Tuesday, May 17, 2022

Is There Immunization For Hepatitis C

Does Having Another Health Condition With Hepatitis C Affect My Place In Line

Ellie Barnes: Hepatitis C vaccine

In most states, people ages 16 to 64 with underlying health conditions that increase the risk of serious complications from COVID-19 are in phase 1c of the vaccine rollout recommendations.

Whether youre included in phase 1c will depend on your states definition of underlying health condition. For instance, you may have cirrhosis as a result of hepatitis C 15 to 30 percent of hepatitis C patients do, according to the World Health Organization. If thats the case, you likely are included in phase 1c. People who have cirrhosis are more at risk of developing COVID-19 side effects and complications than people who do not have cirrhosis, Dr. Maheshwari says, adding that because they are at a higher risk of severe COVID-19 illness, the recommendation to receive the vaccination is even stronger.

Again, youll want to consult your states guidelines to determine if and when youre eligible.

Safety And Adverse Events

Common and local adverse events

HA vaccine

HA vaccine is well tolerated. Reactions are generally mild and transient, and are usually limited to soreness and redness at the injection site. Other less frequent reactions include headache, irritability, malaise, fever, fatigue and gastrointestinal symptoms. Injection site reactions occur less frequently in children than in adults as do mild, systemic events . No significant difference in reactions is evident between initial and subsequent doses of vaccine or in the presence of pre-existing immunity.

HAHB vaccine

Refer to Hepatitis B Vaccine in Part 4 for information about HAHB vaccine.

Ig

Injection site reactions following receipt of standard human Ig include tenderness, erythema and stiffness of local muscles, which may persist for several hours. Mild fever or malaise may occasionally occur.

Less common and serious or severe adverse events

Less common side effects following receipt of standard human Ig include flushing, headache, chills and nausea. Urticaria, angioedema and anaphylactic reactions may occur rarely.

Guidance on reporting Adverse Events Following Immunization

Vaccine providers are asked to report, through local public health officials, any serious or unexpected adverse event temporally related to vaccination. An unexpected AEFI is an event that is not listed in available product information but may be due to the immunization, or a change in the frequency of a known AEFI.

Contraindications and precautions

How Is Hepatitis Contracted

There are various ways of contracting hepatitis, depending on the type. Contracting a viral form of hepatitis depends on the mode of transmission, which the table above shows.

A person may sometimes contract hepatitis nonvirally. In autoimmune hepatitis, the immune system attacks the liver cells. Ingesting substances that contain toxins, such as alcohol, can also induce some types of hepatitis.

A doctor may use a blood test to diagnose viral hepatitis.

A healthcare professional will check a persons blood for:

  • HAV-specific immunoglobulin G antibodies to diagnose HAV
  • the surface antigen HBsAg to diagnose HBV
  • anti-HCV antibodies to diagnose HCV
  • high immunoglobulin G and anti-HDV immunoglobulin M levels to diagnose HDV
  • virusspecific IgM antibodies to identify HEV

To autoimmune hepatitis, a doctor may consider:

  • symptoms

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What Is Hepatitis C Again

Hepatitis is, essentially, inflammation of the liver, and when your liver is inflamed or damaged, it wont function the way it should, according to the Centers for Disease Control and Prevention which means that it may not help your body digest food, store energy, and remove poisons the way it’s meant to.

There are three major forms of hepatitis that are more common in the US: hepatitis A, B, and Ceach of which is spread through a different virus. It can also be caused by drug or alcohol use, per the US National Library of Medicine .

Hepatitis C in particular can be divided into two categories: acute and chronic. Acute hepatitis C happens within the first six months after youre exposed to the hepatitis C virus, the CDC says, and some people’s bodies are able to fight off the infectionsymptoms of which can include dark yellow urine, fatigue, fever, and jaundice.

Generally speaking, people become infected with hepatitis C through blood-to-blood contact with an infected personthat can include blood transfusions, organ transplants, and IV drug use, says Dr. Adalja. Less commonly, the CDC says you can get hepatitis C through sharing personal care items that may have come into contact with an infected persons blood, like razors or toothbrushes having sexual contact with someone infected with hepatitis C being born to a mother with hepatitis C or getting a tattoo or piercing with an infected needle.

Who Is Most At Risk Of Contracting Hepatitis C

Hepatitis C vaccine: How is it developing and is it possible?

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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Getting Tested For Hepatitis C

Seek medical advice if you have persistent symptoms of hepatitis C or there’s a risk you’re infected, even if you do not have any symptoms.

A blood test can be carried out to see if you have the infection.

GPs, sexual health clinics, genitourinary medicine clinics or drug treatment services all offer testing for hepatitis C.

Early diagnosis and treatment can help prevent or limit any damage to your liver, as well as help ensure the infection is not passed on to other people.

Common And Local Adverse Events

HB vaccine

HB vaccine is well tolerated. Reactions are generally mild and transient, and include: irritability, headache, fatigue and injection site reactions in 10% or more of recipients.

HAHB vaccine

There is no increase in adverse events when HAHB vaccine is compared with HA vaccine given alone or concomitantly with HB vaccine at a different injection site. When the adult formulation of HAHB vaccine is given to children in the 2 dose schedule, there is no increase in adverse events compared with those occurring after administration of the pediatric formulation of HAHB vaccine.

DTaP-HB-IPV-Hib vaccine

Reactions are usually mild and transient, and include fever, irritability, restlessness and injection site reactions .

HBIg

Headache, diarrhea, fever, urticaria, angioedema and injection site reactions may occur.

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Guidance On Reporting Adverse Events Following Immunization

Vaccine providers are asked to report, through local public health officials, any serious or unexpected adverse event temporally related to vaccination. An unexpected AEFI is an event that is not listed in available product information but may be due to the immunization, or a change in the frequency of a known AEFI.

Refer to Reporting Adverse Events Following Immunization in Canada and Adverse events following immunization in Part 2 for additional information about AEFI reporting.

When Will I Be Able To Get The Vaccine If I Have Hepatitis C

Challenges Developing a Hepatitis C Vaccine

It depends on where you live. Its up to each state to decide how to distribute the vaccine and which types of underlying health conditions receive priority. In general, having hepatitis C does not put you at increased risk of severe COVID-19, and therefore likely does not give you priority, says Anurag Maheshwari, MD, a physician who is board certified in transplant hepatology, gastroenterology, and internal medicine and works with the Institute for Digestive Health and Liver Disease in Baltimore. Their risk of complications both from COVID and the COVID vaccine are pretty much the same as the general population, like the average Joe, he says. On the other hand, the Centers for Disease Control and Prevention says if hepatitis C is not well controlled, the risk of complications from COVID infection may increase.

Visit your local health departments website or ask your doctor if youre eligible to receive the vaccine now and if not, when.

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Persons New To Canada

Health care providers who see persons newly arrived in Canada should review the immunization status and update immunization for these individuals, as necessary. In many countries outside of Canada, HB vaccine is in limited use.

All persons from a country that is endemic for HB should be assessed and vaccinated against HB if not immune and not infected. Individuals born in developing countries are more likely to be carriers of HB, necessitating vaccination of their sexual and household contacts based on review of their serologic test results. HB vaccine is recommended for all household contacts whose families have immigrated to Canada from areas in which there is a high prevalence of HB and who may be exposed to HB carriers through their extended families or when visiting their country of origin.

Children adopted from countries in which there is a high prevalence of HB infection should be screened for HBsAg and, if positive, household or close contacts in the adopting family should be immunized before adoption or as soon as possible thereafter. Adults going to pick-up children from these countries should be vaccinated before departure. Refer to Immunization of Persons New to Canada in Part 3 for additional information.

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.

Yukon

Available Patient Assistance Programs for Hepatitis C treatment Holkira Pak Maviret

MerckCare Hepatitis C Program 1 872-5773 Zepatier

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Why Is It Important To Get The Vaccine If You Have Hepatitis C

Most people with hepatitis C are not at increased risk of developing severe COVID-19, but the vaccine is still recommended. They need to take all the precautions the rest of us are taking to mitigate against COVID, Dr. Quigley says. That includes mask wearing, social distancing, washing hands frequently, and getting vaccinated once eligible. According to the CDC, becoming vaccinated can keep you from getting seriously ill from COVID-19 and protect those around you.

That protection is especially important if you have a liver disease, such as cirrhosis, as well as hepatitis C, Maheshwari says.

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What Questions Should People With Hepatitis C Ask Their Healthcare Teams About The Covid

Hepatitis C vaccine: Is it possible?

