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.
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.
Spread Of Hepatitis C
Hepatitis C is spread through blood-to-blood contact when blood from a person with hepatitis C enters another persons bloodstream.
The most common way people become infected with hepatitis C in Australia is by sharing injecting equipment such as needles, syringes, spoons and tourniquets. It is possible to be infected with hepatitis C after only one risk event.
Hepatitis C may also be spread through:
- tattooing and body piercing with equipment that has not been properly cleaned, disinfected or sterilised such as backyard tattoos’. Registered parlours with appropriate infection control procedures are not a risk
- needlestick injuries in a healthcare setting
- receiving blood transfusions in Australia prior to 1990 before hepatitis C virus testing of blood donations was introduced
- medical procedures, blood transfusions or blood products and mass immunisation programs provided in a country other than Australia
- pregnancy or childbirth there is a 5% chance of a mother with chronic hepatitis C infection passing on the virus to her baby during pregnancy or childbirth.
Breastfeeding is safe, however if nipples are cracked or bleeding cease breastfeeding until they have healed.
Less likely possible routes of transmission of hepatitis C include:
Hepatitis C cannot be transmitted by:
- sharing food, cups or cutlery
- shaking hands or day-to-day physical contact.
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Should I Be Screened For Hepatitis C
Doctors usually recommend one-time screening of all adults ages 18 to 79 for hepatitis C. Screening is testing for a disease in people who have no symptoms. Doctors use blood tests to screen for hepatitis C. Many people who have hepatitis C dont have symptoms and dont know they have hepatitis C. Screening tests can help doctors diagnose and treat hepatitis C before it causes serious health problems.
Types Of Viral Hepatitis In The United States
| Type | ||
|---|---|---|
| Contaminated food or water or transmitted from person-to-person by the fecal-oral route. | Usually a short-term illness that resolves within 2 months | Yes |
| Hepatitis B | Can be a short term or long term illness. Can lead to liver cirrhosis , liver cancer, or death. | Yes |
| Hepatitis C | Can be a short term or long term illness. Can lead to liver cirrhosis , liver cancer, or death. Treatment is available to cure Hepatitis C | No |
| Can be a short term or long term illness. Can lead to liver cirrhosis , liver cancer, or death. | No, but prevented in uninfected people by HBV vaccine |
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Hepatitis Bspreads In The Following Ways:
- Sex with an infected partner
- Sharing items such as toothbrushes, razors or medical equipment such as a glucose monitor with an infected person
- Sharing needles, syringes, or drug preparation equipment
- Direct contact with the blood or open sores of an infected person
- Exposure to blood from needlesticks or other sharp instruments of an infected person
Blood tests are needed to diagnose hepatitis B and to determine whether or not a person is currently infected or has been infected in the past.
- Acute hepatitis B is a short-term illness that occurs within the first 6 months after someone is exposed to the virus. An acute infection can range in severity from a mild illness to a serious condition requiring hospitalization.
- Some people, especially adults, are able to clear the virus. People who clear the virus become immune and cannot get infected with the hepatitis B virus again. Acute infection can but does not always lead to chronic infection.
- Chronic hepatitis B is a lifelong infection with the hepatitis B virus. This can lead to serious health problems over time, including liver damage, cirrhosis, liver cancer, and even death.
People with chronic hepatitis B should be monitored for signs of liver disease and evaluated for possible treatment. Several medications have been approved for hepatitis B treatment to control the amount of virus in the body as a means to prevent liver damage over time. There is no cure for hepatitis B but new drugs are in development.
Why Is It So Important To Take Hepatitis C Drugs Correctly
Taking any medicine correctly is extremely important. Taking medicines correctly means:
For hepatitis C drugs, these issues are especially important because, if a medicine is not taken correctly, it may not kill the virus completely. Then, because the virus has “seen” the drug, it learns how to mutate and change in ways that allow it to escape the drug and avoid getting killed off. This is called drug resistance.
Developing drug resistance is a serious issue. It means that the treatment may not work and that the patient may not respond to future treatments.
To prevent drug resistance, it is important to take any medication correctly, but especially DAAs such as Harvoni, Mavyret, Epclusa, and Zepatier.
Resistance can develop quickly. It is very important to take these new antiviral medications according to instructions, on schedule, and not to skip or reduce doses.
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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
How Is Hepatitis C Diagnosed
Symptoms alone generally dont offer enough information for a doctor to diagnose hepatitis C. Whats more, you might not have symptoms or notice any signs of the condition.
