What About Patients With Hepatitis C Who Also Have Hepatitis B
Hepatitis B virus can flare in patients who are co-infected with hepatitis B and hepatitis C and are taking medication for hepatitis C. This has been reported as a potential risk for patients who are taking hepatitis C treatment and have underlying hepatitis B as well. The flare usually occurs within a few weeks after the patient starts taking medication for hepatitis C. Therefore, patients who have both hepatitis B and hepatitis C should be seen by a hepatitis expertbeforestarting treatment of the hepatitis C they may need to start taking hepatitis B treatment to avoid a hepatitis B flare.
What Are The Side Effects Of Treatment
Some people stop therapy because of side effects. Since hepatitis C can lead to liver damage, cirrhosis, and liver cancer if not treated, its vital to stick with a treatment plan.
Newer drugs have fewer severe side effects than pegylated interferon and ribavirin. Nevertheless, you may feel some effects while taking hepatitis C medication. Side effects can include:
- nausea, vomiting, or diarrhea
- appetite loss or weight loss
Serious side effects can occur with pegylated interferon and ribavirin treatment. If youre taking these medications, you should be monitored for these serious side effects:
- light sensitivity in the eyes
- trouble breathing because of lung tissue inflammation
- suicidal thoughts, depression, or irritability
- thyroid disease
- elevated liver enzymes
- autoimmune disease flares
Some medications arent recommended if theres evidence of liver damage, like cirrhosis . A co-infection with HIV also affects medication options.
Who Is At Risk For Hepatitis C
- Use drugs and share needles, pipes or other equipment. If you have ever experimented with drugs its very important to get tested
- Received body piercing or tattoos with non-sterile instruments
- Have/had HIV and/or Hepatitis B
- Were born to mothers infected with the Hepatitis C virus
- Were born between 1955 and 1975 and were in contact with poorly sterilized medical equipment
- Were born outside of Canada
- Have had a blood transfusion before 1992 as blood donations were not tested for the Hep C virus
- Hemodialysis patients or persons who spent many years on dialysis for kidney failure
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Hepatitis C Management In Primary Care
- A new direct-acting antiviral oral regimen for the treatment of hepatitis C, glecaprevir + pibrentasvir will be subsidised without restriction from 1 February, 2019.
- Treatment with glecaprevir + pibrentasvir is simpler than with Viekira Pak regimens and patients with hepatitis C should now predominantly receive treatment in primary care.
- Glecaprevir + pibrentasvir can be prescribed to patients with hepatitis C virus infection due to any of the HCV genotypes.
- Glecaprevir + pibrentasvir is taken as a once daily regimen of three tablets, for eight weeks, regardless of HCV genotype.
- Glecaprevir + pibrentasvir can be prescribed to patients infected with any HCV genotype, therefore genotype testing prior to initiating treatment is no longer required.
- Ribavirin is not required for patients with genotype 1a infection receiving glecaprevir + pibrentasvir treatment.
- Patients should present prescriptions for glecaprevir + pibrentasvir to an enrolled pharmacy.
- Viekira Pak regimens will be delisted.
- Ledipasvir + sofosbuvir continues to be subsidised for patients with advanced disease.
Sharing Toothbrushes Scissors And Razors
There’s a potential risk that hepatitis C may be passed on through sharing items such as toothbrushes, razors and scissors, as they can become contaminated with infected blood.
Equipment used by hairdressers, such as scissors and clippers, can pose a risk if it has been contaminated with infected blood and not been sterilised or cleaned between customers. However, most salons operate to high standards, so this risk is low.
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Causes And Risk Factors
THe HCV virus causes hepatitis C.
People contract the virus through blood-to-blood contact with contaminated blood. For transmission to occur, blood containing HCV must enter the body of a person without HCV.
A speck of blood, invisible to the naked eye, can carry hundreds of hepatitis C virus particles. The virus is not easy to kill.
The CDC offers advice on cleaning syringes if it is not possible to use clean and sterile ones. Although bleach might kill the HCV in syringes, it may not have the same effect on other equipment. Boiling, burning, and using alcohol, peroxide, or other common cleaning fluids to wash equipment may reduce the amount of HCV, but it might not stop a person contracting the infection.
It is extremely dangerous to inject bleach, disinfectant, or other cleaning products, so be sure to rinse the syringe thoroughly. Only ever use bleach to clean equipment if new, sterile syringes and equipment are not available.
A person cannot contract the virus from casual contact, breathing, kissing, or sharing food. There is no evidence that mosquito bites can transfer the virus.
The report the following risk factors for developing hepatitis C:
- using or having used injectable drugs, which is currently the most common route in the U.S.
- receiving transfusions or organ transplants before 1992, which is before blood screening became available
- exposure to a needle stick, which is most common in people who work in healthcare
- being born to a mother who has hepatitis C
Who Can I Talk With During Treatment
Since hepatitis C treatment plans last several weeks, you should regularly attend medical appointments. Your doctor may have a list of local groups where you can find emotional support.
There may also be other resources like community nurses and walk-in clinics. With this information, youll know where to go for help between appointments.
Another option is to explore the online hepatitis C community, where people share their experiences with hepatitis C.
For example, the Inspire hepatitis C group allows people to connect, share stories, discuss treatment, and more.
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There Are Many Approved Therapies For Hepatitis B First
You might be interested in the recent by Dr. Timothy Block, president of the Hepatitis B Foundation Dr. Chari Cohen, our senior vice president and Maureen Kamischke, the Foundation’s patient engagement and consult specialist.
For a complete list of FDA-approved drugs and other promising drugs in development for hepatitis B, visit our Drug Watch page.
Who Is Most At Risk Of Contracting Hepatitis C
You have a high risk of contracting hepatitis C if you:
- use or have used injection drugs even if it was just once or many years ago
- have received blood or blood products or an organ transplant before July 1990 in Canada
- have been in jail or
- have been injected or scratched during vaccination, surgery, blood transfusion or a religious/ceremonial ritual in regions where hepatitis C is common.
You have a high moderate risk of contracting hepatitis C if you:
- have tattoos or body piercing
- have multiple sexual partners
- have a sexually transmitted infection , including HIV or lymphogranuloma venereum
- have experienced traumatic sex or rough sex or have used sex toys or fisting that can tear body tissue
- have vaginal sex during menstruation
- have received a kidney treatment
- have received an accidental injury from a needle or syringe
- have another infectious disease
- were born to a hepatitis C infected mother or
- have a sexual partner infected with hepatitis C.
Hepatitis C is NOT passed from person to person by:
- coughing, sneezing
- breastfeeding unless your nipples are cracked and bleeding or
- oral sex, unless blood is present.
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A Researcher Reflects On Progress Fighting Hepatitis C And A Path Forward
The hepatitis C virus was discovered in 1989 research thats now earned a Nobel Prize.
When I began my medical career in Hong Kong in the early 1980s, I chose to focus on hepatitis B, in part because it was very common and because the hepatitis C virus had not yet been discovered. I witnessed the devastation that this virus caused cirrhosis, liver failure and liver cancer and the lack of treatments we could offer to patients.
Back then, scientists knew there was another type of hepatitis, but no one could identify it, so we called it non-A, non-B hepatitis. I would never have imagined that during the course of my career I would witness the discovery of what came to be known as hep C and the development of a cure for nearly all patients with chronic hepatitis C in 2014.
Underscoring the importance of these discoveries for global human health, this years Nobel Prize in Physiology or Medicine was awarded jointly to Harvey J. Alter, Michael Houghton and Charles M. Rice for the discovery of the hepatitis C virus.
Effective treatment for hepatitis C has become even more relevant today in light of the recent surge in new cases of hepatitis C due to rising opioid use.
