The Evolution Of Hepatitis C Treatment
Hepatitis C has been around for a long time. Even before the development of these new treatments, between 15 to 25 percent of individuals infected with HCV did not become chronically infected. Their bodies were able to clear the virus on their own. However, until relatively recently there were few effective treatment options for hepatitis C.
Historically the major treatment regimen was a long course of pegylated interferon and ribavirin. However, these treatments have significant problems. They show an only moderate ability to get rid of the virus and they have significant side effects. For example, one study found that as many as a quarter of people taking interferon developed major depressive episodes due to the treatment regimen.
In addition, those drugs were contraindicated in individuals with advanced liver or kidney disease. That meant that many people with hepatitis C weren’t even eligible to take them.
Interferon and ribavirin were also least effective against the most common types of hepatitis C. Genotype 1 was historically difficult to treat with pegylated interferon and ribavirin. The treatment regimen worked slightly better with genotypes 2 and 3, but those types were also less common.
The combination of poor efficacy and high intolerance were driving forces for the development of interferon-free methods of hepatitis C treatment. These drugs are known as direct acting antivirals . It’s DAAs that have led to hepatitis C being considered curable.
How Do I Get Hepatitis B Treatment
Usually for adults, hepatitis B goes away on its own and you wont need treatment. Your doctor might tell you to rest, eat well, and get plenty of fluids. You may also get medicines to help with any symptoms you might have but be sure to talk with your doctor or nurse before taking anything.
If you have chronic hepatitis, there are medicines you can take to treat it. Your doctor will tell you about your options and help you get whatever treatment you need.
How Is Hepatitis A Treated
If you think youâve been exposed to hepatitis A, you should see your doctor right away. Getting a vaccine or a drug called hepatitis A immune globulin could keep you from getting sick. But for this to work, youâll need to get the vaccine very soon after coming into contact with the virus.
Thereâs no treatment once youâve been infected. Youâll have to wait until your body gets rid of the virus. Most people find that their liver is healed within 6 months.
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Awareness Prevention And Early Diagnosis Are Essential
There’s a good reason why hepatitis C is known as a “silent killer.”
According to the U.S. Centers for Disease Control and Prevention, an estimated 3.2 million Americans live with chronic hepatitis C infection, which is transmitted through infected bodily fluids like blood and semen, and causes inflammation of the liver. Yet up to 75% of people who have hepatitis C aren’t aware they have it.
Most of those living with the virus experience only mild symptoms or don’t have any symptoms at all until they develop serious liver damage or another life-threatening liver disease. Unfortunately, that means they aren’t getting diagnosed and treatment is delayed until the later stages when irreversible liver damage has occurred.
Here, hepatologistNancy Reau, MD, associate director of the Solid Organ Transplant Program at Rush University Medical Center, explains who is at risk for hepatitis C and offers advice to help you protect yourself.
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What Are The Common Types Of Viral Hepatitis
Although the most common types of viral hepatitis are HAV, HBV, and HCV, some clinicians had previously considered the acute and chronic phases of hepatic infections as “types” of viral hepatitis. HAV was considered to be acute viral hepatitis because the HAV infections seldom caused permanent liver damage that led to hepatic failure. HBV and HCV produced chronic viral hepatitis. However, these terms are outdated and not currently used as frequently because all of the viruses that cause hepatitis may have acute phase symptoms . Prevention techniques and vaccinations have markedly reduced the current incidence of common viral hepatitis infections however, there remains a population of about 1 to 2 million people in the U.S. with chronic HBV, and about 3.5 million with chronic HCV according to the CDC. Statistics are incomplete for determining how many new infections occur each year the CDC documented infections but then goes on to estimate the actual numbers by further estimating the number of unreported infections .
Types D, E, and G Hepatitis
Individuals who already have chronic HBV infection can acquire HDV infection at the same time as they acquire the HBV infection, or at a later time. Those with chronic hepatitis due to HBV and HDV develop cirrhosis rapidly. Moreover, the combination of HDV and HBV virus infection is very difficult to treat.
How Is It Tested For And Diagnosed
After you discuss your symptoms with your doctor, they may order a blood test to check for the presence of a viral or bacterial infection. A blood test will reveal the presence of the hepatitis A virus.
Some people have only a few symptoms and no signs of jaundice. Without visible signs of jaundice, its hard to diagnose any form of hepatitis through a physical examination. When symptoms are minimal, hepatitis A can remain undiagnosed. Complications due to a lack of diagnosis are rare.
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Is Hepatitis B Curable
Theres no cure for hepatitis B. The good news is it usually goes away by itself in 4 to 8 weeks. More than 9 out of 10 adults who get hepatitis B totally recover.
