from a region where hepatitis B is more common
- you live or travel to regions where hepatitis B is more common
- you have a family history of liver disease or liver cancer
- you have been in prison
- you are pregnant
- you have ever used injection drugs, even just once
- you have unexplained abnormal liver enzymes or if
- you receive medicines that suppress the immune system.
What Is The Prognosis/outlook For Patients Who Have Hepatitis A
Most cases of hepatitis A are short-lived, but the disease doesnt always look the same for everyone. Some people have short illnesses that only last a few weeks and have mild symptoms. Others can be very ill for several months. Hepatitis A is rarely fatal, but death has happened due to liver failure brought on by HAV. This tends to happen more often in people who are over 50 years old or and in people who have another liver condition.
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Diagnosis Of Hepatitis C
If you are at risk of hepatitis C infection, or think you may have been exposed to hepatitis C in the past, see your doctor for an assessment of your liver health. This will include blood tests and possibly a non-invasive test for liver damage .
There are 2 blood tests used to diagnose hepatitis C. Usually these can be done at the same time but sometimes they will be done separately.
The first test known as a hepatitis C antibody test can tell you whether you have ever been exposed to hepatitis C.
It may take 2 to 3 months from the time of infection until a blood test can detect antibodies to hepatitis C, so there is a window period during which you cannot tell if you are or have been infected. In this time, take precautions to prevent the potential spread of the virus.
The second test is called hepatitis C PCR, which will be done if the antibody test is positive. This determines if the virus is still present in your blood or liver or if you have already cleared the infection.
If you have cleared the virus or had successful treatment to cure it, the PCR test will be negative.
A liver ultrasound or Fibroscan can also be performed to assess if you have any liver damage.
If your doctor is inexperienced in diagnosing hepatitis C you can call the LiverLine on for information, and to find a GP who can help you.