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.
A Cure For Hepatitis C
It kills more Canadians than any other virus. Now theres a cure, but few can afford it.
Linda Zimmerman was at the end of her rope when she went into a health food store in 2008 searching for something to soothe her strange symptoms. Her doctor said her blood platelets were low. She bruised easily. Leg cramps and an unscratchable itch kept her up every night. Then a store employee suggested something might be amiss with her liver. The retired nurse from Winkler, Man., turned to Dr. Google for help. I put in allergies and low platelets and liver, I think it was, the 66-year-old says. Things started to come together.
Her family doctor found Zimmermans liver enzymes had been out of whack since 2004, and a test revealed she had hepatitis C, a blood-borne viral disease that attacks the liver. It affects an estimated 300,000 Canadians and kills around 500 every year, more than any other single virus, including HIV/AIDS and seasonal flu.
Snorting or injecting drugs even once, patronizing a less-than-sanitary tattoo joint, receiving immunizations during military service or getting a blood transfusion or a transplant before July 1990 are just a few of the ways people get it. Zimmerman had been walking around with the virus since July 31, 1976, the day her youngest son was born and she received tainted blood.
Outcomes And Hcv Treatment
There is no treatment recommended for acute hep C infection however, patients should be monitored to see if the infection becomes chronic. Chronic hepatitis C can cause liver cancer or cirrhosis and is the most common reason for liver transplants in this country. The CDC estimates that of every 100 people infected with HCV, 75 to 85 will develop chronic infection, and 10 to 20 will develop cirrhosis within 20 or 30 years. Of 100 people who have hepatitis C and have developed cirrhosis, between three and six will develop liver failure each year and between one and five will develop liver cancer each year. There were 18,153 deaths related to HCV reported to the CDC in 2016, but this is likely an underestimate.
A whole new class of medication, called direct-acting antivirals , was introduced in 2011. The first two drugs to be introduced — boceprevir and telaprevir — improved the outcomes dramatically but still required patients to take interferon. About 70% of patients achieved sustained virologic response on the first generation of DAAs.
Then in 2014, Gilead Sciences introduced ledipasvir/sofosbuvir , which had a 99% SVR rate with a 12-week regimen and did not need to be combined with interferon injections. Newer DAAs have been introduced since that time, including sofosbuvir/velpatasvir and sofosbuvir/velpatasvir/voxilaprevir , also made by Gilead, elbasvir/grazoprevir by Merck, and glecaprevir/pibrentasvir from AbbVie.
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What If I Am Pregnant Or Planning A Pregnancy
- Treatment is generally not recommended during pregnancy. There is not a lot of information on the effects of treatment during pregnancy. Research is being done on hepatitis C treatment during pregnancy so this may change in the future.
- Treatment that includes ribavirin can cause severe birth defects and must not be taken during pregnancy. Ribavirin should not be used by either partner for at least six months before trying to get pregnant.
- Use birth control if you are having sex that can lead to pregnancy.
- Talk to a nurse or doctor about your treatment options and when to start treatment.
Are There Ways To Cure Hepatitis C Other Than With Medications
Patients sometimes ask whether there are ways to treat hepatitis C other than taking medicines. Currently, there are no vaccines to prevent hepatitis C. Once a person is infected, the only way to treat it is with prescribed antiviral medications.
Some patients worry that having hepatitis C means they will need a liver transplant. Only a very small fraction of people with hepatitis C require a liver transplant. By far, most people with hepatitis C never need a liver transplant. A transplant is performedonlywhen damage to the liver is extremely advanced and the liver is unable to perform its basic functions. A transplant provides a new working liver, but a transplant does not get rid of the hepatitis C virus in the patient. Patients with a liver transplant still need antiviral medication to cure their virus.
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How Is Hepatitis C Treated
Hepatitis C is treated using antiviral drugs.
Treatment in the first 6 months focuses on:
- treating symptoms
- preventing the spread of the disease
- preventing complications, such as liver damage
For someone who has the disease beyond 6 months, treatment includes a combination of medications. However, not everyone with this form of hepatitis C will need treatment.
Whether or not you are getting treatment, you can help lower the risk of damage to your liver by:
- avoiding alcohol
What Can People Do To Help The Medications Work Best
- Take the medications every day
- Stay in touch with pharmacy to be sure that all refills are ready on time
- Take the medications exactly as prescribed
- Do not skip doses
- Get all blood tests done on time
- Go to all visits with providers as recommended
- Tell the provider about all other medications that are being taken – including over-the-counter medicines, vitamins, herbs, and supplements
- Complete the entire course of medication
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How Effective Is Treatment
Direct acting antivirals cure 9 out of 10 patients with hepatitis C.
Successful treatment does not give you any protection against another hepatitis C infection. You can still catch it again.
