Diagnosis Of Hepatitis C
If you are at risk of hepatitis C infection, or think you may have been exposed to hepatitis C in the past, see your doctor for an assessment of your liver health. This will include blood tests and possibly a non-invasive test for liver damage .
There are 2 blood tests used to diagnose hepatitis C. Usually these can be done at the same time but sometimes they will be done separately.
The first test known as a hepatitis C antibody test can tell you whether you have ever been exposed to hepatitis C.
It may take 2 to 3 months from the time of infection until a blood test can detect antibodies to hepatitis C, so there is a window period during which you cannot tell if you are or have been infected. In this time, take precautions to prevent the potential spread of the virus.
The second test is called hepatitis C PCR, which will be done if the antibody test is positive. This determines if the virus is still present in your blood or liver or if you have already cleared the infection.
If you have cleared the virus or had successful treatment to cure it, the PCR test will be negative.
A liver ultrasound or Fibroscan can also be performed to assess if you have any liver damage.
If your doctor is inexperienced in diagnosing hepatitis C you can call the LiverLine on for information, and to find a GP who can help you.
How Is Hepatitis C Transmitted
Because HCV is primarily spread through contact with infected blood, people who inject drugs are at increased risk for HCV infection. HCV can also be transmitted from an infected mother to child at the time of birth, from unregulated tattoos or body piercings, and from sharing personal items that may be contaminated with infected blood, even in amounts too small to see. Much less often, HCV transmission occurs through sexual contact with an HCV-infected partner, especially among people with multiple sex partners and men who have sex with men. Currently in the United States, health care related transmission of HCV is rare, but people can become infected from accidental needle sticks and from breaches in infection control practices in health care facilities.
How Do You Get Hepatitis C
The hepatitis C virus is usually spread through blood-to-blood contact.
Some ways the infection can be spread include:
- sharing unsterilised needles particularly needles used to inject recreational drugs
- sharing razors or toothbrushes
- from a pregnant woman to her unborn baby
- through unprotected sex although this is very rare
In the UK, most hepatitis C infections happen in people who inject drugs or have injected them in the past.
Its estimated around half of those who inject drugs have been infected with the virus.
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Early Signs Of Liver Disease
Some people will develop symptoms within two weeks to six months after being infected by the hepatitis C virus. This is called an acute infection.
Exposure can take place through contact with infected blood or needles. This sometimes can happen on the job or recreationally.
In general, early signs of hepatitis C are flu-like, mild and fairly nonspecific, meaning that they can be caused by a laundry list of other illnesses and infections. They include , sore muscles, , , nausea, itchy skin, , and a yellow discoloration of the skin and whites of the eyes . For most people, acute hepatitis C infection will lead to chronic or long-term infection.
If you notice any of these symptoms and think you may have been exposed to hepatitis C, contact your doctor. A blood test can help determine if these symptoms are, in fact, a result of hepatitis C.
What Effects Does Hepatitis C Have During Pregnancy
Hepatitis C can be passed on from a pregnant woman to her child during pregnancy and birth, but this is rare. The risk of passing hepatitis on is slightly higher for mothers with both HIV and hepatitis C .
Antivirals used to treat hepatitis are not currently recommended for pregnant women. This is because there isnât enough information to know if the drugs are safe for your unborn baby.
If you have hepatitis C and are pregnant speak to your doctor. They will be able to give you advice on how to keep yourself and your baby safe during pregnancy and birth.
If youâre planning to have a baby, your doctor may recommend that you treat the hepatitis C before you get pregnant.
Breastfeeding with hepatitis C is considered safe. But if you have cracked or bleeding nipples, itâs generally recommended to stop breastfeeding until they have healed.
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Additional Tests You Might Need
Once youve been diagnosed with Hepatitis C, your doctor will likely order a number of tests to find out about the health of your liver and decide on a treatment plan thats most appropriate for you.
Hepatitis C genotype
The Hepatitis C genotype refers to a specific strain or type of the Hepatitis C virus. There are six major types of Hepatitis C around the world: genotypes 1, 2, 3, 4, 5 and 6. In the United States, genotypes 1, 2, and 3 are common:
- Genotype 1: Most Americans with Hepatitis C have this type
- Genotype 2: About 10% of Americans with Hepatitis C have this type
- Genotype 3: About 6% of Americans with Hepatitis C have this type
The genotype of Hepatitis C does not change over time, so you only need to get tested once.
Genotype tests are done before a person starts treatment. Hepatitis C treatment works differently for different genotypes, so knowing your genotype helps your doctor choose the best treatment for you.
Testing for Hepatitis A and Hepatitis B
Your doctor may test to see if your body is immune to Hepatitis A and Hepatitis B. If these tests show no prior exposure or protection, he or she will recommend that you be vaccinated against these two viruses to eliminate the chance of becoming infected.
Liver function tests or liver enzymes
Liver function tests also include ALP and total bilirubin, among other things.
Tests to measure liver scarring or fibrosis
- Liver Biopsy
Hepatitis C And Liver Transplantation
Some people with advanced hepatitis C infection and severe liver damage undergo a liver transplant, but that doesnt eradicate the infection. Patients with active infection at the time of the transplant will develop hepatitis C in the new liver. Sometimes the infection recurs even when patients are on antiviral treatment. Those who have achieved sustained virologic response meaning no detectable virus in the blood 6 months after treatment have a very low risk of developing hepatitis C infection in the new liver.
