Hiv And Hepatitis C Coinfection
HCV infection is common among people with HIV who also inject drugs. Nearly 75% of people living with HIV who report a history of injection drug use are co-infected with HCV. All people who are diagnosed with HIV are recommended to be tested for HCV at least once. People living with HIV are at greater risk for complications and death from HCV infection. Fortunately, direct acting antivirals that are used to treat HCV work equally well in people with and without HIV infection. For more information about HIV and HCV coinfection, visit the HIV.govs pages about hepatitis C and HIV coinfection.
Prevention Is The Best Medicine
Even though hepatitis C rarely spreads within a household, if you or a family member have the disease, it’s wise to take precautions to prevent its spread especially if anyone in your home is immune compromised, or has cuts or open sores that increase the risk of infection.
In general, use these common sense preventive tips:
- Unless you are in a long-term, monogamous relationship, practice safe sex.
- Clean up spilled or dried blood with a bleach-based cleaning solution and wear rubber gloves.
- Do not share razors.
- Do not share toothbrushes. “Though hepatitis C is not transmitted through saliva, there might be blood on the toothbrush,” Reau says.
Note that hepatitis C is not transmitted by sharing eating utensils, hugging, kissing, coughing or sneezing.
What Laboratory Studies Should Be Ordered To Help Establish The Diagnosis How Should The Results Be Interpreted
The criteria used are: serum aminotransferase levels greater than 10 fold the upper normal limit, serum gamma globulin level greater than twice the upper normal limit, elevated conjugated bilirubin, interface hepatitis on biopsy.
Autoantibody testing includes ANA , ASMA with titers of 1:320 or greater generally reflective of the presence of specific antiactin antibodies which are usually not measured in most clinical laboratories, atypical perinuclear antineutrophil cytoplasmic antibodies , soluble liver antigen and liver-pancreas antigen which is seen in 30% of patients, liver-kidney microsomal antibody type 1 , and anti-liver cytosol antibody type 1 . AMA may sometimes be seen although are typically seen in primary biliary cirrhosis.
Type 1 AIH is typically characterized by positive smooth muscle antibodies , +pANCA, +ANA, and +SLA/LP antibodies . Type 2 is usually characterized by antibodies to ALKM-1 and ALC-1. However, autoantibody testing alone is not diagnostic as positive testing can be seen in other liver disease. Additionally, circulating antibodies are absent in about 10% of patients.
Serologies for viral hepatitides should be ordered to exclude these from the diagnosis.
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Giving Blood And Organ Donation
If you have hepatitis C, you cannot give blood.
In a recent research study in America kidneys from people with hepatitis C who had died were transplanted into patients who did not have the virus.
All of the recipients subsequently contracted hepatitis C but were treated for it and all were cured. The benefit of receiving a kidney outweighed the risk of not clearing hepatitis C.
What Is The Treatment For People With Acute Hepatitis C Infection
When people first get hepatitis C, the infection is said to be acute. Most people with acute hepatitis C do not have symptoms so they are not recognized as being infected. However, some have low-grade fever, fatigue or other symptoms that lead to an early diagnosis. Others who become infected and have a known exposure to an infected source, such as a needlestick injury, are monitored closely.
Treatment decisions should be made on a case-by-case basis. Response to treatment is higher in acute hepatitis infection than chronic infection. However, many experts prefer to hold off treatment for 8-12 weeks to see whether the patient naturally eliminates the virus without treatment. Approaches to treatment are evolving. Patients with acute hepatitis C infection should discuss treatment options with a health care professional who is experienced in treating the disease. There is no established treatment regimen at this time.
How effective is hepatitis C treatment? Is hepatitis C curable?
If the hepatitis C RNA remains undetectable at the end of the treatment and follow-up period, this is called a sustained virologic response and is considered a cure. Over 90% of people treated with DAAs are cured. These people have significantly reduced liver inflammation, and liver scarring may even be reversed.
About 5% of people who are treated for HCV infection are not cured by some of the older regimens. These people may still have options for cure with the newer regimens.
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Is Liver Transplantation An Option For A Person With Hepatitis C
Hepatitis C is the leading reason for 40% to 45% of liver transplants in the U.S. Hepatitis C usually recurs after transplantation and infects the new liver. Approximately 25% of these patients with recurrent hepatitis will develop cirrhosis within five years of transplantation. Despite this, the five-year survival rate for patients with hepatitis C is similar to that of patients who are transplanted for other types of liver disease.
Most transplant centers delay therapy until recurrent hepatitis C in the transplanted liver is confirmed. Oral, highly effective, direct-acting antivirals have shown encouraging results in patients who have undergone liver transplantation for hepatitis C infection and have recurrent hepatitis C. The choice of therapy needs to be individualized and is rapidly evolving.