There’s no vaccine for hepatitis C.
If treatment does not work, it may be repeated, extended, or a different combination of medicines may be tried.
Your doctor or nurse will be able to advise you.
How Does Hepatitis C Treatment Work
- Hepatitis C treatment stops the virus from making copies of itself, and over the weeks of treatment, the virus is cleared from your body.
- The type of treatment you get is not affected if you use street drugs.
- Another medicine called ribavirin may be added to your treatment if your liver is severely injured.
- A nurse or doctor will help you choose the best treatment for you. The goal is to make treatment safe, effective and tolerable.
- After being cured, you will still test positive for antibodies to the hepatitis C virus for the rest of your life. This does not mean that you have hepatitis C.
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Hcv Symptoms And Screening
Acute infection often has no symptoms or has symptoms that are mild and/or mistaken for other common illnesses. And chronic infection occurs over the course of years or even decades, again with symptoms — such as fatigue and depression — that are often attributed to a different cause. In fact, it is estimated that 50% of the 3.9 million adults who are living with HCV in the U.S. do not know it.
The CDC recommends that all adults born between 1945 and 1965, anyone who got clotting factor before 1987, and anyone who received a blood transfusion or organ transplant before 1992 be screened at least once. The agency also recommends screening for long-term hemodialysis patients, as well as anyone who has ever shared needles for drug use , gotten an unregulated tattoo, or has HIV. In addition, the U.S. Preventive Services Task Force recommends that everyone in the prison population be tested for HCV.
Unfortunately, we do not have a robust screening and surveillance system in place to track hepatitis C infections the way we do for HIV. In 2017, only 14 states received money from the CDC for HCV surveillance . And only 22 states require HCV testing for those coming into prison. Moreover, a recent survey of health care providers found that fewer than 30% are following the CDC’s screening recommendations.
Prognosis Improvement After Hbsag Clearance
These related studies provide clear recommendations that patients who achieve HBsAg clearance have favourable clinical outcomes compared to patients who achieve only HBV DNA suppression and HBeAg seroconversion. HBsAg clearance leads to biochemical, virological and liver histological improvements, and it significantly reduces the risk of HCC. However, HCC may occur after HBsAg seroclearance despite it being the ultimate treatment endpoint recommended by current guidelines. The risk factors associated with HCC include the presence of cirrhosis, male sex, and age50 years at the time of HBsAg clearance . Closer attention should be given to patients with one or more of these risk factors.
These high-risk patients should be re-examined in a timely manner even if HBsAg clearance is obtained. These results also suggest that achieving a functional cure early in the absence of cirrhosis results in a better prognosis .
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If I Use Street Drugs Will Treatment Make Me More Likely To Overdose
Some hepatitis C treatment can change the effects of street drugs, which can contribute to an overdose.
If you use street drugs after you start hepatitis C treatment, start slowly and use with someone you trust.
Naloxone helps reverse an opiate overdose and can save someones life. If naloxone is available and you want to learn how to use it, talk to a harm reduction worker about how to get training.
How Can I Cover Medication Costs
New therapies called direct-acting antivirals are effective and can achieve cures of over 90%. Because these new therapies are very new, they remain very expensive. As such, drug coverage from both government and private companies may require that your liver disease has progressed to a certain stage before they are willing to cover the cost of these drugs.
Talk with your healthcare provider about financial support that may be available.
Below are useful resources when looking for financial assistance:Private health insurance or drug plansIf you have private health insurance or a drug plan at work, you may be able to have the medication paid through your plan. Please consult your private health insurance or drug plan provider to see if your drug is covered.
Publicly funded plansEach provincial and territorial government offers a drug benefit plan for eligible groups. Some are income-based universal programs. Most have specific programs for population groups that may require more enhanced coverage for high drug costs. These groups include seniors, recipients of social assistance, and individuals with diseases or conditions that are associated with high drug costs. For more details, please contact your provincial or territorial health care ministry, or click on the appropriate link below.
Available Patient Assistance Programs for Hepatitis C treatment Holkira Pak Maviret
MerckCare Hepatitis C Program 1 872-5773 Zepatier
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What Is Hepatitis B
Hepatitis B is a contagious liver disease caused by the hepatitis B virus. When a person is first infected with the virus, he or she can develop an acute infection. Acute hepatitis B refers to the first 6 months after someone is infected with the hepatitis B virus. This infection can range from a very mild illness with few or no symptoms to a serious condition requiring hospitalization. Some people are able to fight the infection and clear the virus.
For others, the infection remains and is chronic, or lifelong. Chronic hepatitis B refers to the infection when it remains active instead of getting better after 6 months. Over time, the infection can cause serious health problems, and even liver cancer.