Discuss your vaccination plans with your doctor beforehand, especially if you have experienced anaphylaxis following other vaccinations or are on an immunosuppressant. The Toronto Centre for Liver Disease says taking an immunosuppressant may affect the effectiveness of the vaccine, though thats up for debate. Thats actually the million-dollar question, Maheshwari says. A fair number of our patients are on a medication that suppresses their immune system. We dont have any data on the percentage of patients who are likely to respond. Its something were still learning. Maheshwari says people with hepatitis C who have had a liver transplant or have an associated condition that affects the immune system, such as rheumatoid arthritis or Crohns, may be on tacrolimus or Humira .

In the meantime, its still a good idea to get the vaccine, but ask your doctor for the go-ahead to be sure. Hepatitis C in general would not be something that would prevent patients from responding appropriately to the vaccine, Maheshwari says.

Finally, Maheshwari says to ask your doctor when you should receive the vaccine if youve already been infected with COVID-19. The recommendations are different based on your underlying health or illness, he says. Because each individuals health profile is different, your doctor will be able to give the best advice.

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What Is Hepatitis C

Hepatitis C is a viral infection that causes inflammation and damage to the liver. You can have a short-term infection that your bodys immune system fights off. This is called an acute infection. However, in about 70% of cases, the immune system is unable to fight off the infection, and the infection becomes long-term, called chronic hepatitis C. Chronic hepatitis C can lead to cirrhosis of the liver, liver failure and liver cancer.

Persons With Chronic Diseases

Refer to Immunization of Persons with Chronic Diseases in Part 3 for additional general information about vaccination of people with chronic diseases.

Chronic renal disease and patients on dialysis

People with chronic renal disease may respond sub-optimally to HB vaccine and experience more rapid decline of anti-HBs titres, and are therefore recommended immunization with a higher vaccine dose. Individuals undergoing chronic dialysis are also at increased risk for HB infection. In people with chronic renal disease anti-HBs titre should be evaluated annually and booster doses using a higher vaccine dose should be given as necessary.

Neurologic disorders

People with conditions such as autism spectrum disorders or demyelinating disorders should receive all routinely recommended immunizations, including HB-containing vaccine.

Chronic liver disease

HB immunization is recommended for non-immune persons with chronic liver disease, including those infected with hepatitis C, because they are at risk of more severe disease if infection occurs. Vaccination should be completed early in the course of the disease, as the immune response to vaccine is suboptimal in advanced liver disease. Post-immunization serologic testing may be used to confirm vaccine response.

Non-malignant hematologic disorders

Persons with bleeding disorders and other people receiving repeated infusions of blood or blood products are considered to be at higher risk of contracting HB and should be offered HB vaccine.

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Hepatitis A And B: Diseases Of The Liver

Hepatitis is an inflammation of the liver, most often caused by a viral infection. There are three common types of hepatitis caused by viruses: hepatitis A, hepatitis B, and hepatitis C. Vaccines have been developed that protect people from contracting hepatitis A and B. There is no vaccine for hepatitis C.

Hepatitis A and hepatitis B can be spread from person to person, although in different ways. They have similar symptoms, which include abdominal pain, fever, fatigue, joint pain, and jaundice .

Over the last 20 years, there has been a 90% decrease in cases of hepatitis A and an 80% decrease in hepatitis B cases in the U.S. Health experts believe that immunization efforts have led to this drop in rates of infection.

Treatments For Hepatitis C

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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 simeprevir, 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.

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Hepatitis C Vaccine Could Be Available Within Five Years Says U Of A Nobel Laureate Michael Houghton

New vaccine has potential to save hundreds of thousands of lives each year and dramatically reduce cost of treating infections with antiviral drugs.

Michael Houghton, who won the Nobel Prize in Physiology or Medicine last year for his co-discovery of the hepatitis C virus, says a vaccine could be in use within five years if clinical trials prove it is safe and effective.

A vaccine to protect against hepatitis C virus could be in use within five years, according to University of Alberta Nobel laureate Michael Houghton, who made the announcement during a special presentation at this years European Congress of Clinical Microbiology and Infectious Diseases held in Vienna, Austria, over the weekend.

While the advent of directly acting antivirals to cure HCV has given us a huge weapon to turn the tide on this pandemic, there is no doubt that a vaccine is required to help the world reach its ambitious target of reducing new HCV infections by 90 per cent and mortality rates by 65 per cent by 2030, said Houghton, a virologist in the Faculty of Medicine & Dentistry and director of the Li Ka Shing Applied Virology Institute.

Up to two million new HCV infections occur every year around the world, with an estimated 70 million carriers of the virus globally, most of whom are not diagnosed. The virus is estimated to cause some 400,000 deaths annually. Many infected with the virus go on to develop liver cirrhosis and liver cancer.

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