How Can I Protect Myself From Hepatitis C Infection
If you dont have hepatitis C, you can help protect yourself from hepatitis C infection by
- not sharing drug needles or other drug materials
- wearing gloves if you have to touch another persons blood or open sores
- making sure your tattoo artist or body piercer uses sterile tools and unopened ink
- not sharing personal items such toothbrushes, razors, or nail clippers
Hepatitis C can spread from person to person during sex, but the chances are low. People who have multiple sex partners, have HIV or other sexually transmitted diseases, or who engage in rough or anal sex have a higher chance of getting hepatitis C. Talk with your doctor about your risk of getting hepatitis C through sex and about safe sex practices, such as using a latex or polyurethane condom to help prevent the spread of hepatitis C.
If you had hepatitis C in the past and your body fought off the infection or medicines cured the infection, you can get hepatitis C again. Follow the steps above, and talk with your doctor about how to protect yourself from another hepatitis C infection.
If you think you may have been exposed to the hepatitis C virus, see your doctor as soon as possible. Early diagnosis and treatment can help prevent liver damage.
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Cost Of Hepatitis C Medicines
The newer direct-acting antiviral medicines for hepatitis C can be costly. Most government and private health insurance prescription drug plans provide some coverage for these medicines. Talk with your doctor about your health insurance coverage for hepatitis C medicines.
Drug companies, nonprofit organizations, and some states offer programs that can help pay for hepatitis C medicines. If you need help paying for medicines, talk with your doctor. Learn more about financial help for hepatitis C medicines.
When To See A Doctor
Whats galling about hepatitis C is that it all-too-often goes undetected for a long time some carry it for 10-20 years without any signs. If you or a loved one is experiencing any of the above-listed symptoms, of course, seek out treatment as soon as possible. The best bet, oftentimes, is screening for this disease to prevent its progression.
In the US, an estimated 3.5 million people have hepatitis Cthats over 2 million menand around half of these carry it without knowing it.
Testing for hepatitis C can be of paramount importance for certain groups of men. These include:
It never hurts to be safe with the number of people who carry this disease unknowingly, care should certainly be taken. That said, with regular testing and prompt treatment, hepatitis C can be taken on.
If you have hepatitis C or believe you do, the best bet is to be proactive. Seek out the care you need and talk to loved ones and family the sooner you get on the path towards treatment, the better off youll be. With the right support system, this disease can be taken on and eradicated.
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Fast Facts About Hepatitis C
- Hepatitis C is passed on from blood-to-blood contact
- Most cases of hepatitis C occur from unsafe injecting drug use, and some cases occur from unprotected anal sex
- If you contract hepatitis C, you may get flu-like symptoms, nausea or abdominal pain
- At the moment, there are no vaccines to prevent you from contracting hepatitis C
- If youre poz, make sure you get tested regularly for hepatitis C
How Common Is Hepatitis C In The United States
In the United States, hepatitis C is the most common chronic viral infection found in blood and spread through contact with blood.14
Researchers estimate that about 2.7 million to 3.9 million people in the United States have chronic hepatitis C.13 Many people who have hepatitis C dont have symptoms and dont know they have this infection.
Since 2006, the number of new hepatitis C infections has been rising, especially among people younger than age 30 who inject heroin or misuse prescription opioids and inject them.15,16
New screening efforts and more effective hepatitis C treatments are helping doctors identify and cure more people with the disease. With more screening and treatment, hepatitis C may become less common in the future. Researchers estimate that hepatitis C could be a rare disease in the United States by 2036.17
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When To See A Healthcare Provider
If you develop any of the symptoms of chronic hepatitis, liver damage, or liver cancer, see your healthcare provider. It takes only a blood test to detect the presence of a hepatitis virus in your body .
A blood test also can determine which hepatitis virus youre infected with, which will determine what your treatment should be .
What Can I Do If I Think I Have Hepatitis C
A doctor or sexual health clinician can test you to see if you have hepatitis C. If you do, effective treatment with fewer side effects than the older medicine is available and you can discuss how to avoid infecting your sexual partners or people you live with.
It can take three to six months before the blood test for hepatitis C will be able to detect signs of infection in your blood. For people with HIV who may be immunocompromised, the antibody may not be detectable and it may be necessary to request an RNA test which detects the virus.
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How Do I Get Tested
Hepatitis C is diagnosed with a blood test. Unlike hepatitis A and B, you can be infected more than once and you do not develop immunity if you contract hepatitis C. Speak to your doctor or healthcare provider to arrange a test for hepatitis C or visit your nearest sexual health clinic to organise a test for hepatitis C as part of your next test.