Thats why its so important to connect with a doctor or other healthcare professional and ask about getting tested if youve been exposed to the hepatitis C virus.
The also recommend hepatitis C testing for people who have abnormal liver tests, along with those who are:
- on hemodialysis
A healthcare professional can order a few different tests to help diagnose hepatitis C. These include:
- Blood tests. They may order a series of blood tests to check for the virus, starting with a hepatitis C antibody test. A PCR test can tell your healthcare professional whether the virus is currently active, and viral load testing can measure the amount of virus in your blood.
- Genotype test. This test can reveal which hepatitis C genotype you have. This information will help your healthcare professional find an effective treatment approach.
- Liver function test. If blood test results suggest chronic hepatitis C or your healthcare professional believes you could have liver damage, theyll order a liver function test. This test checks your blood for signs of heightened enzymes from your liver.
- Liver biopsy.This procedure can also help check for liver damage. A biopsy involves taking a small piece of tissue from your liver and testing it for cell abnormalities.
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Hepatitis Ctesting Recommended For:
- People born from 1945-1965
- People who received clotting factors before 1987
- People who received blood transfusions or solid organ transplants before 1992
- Current or former injection drug users or users who snorted drugs through the nose
- Long term hemodialysis patients
- Healthcare works who get a needle stick
- People with HIV
- Children born to others with Hepatitis C
- People who get tattoos in unregulated facilities
What is Hepatitis C and Why Should You Care?
Hepatitis C is a viral infection causing liver disease. Over 3 million people in the US are infected with hepatitis C and over half remain undiagnosed. The Johns Hopkins Viral Hepatitis Center is here to help more people get tested, treated and cured of this life-threatening disease.
From Cirrhosis to a Hepatitis C Cure – William’s Story
This is the story of William who never worried about his hepatitis C infection until he developed severe itching throughout his body. He entered into care in the Johns Hopkins Viral Hepatitis Centers outpatient clinical program located in the Bartlett Specialty Practice where he was diagnosed with advanced liver disease from chronic hepatitis C infection. This video describes his journey from symptomatic liver disease to treatment to a cure.
Hepatitis C is Curable
Are There Supplements That Are Bad For My Liver
Taking too many vitamin and mineral supplements may do more harm than good to a damaged liver.
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How Do Doctors Treat The Complications Of Hepatitis C
If hepatitis C leads to cirrhosis, you should see a doctor who specializes in liver diseases. Doctors can treat the health problems related to cirrhosis with medicines, surgery, and other medical procedures. If you have cirrhosis, you have an increased chance of liver cancer. Your doctor may order an ultrasound test to check for liver cancer.
If hepatitis C leads to liver failure or liver cancer, you may need a liver transplant.
Ways To Catch Hepatitis C
Hepatitis C is passed on through infected blood. Most people in Europe who get hepatitis C are injecting drug users who have caught the infection by sharing contaminated needles. Hepatitis C can also be passed on by tattooing, body piercing and acupuncture, if these are done in unsterile conditions.
Pregnant women with hepatitis C may pass the infection on to their babies.
In the past, blood transfusions could be a way of catching hepatitis C. Now, all blood donors should be screened and all blood products tested to stop this from happening. People on renal dialysis may be at higher risk.
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Treatments For Hepatitis C
Hepatitis C can be treated with medicines that stop the virus multiplying inside the body. These usually need to be taken for several weeks.
Until recently, most people would have taken 2 main medicines called pegylated interferon and ribavirin .
Tablet-only treatments are now available.
These new hepatitis C medicines have been found to make treatment more effective, are easier to tolerate, and have shorter treatment courses.
They include sofosbuvir and daclatasvir.
Using the latest medications, more than 90% of people with hepatitis C may be cured.
But it’s important to be aware that you will not be immune to the infection and should take steps to reduce your risk of becoming infected again.
Criteria To Distinguish A New Case From An Existing Case
A new case is an incident case that has not previously been reported meeting case criteria for hepatitis C. A new probable acute case may be reclassified as confirmed acute case if a positive NAT for HCV RNA or a positive HCV antigen test is reported within the same reporting year. A confirmed acute case may be classified as a confirmed chronic case if a positive NAT for HCV RNA or a positive HCV antigen is reported one year or longer after acute case onset. A confirmed acute case may not be reported as a probable chronic case . States and territories may choose to track resolved hepatitis C cases in which spontaneous clearance of infection or sustained viral response to treatment are suspected to have occurred before national notification or are known to have occurred after national notification as a confirmed or probable case to CDC.