Accessibility And Hbsag Clearance Rate
HBsAg clearance occurs spontaneously or via antiviral treatment in CHB patients. The most commonly used drugs are nucleoside analogue and pegylated interferon . NA drugs include entecavir , tenofovir disoproxil fumarate and tenofovir alafenamide fumarate . The 2018 AASLD guidelines recommend Peg-IFN, ETV, or TDF as the preferred initial therapy for adults with immune-active CHB. It also suggests that alanine transaminase levels be tested at least every 6 months for adults with immune-tolerant CHB to monitor for potential transition to immune-active or immune-inactive CHB . The 2017 EASL guideline recommends ETV, TDF and TAF as the preferred monotherapy regimens, and the extension of the duration of Peg-IFN therapy beyond week 48 may be beneficial in selected HBeAg-negative CHB patients . The potential side effects of NAs include lactic acidosis for ETV and nephropathy, osteomalacia, lactic acidosis for TDF. CHB patients should be clinically monitored. The most frequently reported side effects for Peg-IFN are flu-like syndrome, myalgia, fatigue, mood disturbances, weight loss, hair loss and local reactions at the site of injection, and these side effects may be partially managed with dose reduction . Currently, the clearance of HBsAg is based primarily on sequential or combined treatment with NA and Peg-IFN.
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What Will My Doctor Need To Know To Treat Me
If you want to be assessed for treatment, you need to make an appointment with a doctor. They will be mostly interested in the condition of your liver. Your doctor will organise, if possible, for you to have a Fibroscan examination. If Fibroscan is not available, your doctor will probably use an APRI test. This is an online calculator that estimates the health of your liver. It involves a blood test called a liver function test.
Dont forget, its very important to get a PCR test 12 weeks after finishing treatment this will mean the doctor can make sure you are cured.
There Is No Vaccine For Hepatitis C
But, did you know?
- Hepatitis C can be treated with medication that has cure rates > 90%.
- Earlier diagnosis and treatment lead to better health outcomes.
- Early treatment may even prevent liver disease, liver cancer, or cirrhosis.
Testing is quick and simple with a blood test.
Ask your health care provider for a test if you think you could have hepatitis C.
The best way to know is to get tested.
To learn about how to protect yourself and where you can get tested, visit Canada.ca and search ‘hepatitis C.’
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Can I Drink Alcohol If I Have Hepatitis C
The combination of any cause of hepatitis, such as alcohol on top of HCV, adds to and accelerates liver damage. Both hepatitis B and C can cause chronic hepatitis and progression to cirrhosis and liver cancer, although the disease is much more likely to become chronic in the U.S. Therefore, people with chronic HCV should not drink alcohol and should talk to a doctor about vaccines for other hepatitis viruses.
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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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.
Screening For Viral Hepatitis
The purpose of screening for viral hepatitis is to identify people infected with the disease as early as possible, even before symptoms and transaminase elevations may be present. This allows for early treatment, which can both prevent disease progression and decrease the likelihood of transmission to others.
Hepatitis A causes an acute illness that does not progress to chronic liver disease. Therefore, the role of screening is to assess immune status in people who are at high risk of contracting the virus, as well as in people with known liver disease for whom hepatitis A infection could lead to liver failure. People in these groups who are not already immune can receive the hepatitis A vaccine.
Those at high risk and in need of screening include:
- People with poor sanitary habits such as not washing hands after using the restroom or changing diapers
- People who do not have access to clean water
- People in close contact with someone who has hepatitis A
- People who use illicit drugs
- People with liver disease
- People traveling to an area with endemic hepatitis A
The presence of anti-hepatitis A IgG in the blood indicates past infection with the virus or prior vaccination.
Hepatitis B and C
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Risk Of Hcv Infection
Hepatitis is an inflammation of the liver that can lead to decreased liver function. Hepatitis can be caused by toxins, including alcohol and certain medications, or it can be caused by a virus. HCV is the virus that causes hepatitis C, or hep C. It is one of the most common hepatitis viruses.
HCV is transmitted through blood-to-blood contact. Before we had a screening test for hep C in 1992, most people got infected through blood transfusions. This explains why baby boomers, those born between 1945 and 1965, are five times more likely to have the virus.
Today, most people with the virus get infected by sharing needles or other equipment for injecting drugs. Recent research has shown that the growing opioid epidemic is driving up rates of hep C infection, especially among young people. In addition, the prison population is at high risk for infection because of the high number of injection drug users who enter correctional facilities who are already living with hep C. Inside prisons, hep C is transmitted through injection drug use and unsafe practices for tattoos and piercings. It is estimated that one in three people in U.S. jails and prisons have HCV.
Hep C can be transmitted through sexual activity however, this is rare and most likely to happen if a person is already living with HIV or another sexually transmitted infection. The Centers for Disease Control and Prevention estimates that 25% of people living with HIV also have HCV.