What Are The Long
75% of people who have Hepatitis C could potentially develop chronic liver disease and liver cancer. Long term liver damage can have many effects on the body, including:
- Digestion Painful digestion, nausea, vomiting, and loss of appetite
- Central Nervous System Confusion, forgetfulness, disorientation, shaking, slurred speech, and even a coma
- Circulatory System Hypertension, internal bleeding, swollen legs and abdomen, anemia, and type 2 diabetes
- Hair, Skin, and Nails Hair loss, jaundice, and softened yellow fingernails
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It’s Different Than Hepatitis A And B
Each form of hepatitis has its own specific virus that spreads and is treated differently. “Hepatitis simply means inflammation of the liver, or that the virus has an affinity for hurting the liver,” Reau says.
- Hepatitis A is an acute, short-term infection that often does not require treatment.
- Hepatitis B hides deep in the body and, like hepatitis C, is treated in a variety of ways, from antiviral medications to liver transplants.
“The viruses are different, but all of them should be taken very seriously since they can lead to significant liver disease and even death,” she adds.
What Are The Names Of The Medications For Treating Hepatitis C
Since 2014, multiple different antiviral treatments for hepatitis C have been developed. With the many options now available, often there is more than one good choice for a patient. Some of the treatments are recommended as first-line options, some are second-line options, and others are used less commonly in light of all the available choices.
Second line hepatitis C medications:
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Theres Now A Cure For Hepatitis C But Most Cant Afford It
Dominique Godbout under a Creative Commons Licence
It sounds like some sci-fi dystopia but this is the situation the 150 million people who have the hepatitis C virus find themselves in today. HCV is spread through blood-to-blood contact, mostly through shared needles. Around 350,000 people die of HCV-related liver complaints each year but new drugs have been developed within the last 6 months with cure rates higher than 90 per cent. Even though these drugs could be produced generically for as little as $68 for a 12-week course, big pharmaceutical companies such as Gilead are pricing it up to $84,000 thats $1,000 a pill.
Not only is eradicating HCV within our grasp, its something that could be achieved well within in our lifetime, says Leigh Daynes, executive director of Doctors of the World UK, which is campaigning to increase global access to the new HCV drugs. Pharmaceutical companies need to work with us to get these essential, life-saving drugs to those that need them thousands are dying each week they delay.
Gilead are only giving a discount to a restricted number of people who access public health centres in Egypt, said Chloé Forette, harm reduction and Hepatitis C advocacy officer at the launch of Doctors of the Worlds report on access to HCV medicines. For those forced to buy it privately it is likely to be 5 times more expensive.
To put this in context, the monthly average salary in Egypt is $250.
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Contaminated Needles And Infected Blood
You can get hepatitis C from sharing contaminated needles, syringes and other injecting equipment during recreational drug use. Banknotes and straws used for snorting may also pass the virus on.
Being exposed to unsterilised tattoo and body piercing equipment can also pass hepatitis C on. Occasionally, you can get it from sharing a towel, razor blades or a toothbrush if there is infected blood on them.
Hepatitis C infection is also passed on in healthcare settings, from needle stick injuries or from medical and dental equipment that has not been properly sterilised. In countries where blood products are not routinely screened, you can also get hepatitis C by receiving a transfusion of unscreened blood and blood products.
You can prevent hepatitis C by:
- never sharing needles and syringes or other items that may be contaminated with infected blood
- only having tattoos, body piercings or acupuncture in a professional setting, where new, sterile needles are used
- following the standard infection control precautions, if youre working in a healthcare setting.
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What Do Hepatitis C Symptoms Look Like
Hepatitis C infection can go through two stages: acute and chronic. In the early, or acute stage, most people don’t have symptoms. If they do develop symptoms, these can include:
- flu-like symptoms, tiredness, high temperature and aches and pains
- loss of appetite
- tummy pain
- jaundice, meaning your skin and the whites of your eyes turn yellow
While for some people, the infection will clear without treatment, in most cases, acute infection will develop into long-term chronic infection. Chronic infection may not become apparent for a number of years until the liver displays signs of damage. These symptoms can include:
- mental confusion and depression these are specific to hepatitis C
- constantly feeling tired
- nausea, vomiting or tummy pain
- dark urine
- feeling bloated
- joint and muscle pain
Without treatment, chronic hepatitis C can cause scarring of the liver , which can cause the liver to stop working properly. A small number of people with cirrhosis develop liver cancer and these complications can lead to death. Other than a liver transplant, theres no cure for cirrhosis. However, treatments can help relieve some of the symptoms.
But Even If You’ve Been Cured It Can Have Lifelong Health Implications
“Hepatitis C is a lot more than just a liver disease,” Reau says. “It has been associated with many medical conditions, such as an increased risk of developing diabetes, kidney disease and cancer.”
While curing hepatitis C significantly reduces the risk of serious complications, like liver failure, liver cancer and the need for transplantation, it doesn’t completely eliminate the health risks associated with the disease.
“Hep C is linked to scarring of the liver or cirrhosis and the more scar tissue that develops, the greater the likelihood of complications,” Reau says. “If there is a lot of scarring, you will need lifelong monitoring.”
Reau also recommends leading a healthy lifestyle to help prevent re-infection and further liver damage: Limit alcohol consumption, control your weight, avoid high-risk activities and manage diabetes if you have it.
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Hepatitis C Symptoms & Treatment
Hepatitis C is found in infected blood. It is also rarely found in semen and vaginal fluids.
Hepatitis C is mainly passed on through using contaminated needles and syringes or sharing other items with infected blood on them. It can also be passed on through unprotected sex, especially when blood is present.
You can prevent hepatitis C by never sharing needles and syringes, practising safer sex, and avoiding unlicensed tattoo parlours and acupuncturists.
Hepatitis C will often not have any noticeable symptoms, but a simple blood test carried out by a healthcare professional will show whether you have hepatitis C.
In the early stages, some peoples bodies can clear a hepatitis C infection on their own, others may develop chronic hepatitis C and will need to take antiviral treatment to cure the infection.
Without treatment, chronic hepatitis C can lead to permanent liver damage.
Hepatitis C is part of a group of hepatitis viruses that attack the liver.
Its mainly passed on through contaminated needles, either from injecting drugs or from needle stick injuries in healthcare settings. It can also be transmitted sexually, especially during anal sex or other types of sex that may involve blood.
Some groups are more at risk of getting hepatitis C than others, including people who use drugs, people in prisons, men who have sex with men, health workers and people living with HIV.
Is There A Way To Prevent Hepatitis C
Although currently theres no vaccine to protect people from contracting hepatitis C, there are vaccines for other hepatitis viruses, including hepatitis A and hepatitis B.
If you receive a hepatitis C diagnosis, your healthcare provider may advise you to get vaccinated against hepatitis A and B.
The vaccinations are recommended because these hepatitis viruses can lead to additional health and liver complications, especially in those with preexisting liver disease.
Since you cant prevent hepatitis C through a vaccine, the best prevention is to avoid exposure. Hepatitis C is a bloodborne pathogen, so you can limit your chances of exposure through these healthy lifestyle practices:
- Avoid sharing needles, razor blades, or nail clippers.
- Use proper safety precautions if youll be exposed to bodily fluids, such as when performing first aid.
- Hepatitis C isnt usually transmitted through sexual contact, but its possible. Limit your exposure by practicing sex with a condom or other barrier method. Its also important to openly communicate with sexual partners and to get tested if you suspect youve been exposed to the hepatitis C virus.
Because hepatitis C is transmitted through blood, its possible to contract it through a blood transfusion.
However, since the early 1990s, blood product screening tests have been standard protocol for minimizing the risk of this type of transmission.
Subsequent testing is based on risk. Talk to your doctor about your needs.
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