For Probable Acute HCV
If the initial tests include both a positive anti-HCV and a negative HCV RNA, the case will be classified as “Not a Case” since the person does not have current infection. If the person has a positive anti-HCV, followed by a negative HCV RNA that was collected more than 30 days after the collection date of a positive anti-HCV along with the presence of jaundice, ALT > 200 IU/L, or total bilirubin 3.0 mg/dL, the cases will remain probable acute.
For Probable Chronic HCV
Evidence for Reinfection
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Medications For Hepatitis C
Many different medications can treat hepatitis C. Treatments most often include antivirals, with Riboviria sometimes prescribed if previous treatments were ineffective.
Medications called direct-acting antivirals work to fully remove the hepatitis C virus from your body while helping prevent liver damage at the same time.
A few brand names of these medications include:
6 different genotypes , or strains, of hepatitis C.
Once your doctor or other healthcare professional knows your genotype, theyll have a better idea of which medication will work best for you. Some strains have developed a resistance to some medications, so your genotype can affect your treatment options.
The Role Of Hcv Genotype Determination
HCV may be divided into at least 6 distinct genotypes. Genotyping that uses the reverse hybridization line probe assay has become a useful clinical tool, although it is not routinely used by all hepatologists. Genotype is the single strongest predictor of response to currently available antiviral therapy. Patients with genotype 1 HCV infectionunfortunately, this is overwhelmingly the most prevalent genotype in the United Statesrespond less well to IFN and ribavirin than do patients with other HCV genotypes, with sustained virologic response rates approximately half of those achieved in patients with nongenotype 1 infections . Recent data indicate that the response rate to pegylated IFN plus ribavirin in patients with genotypes 2 and 3 is as high as 88%, as opposed to 48% in patients with genotype 1 . As discussed above, the high response rate among patients with virus genotype 2 and 3 has led many hepatologists to question the need for pretreatment biopsy in these patients.
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How Common Is Hepatitis C
The Centers for Disease Control and Prevention think that 2.4 million Americans are infected with HCV. It is the most common infection carried by blood in the United States. Veterans have higher rates of hepatitis C than the rest of the country so it is especially important to discuss hepatitis C testing with your provider if you are a Veteran. But, Veterans are not the only ones with high rates of hepatitis C. Baby boomers have higher rates of hepatitis C than people in other age groups in the country as well. Often, people infected with hepatitis C are not aware of their infection because they have no symptoms and they do not feel ill so getting tested if you are at higher risk is important step.
Reporting Form And/or Mechanism
The Ohio Disease Reporting System should be used to report cases and lab findings to the Ohio Department of Health . For healthcare providers without access to ODRS, the Ohio Confidential Reportable Disease Form may be used.
The Positive Laboratory Findings for Reportable Disease Form may be used for laboratories without access to ODRS or electronic laboratory reporting to report positive results.
The Viral Hepatitis Case Report is available for use by the local public health department when following up with cases. Do not send this form to ODH unless otherwise requested information collected from the form should be entered into ODRS where fields are available.
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Treatment Of Hepatitis C
Hepatitis C is treated with antiviral medications that aim to clear the virus from your body.
New all-tablet treatments have greatly improved the outcomes for people with hepatitis C. These treatments can cure more than 95% of individuals with chronic hepatitis C. There are several new tablets that are used in combination to treat all hepatitis C strains . They are effective for people with no liver damage and those who have more advanced liver damage or cirrhosis.
These new tablet medications are available and subsidised on the Pharmaceutical Benefits Scheme, and can be prescribed by specialists, general practitioners and specialised nurse practitioners.
There are no restrictions on accessing treatment it is available for all adults with a Medicare card. People under 18 are able to access treatment and it is recommended they are referred to a pediatrician experienced in the treatment of hepatitis C.
For more information on the new medications for the treatment of hepatitis C, see our video: Hepatitis C Cure what it means for Victorians.
If your doctor does not know about the new treatments, you can call the LiverLine on for information, and to find a GP who can help you.
Talk with your doctor about treatment options and the potential for interactions with other medications, herbal preparations and other drugs. If you take prescribed medication this will be managed so you can access treatment.
In general, if you have hepatitis C you will feel better if you: