Can You Have A Normal Liver Enzyme Level And Still Have Chronic Hepatitis C
Yes. It is common for persons with chronic hepatitis C to have a liver enzyme level that goes up and down, with periodic returns to normal or near normal. Some persons have a liver enzyme level that is normal for over a year but they still have chronic liver disease. If the liver enzyme level is normal, persons should have their enzyme level re-checked several times over a 6 to 12 month period.
What Causes Hepatitis C
Hepatitis C is caused by infection with the hepatitis C virus. The virus is spread from person to person through contact with blood. People who use intravenous drugs can get hepatitis C when they share needles with someone who has the virus. Health care workers can be exposed to hepatitis C. They can become infected if they are accidentally stuck with a needle that was used on an infected patient. You are also at a higher risk if you got a blood transfusion or an organ transplant before 1992.
Hepatitis C cant be spread unless a person has direct contact with infected blood. This means a person who has hepatitis C cannot pass the virus to others through casual contact such as:
- using public toilets
- touching doorknobs
What If I Am Pregnant And I Have Hepatitis C
Hepatitis C can be passed from a mother to her child during pregnancy and during delivery. Per the Centers for Disease Control and Prevention , approximately 6 of every 100 infants born to HCV-infected mothers become infected with the virus. The risk is 2-3 times greater when the mother has HIV as well.
You and your doctor should discuss and decide if you should receive treatment for hepatitis C during your pregnancy.
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Getting Tested Is The Only Way To Know If You Have Hepatitis C
A blood test called a hepatitis C antibody test can tell if you have been infected with the hepatitis C viruseither recently or in the past. If you have a positive antibody test, another blood test is needed to tell if you are still infected or if you were infected in the past and cleared the virus on your own.
- Are 18 years of age and older
- Currently inject drugs
- Have ever injected drugs, even if it was just once or many years ago
- Have abnormal liver tests or liver disease
- Are on hemodialysis
Can Hepatitis C Be Prevented Or Avoided
The only way to prevent hepatitis C is to avoid coming in contact with an infected persons blood. Always have protected sex . Dont do intravenous drugs. Dont share personal care items with a person who has hepatitis C. If youre a health care worker, follow your workplaces standard safety practices.
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How Could A Person Have Been Exposed To Hepatitis C
HCV is spread primarily by direct contact with human blood. For example, you may have gotten infected with HCV if:
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You ever injected street drugs, that may have had someone else’s blood that contained HCV on them. With the opioid crisis we are facing, we are now seeing increased rates of new hepatitis C infection.
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You received blood, blood products, or solid organs from a donor whose blood contained HCV.
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You were ever on long-term kidney dialysis as you may have unknowingly shared supplies/equipment that had someone else’s blood on them.
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You were ever a healthcare worker and had frequent contact with blood on the job, especially accidental needlesticks.
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Your mother had hepatitis C at the time she gave birth to you. During the birth her blood may have gotten into your body.
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You ever had sex with a person infected with HCV.
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You lived with someone who was infected with HCV and shared items such as razors or toothbrushes that might have had his/her blood on them.
What Is The Outlook For People With Hepatitis B
The outlook for people with HBV is better now than ever before. You are certainly able to live a full life and help yourself stay healthy. You should make sure to have regular check-ups with a healthcare provider who is qualified to treat hepatitis B, possibly a liver doctor.
Make sure you are vaccinated against hepatitis A. Check with your healthcare provider or pharmacist before taking other medications or over-the-counter products, including supplements and natural products. These could interfere with your medication or damage your liver. For instance, taking acetaminophen in large doses may harm your liver.
Follow the usual guidelines for living a healthy life:
- Eat nutritious foods, choosing from a variety of vegetables, fruits and healthy proteins. It is said that cruciferous vegetables are especially good at protecting the liver.
- Exercise regularly.
- Dont smoke and dont drink. Both tobacco and alcohol are bad for your liver.
- Do things that help you cope with stress, like journaling, talking with others, meditating and doing yoga.
- Avoid inhaling toxic fumes.
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How Is Hepatitis B Treated
Your healthcare provider will treat you based on what type of hepatitis B you have, acute or chronic.
Acute hepatitis B infections
If you develop an acute form of the condition, you probably wont need medical treatment. Instead, your doctor will likely suggest that you get plenty of rest, drink lots of fluids and maintain a healthy diet to support your body as it fights off the infection.
Chronic hepatitis B infections
If you have chronic hepatitis B, you might be a candidate for drug therapy. Usually, drug therapy is used only if you have active liver disease. There are seven drugs that are approved by the U.S. Food and Drug Administration to treat hepatitis B. Two are injectable forms of interferon, while the five other antivirals are tablets.
You will need to take these medications every day. They help by slowing the viruss ability to multiply in your system. This helps reduce swelling and liver damage. Youll need to be regularly monitored for early signs of liver damage and liver cancer. Your healthcare provider will want to see you once or twice a year.
Chronic Hepatitis B Infection
People who test positive for the hepatitis B virus for more than six months are diagnosed as having a chronic infection. This means their immune system was not able to get rid of the hepatitis B virus and it still remains in their blood and liver.
The risk of developing a chronic hepatitis B infection is also directly related to the age at which one first becomes exposed to the hepatitis B virus:
- 90% of infected newborns and babies will develop a chronic hepatitis B infection
- Up to 50% of infected children will develop a chronic hepatitis B infection
- 5-10% of infected adults will develop a chronic hepatitis B infection
Learning that you have a chronic hepatitis B infection can be very upsetting. Because most people do not have symptoms and can be diagnosed decades after their initial exposure to the hepatitis B virus, it can be a shock and a surprise to be diagnosed with a chronic hepatitis B infection. The good news is that most people with chronic hepatitis B should expect to live a long and healthy life.
There are effective drug therapies that can control and even stop the hepatitis B virus from further damaging a liver. There are also promising new drugs in the research pipeline that could provide a cure in the very near future. Although the risk of developing a serious liver disease or liver cancer is higher for those living with chronic hepatitis B than those who are not infected, there are still many simple things a person can do to help reduce their risks.
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What Is The Risk That Hcv Infected Women Will Spread Hcv To Their Newborn Infants
About 5 out of every 100 infants born to HCV infected women become infected. This occurs at the time of birth, and there is no treatment that can prevent this from happening. Most infants infected with HCV at the time of birth have no symptoms and do well during childhood. More studies are needed to find out if these children will have problems from the infection as they grow older. There are no treatments or guidelines for the treatment of infants or children infected with HCV. Children with elevated ALT levels should be referred for evaluation to a specialist familiar with the management of children with HCV-related disease.
How Likely Am I To Become Infected With Hepatitis C From A Family Member Living In The Same House
Household transmission of hepatitis C is extremely rare. Fewer than 1 in 1,000 family members or close acquaintances becomes infected each year through common, nonsexual contact with hepatitis C-infected persons.
There are many possible ways by which hepatitis C could be passed from one person to another. Because the virus is carried in the blood, it could be transmitted between household members if a mucous membrane were to come in contact with blood or body fluids containing hepatitis C. Family members sometimes share razors, toothbrushes, or toothpicks, perhaps unknowingly. If an item were contaminated with hepatitis C-infected blood from one person, the virus could be passed to a second person if it were to tear the lining of the mouth or break through the skin.
Although these sorts of possibilities are often discussed as potential ways for hepatitis C to infect family members, such events occur very rarely.
If you aren’t sure of your hepatitis C status, get tested. If you test negative and have lived in a household with an infected family member or close acquaintance, you shouldn’t worry that any more contact will put you at risk.
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Theres Been A Demographic Shift In Whos Getting Hep C
Although baby boomers used to account for the bulk of hepatitis C cases , the disease has been rapidly spreading among young adults so much so that in 2020, the CDC reported that younger adults now make up the majority of newly reported chronic hepatitis C infections.
Millennials now account for 36.5 percent of these new infections according to the CDC. Generation X accounts for 23.5 percent of new infections.
People between ages of 20 and 40 are primarily acquiring hepatitis C through injection drug use, says Douglas Dieterich, MD, a professor of medicine with the division of liver diseases at Icahn School of Medicine at Mount Sinai in New York City. And, as he points out, people of those ages are a much larger group than the baby boomers.
The drug use explosion during the past COVID-19 year has increase hepatitis C exponentially, says Dr. Dieterich, who is a member of the American Liver Foundations national medical advisory committee.
Dr. Rizza adds that cocaine users may also spread the infection by sharing straws used for snorting.
