How Do My Healthcare Professional And I Decide On Treatment
Your healthcare professional will look at your health history and decide if treatment is right for you. The treatment you receive and the length of treatment may depend on:
- How much virus is in your body
- Your genotype of hep C
- Whether you have liver damage
- Whether or not youve been treated previously
Next:
Traveling While On Treatment
If you plan to travel while on treatment, there are several considerations you need to think about when making arrangements:
- If youre traveling by car, do not leave medications in a hot vehicle.
- If youre traveling by air, carry on all medications with you in the cabin. Keep them in their original containers with the prescription label.
- Make sure to bring contact information for your healthcare providers with you in case you need to contact them with a question or concern.
- Keep a card in your wallet that indicates who to call in an emergency. This should include contact information for a family member and your doctor.
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.
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Importance Of Adhering To Your Treatment Plan
Once you begin treatment for your Hepatitis C infection, youll want to do everything you can to make it a success. Adherence to your Hepatitis C medication regimen is an important predictor of successful treatment. When it comes to medications, this means that you want to adhere to taking them as prescribed meaning taking the right dose, the right way, at the right time, for as long as prescribed.
The goal of using medications to treat Hepatitis C is to:
- Clear the Hepatitis C virus from your body
- Prevent or slow down scarring of your liver
- Reduce your chance of developing cirrhosis and liver cancer
Proper adherence to Hepatitis C therapy will increase your chance of being cured and decrease the long-term complications of Hepatitis C.
Adhering to other aspects of your treatment plan is also important. Keeping your medical appointments and getting the necessary lab tests will help to maximize your chance of treatment success and minimize potential problems.
How Many People Have Hepatitis C
During 2013-2016 it was estimated that about two and half million people were chronically infected with HCV in the United States. The actual number may be as low as 2.0 million or as high as 2.8 million.Globally, hepatitis C is a common blood-borne infection with an estimated 71 million people chronically infected according to the World Health Organization .
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Sofosbuvir Velpatasvir And Voxilapresvir
This drug combination is similar to Epclusa but also includes a drug called voxilapresvir.
Facts about Vosevi include:
- Treatment time is 12 weeks for people without cirrhosis or compensated cirrhosis .
- Dosage is fixed at 400 mg of sofosbuvir, 100 mg of velpatasvir, and 100 mg of voxilapresvir once per day with food.
- Common side effects include tiredness, a headache, diarrhea, and nausea.
Doctors often recommend Vosevi for people who have had previous treatment for hepatitis C that did not work.
We Now Have The Cure For Hepatitis C But Can We Afford It
A long, difficult and costly research effort gives doctors a new cure for hepatitis C
A decades-long search for better treatments for a debilitating liver disorder is finally coming to fruition. Later this year the U.S. Food and Drug Administration is expected to approve a new pill that can cure hepatitis Ca chronic infection that afflicts about 170 million people worldwide and annually kills 350,000 people, including 15,000 in the U.S.faster and with fewer side effects than current remedies.
The breakthrough treatment comes, however, at a price that may place it out of reach for all but the wealthiest or best-insured patients. It will contain two drugs, one of which is already available at $1,000 per dose, or $84,000 for a complete 12-week course. The dual-drug combination will likely cost even more, which has prompted outrage from physicians and patient advocates alike, as well as plans from insurers to ration the combination when it becomes commercially available.
Over the coming months, physicians, patients, economists and insurance companies will no doubt hotly debate whether the treatment is worth the full asking price. There is little doubt, however, that the medications effectiveness is unprecedented and that its development is a significant achievement. A closer look at the complex chemical problems that needed to be solved to develop the cure shows why.
doi:10.1038/scientificamerican0914-32
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What Are The Treatments For Hepatitis C
Treatment for hepatitis C is with antiviral medicines. They can cure the disease in most cases.
If you have acute hepatitis C, your health care provider may wait to see if your infection becomes chronic before starting treatment.
If your hepatitis C causes cirrhosis, you should see a doctor who specializes in liver diseases. Treatments for health problems related to cirrhosis include medicines, surgery, and other medical procedures. If your hepatitis C leads to liver failure or liver cancer, you may need a liver transplant.