However, about 1 in 20 people who get hepatitis B as adults become carriers, which means they have a chronic hepatitis B infection. Carriers are more likely to pass hepatitis B to other people. Most carriers are contagious meaning they can spread hepatitis B for the rest of their lives.
Hepatitis B infections that last a long time may lead to serious liver diseases like cirrhosis and liver cancer. About 1 in 5 people with chronic hepatitis B die from it. There are medicines that can help treat chronic hepatitis B infections.
Most babies who get hepatitis B during birth develop chronic infection, unless they get treated right away. But treatments are almost always effective if your baby gets them quickly. Thats why its important for pregnant people to get tested for hepatitis B.
Hepatitis C: Common Deadly And Curable
18 September 2017 By Rich Hutchinson, Pedro Valencia, Shana Topp, and Thomas Eisenhart
Consider some sobering and little-known facts: Hepatitis C is the most common and deadly infectious disease in the United States, beating out HIV, tuberculosis, and 57 other illnesses tracked by the Centers for Disease Control and Prevention . More than 4 million Americans are infectedmost of them baby boomers but only 50% have been diagnosed. The remainder are unaware that they have contracted the virus, thus putting themselves and others at risk. And while mortality rates for most infectious diseases are decreasing, deaths from HCV are rising over time. According to the CDC, nearly 20,000 deaths were reported in 2014, up from just 11,000 in 2003.
Perhaps worst of all is that although HCV is common and deadly, about 95% of the time it can be cured with antiviral treatments. Media attention has focused on the high cost of these therapies, but other roadblocks are even more problematic. For instance, there is a lack of awareness about the disease, its risk factors, and available treatments not only among patients and members of the general populationbut also among nurses, physicians, and other health care providers.
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What Is The Treatment For Viral Hepatitis
Treatment of acute viral hepatitis and chronic viral hepatitis are different. Treatment of acute viral hepatitis involves resting, relieving symptoms, and maintaining an adequate intake of fluids. Treatment of chronic viral hepatitis involves medications to eradicate the virus and taking measures to prevent further liver damage.
In patients with acute viral hepatitis, the initial treatment consists of relieving the symptoms of nausea, vomiting, and abdominal pain . Careful attention should be given to medications or compounds, which can have adverse effects in patients with abnormal liver function . Only those medications that are considered necessary should be administered since the impaired liver is not able to eliminate drugs normally, and drugs may accumulate in the blood and reach toxic levels. Moreover, sedatives and “tranquilizers” are avoided because they may accentuate the effects of liver failure on the brain and cause lethargy and coma. The patient must abstain from drinking alcohol since alcohol is toxic to the liver. It occasionally is necessary to provide intravenous fluids to prevent dehydration caused by vomiting. Patients with severe nausea and/or vomiting may need to be hospitalized for treatment and intravenous fluids.
Medications for chronic hepatitis C infection include:
- oral daclatasvir
Medications for chronic hepatitis B infection include:
- oral entecavir
- oral tenofovir
Medically Reviewed By Dr Gerardo Sison Pharmd
Gerardo Sison, Pharm.D., is a registered pharmacist who has worked in clinical and retail settings providing drug education for healthcare professionals and patients alike. He graduated Cum Laude from the University of Florida where he earned a Doctorate of Pharmacy . He piloted a longitudinal clinical research program and completed his clinical internship at St. Josephs Hospital in Tampa, Florida. Read More > >
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What Is Hepatitis E
Hepatitis E, also called enteric hepatitis , is similar to hepatitis A, and more prevalent in Asia and Africa. It is also transmitted through the fecal-oral route. It is generally not fatal, though it is more serious in women during pregnancy and can cause fetal complications. Most patients with hepatitis E recover completely.
What Do My Test Results Mean
There are two blood tests that are used to detect hepatitis C. The first tests for hepatitis C antibodies, or signs that your body fought or is fighting an infection. The results will tell your doctor whether youve ever had the virus.
If the antibody test is positive, youll receive a second test, which can detect the amount of virus, or viral load, in your blood. Your doctor may then conduct a third blood test to determine which type you have, to allow for more targeted hepatitis C treatment.
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Antiviral Medication For Hepatitis B
Doctors may recommend antiviral medication for people with chronic hepatitis B, which occurs when the virus stays in your body for more than six months.
Antiviral medication prevents the virus from replicating, or creating copies of itself, and may prevent progressive liver damage. Currently available medications can treat hepatitis B with a low risk of serious side effects.
NYU Langone hepatologists and infectious disease specialists prescribe medication when they have determined that without treatment, the hepatitis B virus is very likely to damage the liver over time. People with chronic hepatitis B may need to take antiviral medication for the rest of their lives to prevent liver damage.