If you get blood from the nose on the straw and share it with the next person, you can transmit the virus this way, she says. It takes only a drop of contaminated blood entering the bloodstream to transmit the disease, and the virus can live outside the body for at least four days.
How Do I Tell Someone I Have Hepatitis C
Informing someone that you have hepatitis C can be hard. Most people know little about this disease. You can start with how you found out about your diagnosis. It helps to be prepared with educational materials on HCV, and to be aware of the ways that people can and cannot be infected. For example, it is very rare for HCV to be transmitted during sex. Be sure to tell anyone who may be directly affected, such as:
You may want to encourage others to be tested for HCV if they have similar risk factors.
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Can You Have A False Positive Anti
Yes. A false positive test means the test looks as if it is positive, but it is really negative. This happens more often in persons who have a low risk for the disease for which they are being tested. For example, false positive anti-HCV tests happen more often in persons such as blood donors who are at low risk for hepatitis C. Therefore, it is important to confirm a positive anti-HCV test with a supplemental test as most false positive anti- HCV tests are reported as negative on supplemental testing. There are certain situations where individuals with autoimmune disorders, such as Lupus, may have a false positive HCV antibody test. Confirming this with a HCV-RNA will usually be negative-indicating no active hepatitis C.
How Does Hepatitis C Progress
When someone is first infected with hepatitis C, most likely they have no symptoms and are unaware. Occasionally people experience fatigue, loss of appetite, weakness or sometimes having a yellow color in their skin or eyes. Although having any symptoms at all is rare, if they do occur, they usually go away within a few weeks.
Around 15-25% of people who are infected will spontaneously fight off the virus on their own and they will not have a chronic hepatitis C infection and no long term damage occurs.
But around 75-85% of people will develop chronic infection. Most of the time, people with chronic hepatitis C have no symptoms at the time of infection and no symptoms for years or even decades of chronic infection. The virus will be with them until they are successfully treated with hepatitis C medications.
Around 10-20% of people with chronic infection will slowly have gradual damage in the liver over years and will eventually develop cirrhosis . This can take 20 years or more from the time of the initial infection.
Cirrhosis is the replacement of liver cells with permanent scar tissue. Cirrhosis can lead to problems such as bleeding from veins in the esophagus, fluid buildup in the belly, and damaged brain function.Approximately 15% of people with cirrhosis will develop liver cancer during their lifetime. Drinking excessively can double the chance of liver cancer in people infected with HCV.
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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.
What Are The Chances Of Getting Hepatitis C From Sex
Hepatitis C can spread through sexual intercourse, but it’s rare. And it’s extremely rare among monogamous couples. In fact, the CDC considers the risk of sexual transmission between monogamous couples so low that it doesn’t even recommend using condoms. Also, there’s no evidence that hepatitis C is spread by oral sex. But you should avoid sharing razors, toothbrushes, and nail clippers, and sex during menstruation.
If you have HIV or if you have multiple partners, you should take precautions. Using condoms will protect you and your partners.
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Acute Hepatitis B Infection
An acute hepatitis B infection may last up to six months and infected persons are able to pass the virus to others during this time. A simple blood test can let a person know if the hepatitis B virus is in their blood or if they have successfully gotten rid of the virus. The doctor should periodically test your blood over the six-month period to monitor the health of your liver and check progress towards recovery. In a person who has recovered from an acute hepatitis B infection, a taken six-months after initial diagnosis will show that there is no more hepatitis B virus in your blood.
Being diagnosed with acute hepatitis B can be difficult. As you move through the initial six-month period, there are tips and strategies to help.
Until your health care provider confirms that the blood test shows that there is no more hepatitis B virus in your blood, it is important to protect others from a possible infection.
It is also important to have your sexual partner and family members get tested for hepatitis B. If they have not been infected and have not received the hepatitis B vaccine then they should also start the hepatitis B vaccine series.
Be sure to follow-up with your health care provider for any additional blood tests that are needed to confirm your recovery from an acute infection.
How Can We Prevent Hepatitis C In The Workplace
There is currently no vaccine for hepatitis C. The risk of hepatitis C can be significantly reduced by implementing infection control guidelines suitable for the specific workplace.
Infection control precautions are the first line of defense to protect workers from hepatitis C and other blood-borne diseases. For this reason, the Public Health Agency of Canada recommends routine practices when there is a risk of exposure to blood or certain body fluids.
Please see the OSH Answers document Routine Practices for more information.
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