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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Hepatitis C And Blood Spills
When cleaning and removing blood spills, use standard infection control precautions at all times:
- Cover any cuts or wounds with a waterproof dressing.
- Wear single-use gloves and use paper towel to mop up blood spills.
- Clean the area with warm water and detergent, then rinse and dry.
- Place used gloves and paper towels into a plastic bag, then seal and dispose of them in a rubbish bin.
- Wash your hands in warm, soapy water then dry them thoroughly.
- Put bloodstained tissues, sanitary towels or dressings in a plastic bag before throwing them away.
Antiviral Treatment In Pregnancy
The risk of vertical transmission in mothers with an HCV monoinfection is 5% and is not diminished by cesarean section . Mothers are not advised against breastfeeding either. Vertically acquired hepatitis C takes a mild course in childhood, with very slow progression of hepatic fibrosis . Antiviral treatment during pregnancy cannot be recommended, as there are insufficient data on the potential teratogenicity of DAAs.
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Can A Transplant Cure Hepatitis C
If you develop chronic hepatitis C and it leads to liver cancer or liver failure, you may need a liver transplant. Hepatitis C is one of the most common reasons for a liver transplant.
A liver transplant removes a damaged liver and replaces it with a healthy one. However, theres a high likelihood that the hepatitis C virus will be transmitted to the new liver in time.
The virus lives in your bloodstream, not just your liver. Removing your liver wont cure the disease.
If you have active hepatitis C, continued damage to your new liver is very likely, especially if hepatitis C remains untreated.
Sustained Viral Response: A Patient
The molecular demonstration of the absence of HCV-RNA twelve weeks after the end of a course of antiviral treatment confirms the sustained eradication of the virus. The likelihood of a late recurrence is well under 1% , and most such events are actually not recurrences but reinfections . The eradication of HCV does not generate protective immunity .
A meta-analysis of 129 studies involving a total of 34 563 patients who had undergone interferon-based treatment revealed that a sustained virological response was associated with a 62% to 84% reduction of mortality, a 68% to 79% reduction of the risk of hepatocellular carcinoma , and a 90% reduction of the risk of needing liver transplantation . As interferon-based treatment was contraindicated in patients with decompensated cirrhosis, these data are uninformative with respect to any potential clinical benefit, for these patients, of sustained viral eradication with direct antiviral agents . Initial studies have yielded clinical and laboratory evidence of improvement mainly for patients with a MELD score below 1618 points . In large-scale cohort studies, sustained viral eradication was associated both with lower liver-associated mortality and with substantially lower extrahepatic mortality . Sustained viral eradication eliminates the risk of individual transmission and is associated with a better quality of life .
HCV genotypes
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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.
How Do Doctors Treat Hepatitis C
Doctors treat hepatitis C with antiviral medicines that attack the virus and can cure the disease in most cases.
Several newer medicines, called direct-acting antiviral medicines, have been approved to treat hepatitis C since 2013. Studies show that these medicines can cure chronic hepatitis C in most people with this disease. These medicines can also cure acute hepatitis C. In some cases, doctors recommend waiting to see if an acute infection becomes chronic before starting treatment.
Your doctor may prescribe one or more of these newer, direct-acting antiviral medicines to treat hepatitis C:
You may need to take medicines for 8 to 24 weeks to cure hepatitis C. Your doctor will prescribe medicines and recommend a length of treatment based on
- which hepatitis C genotype you have
- how much liver damage you have
- whether you have been treated for hepatitis C in the past
Your doctor may order blood tests during and after your treatment. Blood tests can show whether the treatment is working. Hepatitis C medicines cure the infection in most people who complete treatment.
Hepatitis C medicines may cause side effects. Talk with your doctor about the side effects of treatment. Check with your doctor before taking any other prescription or over-the-counter medicines.
For safety reasons, talk with your doctor before using dietary supplements, such as vitamins, or any complementary or alternative medicines or medical practices.
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Managing Side Effects Of Treatment
In the past when interferon was used, management of side effects was critical to have success with Hepatitis C treatment. Side effects are much less common now with the new Hepatitis C medications, but they can still happen. Fortunately, there are many steps you can take to manage them. Its important to talk to your Hepatitis C provider to help you manage side effects and have a good experience on treatment.