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Southern Cross Medical Library
The purpose of the Southern Cross Medical Library is to provide information of a general nature to help you better understand certain medical conditions. Always seek specific medical advice for treatment appropriate to you. This information is not intended to relate specifically to insurance or healthcare services provided by Southern Cross. For more articles go to the Medical Library index page.
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How Do Doctors Treat The Complications Of Hepatitis C
If hepatitis C leads to cirrhosis, you should see a doctor who specializes in liver diseases. Doctors can treat the health problems related to cirrhosis with medicines, surgery, and other medical procedures. If you have cirrhosis, you have an increased chance of liver cancer. Your doctor may order an ultrasound test to check for liver cancer.
If hepatitis C leads to liver failure or liver cancer, you may need a liver transplant.
What Are The Types Of Hepatitis C Infection
There are two types of hepatitis C infection:
- Acute: a short-term infection that occurs within 6 months after a person is exposed to the virus. However, about 75 to 85 percent of people with the acute form go on to develop the chronic form.
- Chronic: a long-term illness that can continue throughout a persons life. It can lead to cirrhosis of the liver and other serious problems, such as liver failure or cancer. About 15,000 people a year die from liver disease associated with hepatitis C.
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Can Hepatitis C Be Cured
Unlike Hepatitis A and Hepatitis B, a vaccine for Hepatitis C is not available.
However, treatment options are available and Hepatitis C may be cured .
Learn more about your treatment options and speak to your healthcare provider today.
The Hepatitis C virus is considered cured if the virus is not detected in your blood when measured with a blood test 3 months after treatment is completed. This is called a sustained virologic response and data suggest that you will stay virus free indefinitely.
Try to keep yourself as healthy as possible, keep your medical appointments and get regular check-ups. Remember that you could become re-infected if you expose yourself to high-risk situations such as injection drug use, and so do everything possible to avoid these situations. Speak with a substance abuse counselor if needed.
What About Sex And Hepatitis C
Hepatitis C can be spread through sexual intercourse, but the risk is considered to be low. It is extremely rare among monogamous couples, meaning couples who only have sex with one another. The risk increases if you:
- Have multiple sex partners
- Have a sexually transmitted disease
- Are infected with HIV
There is no evidence that Hepatitis C is spread by oral sex.
To reduce the chance of getting or giving Hepatitis C through sexual contact, follow these guidelines:
- Use latex condoms every time you have sex, particularly if you have:
- More than one partner
- Rough sex that might make one of you bleed
- Sex during your or your partners menstrual period
- Sex when you or your partner has an open sore on either of your genitals
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Why Should I Get Treated
Hepatitis C can be fatal when left untreated.
Untreated hepatitis C can lead to scarring of the liver known as cirrhosis.
A small number of people with cirrhosis will go on to get liver failure, the only treatment for which is a liver transplant. A small proportion of people with cirrhosis develop liver cancer.
Tests To Diagnose Hepatitis C
How is Hepatitis C diagnosed?
There are two main blood tests typically used to diagnose Hepatitis C. First, youll have a screening test that shows if youve ever had Hepatitis C at some point in your life. If this test is positive, youll have a second test to see if you have Hepatitis C now. These blood tests are described below:
Hepatitis C antibody test
This is the screening test used by doctors to show whether or not you have ever been exposed to Hepatitis C at some time in your life, by detecting antibodies in your blood. Antibodies are substances your body makes to fight off all kinds of infections. If you were ever infected with Hepatitis C, your body would have made antibodies to fight the virus.
If the test result is:
- Negative, it means you have not been exposed to Hepatitis C and further testing is usually not needed.
- Positive, you have had Hepatitis C at some point. However, it does not tell you whether you have it now. Youll need to see your doctor for another test the Hepatitis C RNA test to determine if the virus is still active and present in your blood.
Hepatitis C RNA Qualitative Test
This test will determine whether or not you are currently infected with Hepatitis C. It is often called the PCR test because of the process used . It looks for the genetic material of the Hepatitis C virus in your blood.
If the test result is:
Hepatitis C RNA Quantitative Test
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How Do People Get Hepatitis C
HCV spreads by direct contact with an infected person’s blood and other body fluids. This can happen through:
- sharing drug needles and intranasal drug devices
- getting a tattoo or body piercing with unsterilized tools
- sexual contact
- passing of the infection from a pregnant woman to her unborn child
Thanks to blood screening and other health care safety rules adopted in the early 1990s, the spread of HCV from hemodialysis, blood transfusions, or organ transplants is now rare.
It’s also rare, but possible, for someone to get HCV by sharing household items that might contain an infected person’s blood, such as razors, toothbrushes, or scissors.
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
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