There are many different types of antiviral medications available, and your doctor recommends the right type for you based on your symptoms, your overall health, and the results of diagnostic tests. A doctor may take a wait-and-see approach with a person who has a healthy liver and whose blood tests indicate a low viral load, the number of copies of the hepatitis B virus in your bloodstream.
Someone with HIV infection or AIDS may have a weakened immune system and is therefore more likely to develop liver damage. The U.S. Centers for Disease Control and Prevention strongly recommends that people with HIV infection who are diagnosed with hepatitis B immediately begin treatment with antiviral medication.
Hepatitis A Vaccine And Travel
If youâre going to a country where hepatitis A is common and youâve never had the virus or the vaccine, start the vaccination process as soon as you can. It takes 2 to 4 weeks after the first dose for the vaccine to work, but even one shot a few days before you leave will give you some protection.
People who are allergic to something in the vaccine and children younger than 6 months might instead get a shot of immune globulin , which will protect against hepatitis A for up to 2 months.
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Three Million In Us Diagnosed With Hep C
Chronic Hepatitis C has been diagnosed in about three million people in the United States. It often causes no symptoms, and many who have been infected for years or even decades may remain unaware of it until symptoms finally appear. The ultimate cause of death attributable to chronic infection is cirrhosis or liver cancer, although the disease progresses to cirrhosis in fewer than half of cases. There is no vaccine.
The main risk factor in the United States is past injection-drug use, Monto says. The others most at risk are those who received blood transfusions before 1992, Monto says, referring to the year when high-quality screening of the blood supply was implemented.
Compared to HIV or hepatitis B, the risk of hepatitis C being transmitted by sex is low, Monto says, but among men who have sex with men there has been an increase in reports of the virus being sexually transmitted, more so among those who are infected with HIV.
Anybody with a history of ever being exposed to injection drugs or who received a transfusion before the blood supply was screened should be tested, Monto says. Thats not controversial at all. What has been controversial is whether or not all baby boomers should be screened.
Those who are chronically infected may be able to reduce the likelihood of disease progression by avoiding alcohol, by maintaining a healthy weight, and by being vaccinated against hepatitis A and hepatitis B, Monto says.
Preventing The Spread Of Viral Hepatitis
Having good personal health habits is the key to preventing the spread of many diseases, including hepatitis. Other preventive measures include:
Getting vaccines. A hepatitis B vaccine is given to newborns, babies, and toddlers. It is as part of the routine vaccine schedule. A hepatitis A vaccine is available for people at risk for the disease while traveling. There are no vaccines for hepatitis C, D, or E at this time.
Blood transfusion screening. Blood for transfusions is routinely screened for hepatitis B and C to reduce the risk of infection.
Antibody treatment. If a person has been exposed to hepatitis, an antibody treatment can be given to help protect him or her from the disease.
Safe sex. Practice safe sex, including using condoms.
Safe needle use. Don’t share or reuse needles, syringes, or other equipment.
Not sharing personal items. Don’t use personal items that may have even a small amount of an infected person’s blood. These include nail clippers, toothbrushes, glucose monitors, or razors.
Getting tattoos safely. If you plan on getting a tattoo, use a licensed facility only. Don’t get tattoos in an unsafe setting.
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If You Notice Symptoms See A Doctor Right Away
Symptoms of hepatitis C include the following:
- Jaundice a yellowish tone to the eyes and skin
- Mild, chronic right belly pain
- Loss of appetite
If you believe you have been exposed to hepatitis C or notice any symptoms, visit your primary care doctor as soon as possible. If you test positive for the virus, your doctor can refer you to a hepatologist to discuss your options.
“I strongly encourage all baby boomers and others who are at high risk to get tested, even if you don’t look or feel sick,” Reau says. “If you do have hepatitis C, the earlier we discover it, the more likely we can prevent it from progressing and causing more serious damage.”
What Is Hepatitis A
Hepatitis A, also called hep A, is a contagious liver infection caused by the hepatitis A virus. Some people have only a mild illness that lasts a few weeks. Others have more severe problems that can last months. You usually get the disease when you eat or drink something contaminated by poop from a person who has the virus.
The hepatitis A virus usually isnât dangerous. Almost everyone who has it gets better. But because it can take a while to go away, youâll need to take care of yourself in the meantime.
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What Is Acute Fulminant Hepatitis
Rarely, individuals with acute infections with HAV and HBV develop severe inflammation, and the liver fails . These patients are extremely ill with the symptoms of acute hepatitis already described and the additional problems of confusion or coma , as well as bruising or bleeding . In fact, up to 80% of people with acute fulminant hepatitis can die within days to weeks therefore, it is fortunate that acute fulminant hepatitis is rare. For example, less than 0.5% of adults with acute infection with HBV will develop acute fulminant hepatitis. This is even less common with HCV alone, although it becomes more frequent when both HBV and HCV are present together.