Keep in mind that not everyone will experience the same side effects, nor are they necessarily severe. Developing a good support system before beginning therapy with family, friends, and peer support group members can help you cope with treatment-related side effects.
The following tips will help you manage some of the more common side effects of Hepatitis C treatment:
Fatigue
- Modify your work schedule if possible.
- Get regular low-impact exercise such as walking.
- Eat well-balanced meals and drink enough fluids.
Insomnia
- Develop a regular routine go to bed and get up the same time every day.
- Use relaxation techniques such as meditation, warm baths or massage read or listen to music.
- Avoid exercise, caffeinated products, or heavy meals close to bedtime.
- Limit fluid intake about 2 hours before bedtime so you dont have to get up to go to the bathroom.
- Take over-the-counter or prescription medications as recommended by your provider.
Poor Appetite
- Eat smaller, more frequent meals.
- Eat whatever appeals to you most.
- Eat snacks high in protein have protein drinks .
Side Effects Of Treatment
Treatments with direct-acting antivirals have very few side effects. Most people find DAA tablets very easy to take.
You may feel a little sick and have trouble sleeping to begin with, but this should soon settle down.
Your nurse or doctor should be able to suggest things to help ease any discomfort.
You need to complete the full course of treatment to ensure you clear the hepatitis C virus from your body.
If you have any problems with your medicines, speak to your doctor or nurse straight away.
Side effects for each type of treatment can vary from person to person.
For a very small number of people, more severe side effects from hepatitis C treatments may include:
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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.
Initial Treatment Of Adults With Hcv Infection
Initial treatment of HCV infection includes patients with chronic hepatitis C who have not been previously treated with interferon, peginterferon, ribavirin, or any HCV direct-acting antiviral agent, whether investigational, or US Food and Drug Administration approved.
Simplification of the treatment regimen may expand the number of healthcare professionals who prescribe antiviral therapy and increase the number of persons treated. This would align with the National Academies of Science, Engineering, and Medicine strategy to reduce cases of chronic HCV infection by 90% by 2030 .
Recommended and alternative regimens are listed in order of level of evidence. When several regimens are at the same recommendation level, they are listed in alphabetical order. Regimen choice should be determined based on patient-specific data, including drug-drug interactions. Patients receiving antiviral therapy require careful pretreatment assessment for comorbidities that may influence treatment response or regimen selection. All patients should have access to an HCV care provider during treatment, although preset clinic visits and/or blood tests depend on the treatment regimen and may not be required for all regimens/patients. Patients receiving ribavirin require additional monitoring for anemia during treatment .
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Hepatitis C And Injecting Drugs
If you inject drugs, avoid sharing needles, syringes or other equipment such as tourniquets, spoons, swabs or water.
Where possible, always use sterile needles and syringes. These are available free of charge from needle and syringe programs and some pharmacists. To find out where you can obtain free needles, syringes and other injecting equipment, contact DirectLine
Try to wash your hands before and after injecting. If you cant do this, use hand sanitiser or alcohol swabs from a needle and syringe program service.
Hepatitis C Treatment And Herbs
Unlike conventional medical treatments, most herbal therapies have not undergone rigorous scientific study. Fortunately, a greater effort is being made to evaluate the safety and effectiveness of various types of dietary supplements, including herbs, through the National Center for Complementary and Integrative Health formerly called the National Center for Complementary and Alternative Medicine a center of the National Institutes of Health .
So while some products may be safe others may actually pose significant risks for example, by producing serious side effects or interacting badly with your Hepatitis C medication. Because herbs can interfere with the action of Hepatitis C medications, its important to tell your doctor about everything youre taking before starting treatment for Hepatitis C. And while getting treated, its important not to take any new herbs or supplements before consulting with your healthcare provider. For example, you should NOT take St. Johns wort , or a product that contains St. Johns wort, with several of the medications used to treat Hepatitis C, including Olysio, Sovaldi, Harvoni, and Daklinza.
CERTAIN HERBS ASSOCIATED WITH LIVER DAMAGE
Its also important to be aware that several common herbs can cause liver damage, especially in people with an existing liver disease such as Hepatitis C. These include:
Additionally, the following groups of people should avoid the use of herbs in general unless ordered by their medical provider:
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