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Should I Be Screened For Hepatitis C
Doctors usually recommend one-time screening of all adults ages 18 to 79 for hepatitis C. Screening is testing for a disease in people who have no symptoms. Doctors use blood tests to screen for hepatitis C. Many people who have hepatitis C dont have symptoms and dont know they have hepatitis C. Screening tests can help doctors diagnose and treat hepatitis C before it causes serious health problems.
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How Do Women Get Liver Disease C
Liver disease C spreads out from person-to-person through contact with infected blood. If you work in a market where you might come in contact with blood, theres a small risk of exposure. This consists of personal care such as:
- house cleaning
To protect yourself, prevent contact with cuts or open sores on patients and clients. Use non reusable latex or non-latex gloves and sterilize equipment after each use . If you operate in the janitorial or housekeeping market, wear gloves to prevent contact with blood from feminine health products.
Liver disease C can likewise be spread to a sexual partner during a menstruation .
Numerous women with the virus are able to have a healthy baby. However, there is a small risk that the infection will be transferred to a baby during pregnancy. If you have hepatitis C and give birth, your baby will be checked for the infection at around 18 months.
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What Are The Long
Without treatment, chronic hepatitis C can cause the liver to stop working properly. This scarring of the liver is called cirrhosis. A small number of people with cirrhosis develop liver cancer. Other than a liver transplant, thereâs no cure for cirrhosis. But, treatments can help relieve some of the symptoms.
Treatments For Hepatitis C
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 sofosbuvir and daclatasvir.
Using the latest medications, more than 90% of people with hepatitis C may be cured.
But its 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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How Is Viral Hepatitis Diagnosed
Talk to your doctor if you have symptoms of viral hepatitis. Your doctor will:
- Ask questions about your health history
- Do a physical exam
- Order blood tests that look for parts of the virus or antibodies that your body makes in response to the virus. Other tests may measure the amount of the virus in your blood.
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What Are The Complications Of Undiagnosed Hepatitis C
- Hepatitis C is known to be associated with two skin conditions, lichen planus and porphyria cutanea tarda.
- Diabetes, heart disease, and arterial blockage are more common among patients with chronic hepatitis C infection than in the general population. It may be that liver damage and chronic inflammation caused by hepatitis C may affect the levels of blood fats and blood sugar.
- Low platelet counts may occur as a result of the destruction of platelets by antibodies.
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Acute Vs Chronic Hepatitis C Infection
Acute hepatitis C infection refers to symptoms that appear within 6 months of newly acquiring the virus. About 20% to 30% of those who acquire hepatitis C experience acute illness. After this, the body either clears the virus or goes on to develop chronic infection. Chronic hepatitis C infection refers to long-lasting infection. The majority of people who have acute hepatitis C infection go on to develop the chronic form of the illness.
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How Do I Test For Hepatitis C
A simple blood test will show whether you have the virus. You may also be given an extra test to see if your liver is damaged.
If youâve got hepatitis C you should be tested for other STIs. It’s important that you tell your recent sexual partner/s so they can also get tested and treated. Many people who have hepatitis C do not notice anything wrong, and by telling them you can help to stop the virus being passed on. It can also stop you from getting the infection again.
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Can I Breastfeed My Baby If I Have Viral Hepatitis
Yes, you can breastfeed your baby if you have viral hepatitis. You cannot pass viral hepatitis through breastmilk.
But, if you have hepatitis C and your nipple or the surrounding skin is cracked or bleeding, stop nursing your baby on that breast until the sores heal. You can pump or hand-express your milk from that breast until it heals. Throw any breastmilk from that breast away, because it might have been contaminated with hepatitis C from the cracked or bleeding skin.
Pumping the breast that is cracked or bleeding will help keep up your milk supply and prevent the breast from getting overly full and painful. You can feed your baby your milk from your healthy breast.24
How Can I Prevent Getting Hepatitis C
There is no vaccine to prevent Hepatitis C, but there is research being done to develop one. Currently, vaccines are only available for Hepatitis A and Hepatitis B.
Remember that Hepatitis C is transmitted or spread when the blood from a Hepatitis C-infected person enters the bloodstream of someone who is not infected. If you dont have Hepatitis C, you can reduce your risk of becoming infected by doing the following:
- If youre injecting drugs, try to get into a treatment program. If you continue to use drugs, dont share needles or other equipment with anyone else. Many cities have needle exchange programs that provide free, sterile needles.
- Make sure all equipment has been sterilized if youre getting body piercings or a tattoo.
- If youre a healthcare worker follow your institutions safety precautions. For example, wear protective clothing and gloves and dispose of contaminated sharp objects properly.
- If you have more than one sex partner or are a man having sex with other men, use condoms for intercourse.
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Who Gets Viral Hepatitis
Viral hepatitis is common in the United States and affects women and men. Hepatitis B and C are more common than hepatitis A.
- In 2015, hepatitis A affected an estimated 2,500 Americans.6 The percentage of people with hepatitis A has gone down by 95% since the hepatitis A vaccine became available in 1995.
Chronic hepatitis B may affect more than 1 million Americans.6 Asian-Americans and Pacific Islanders have the highest rates of hepatitis B infection. About 50% of the people living with Hepatitis B are Asian-Americans and Pacific Islanders.7
Within this high-risk group, hepatitis B is usually passed from a mother to her baby during pregnancy. Babies born with hepatitis B are likely to have it their entire lives and are at higher risk of liver damage and liver cancer.
- Hepatitis C is the most common type of viral hepatitis infection in the United States. An estimated 3.5 million Americans have chronic hepatitis C.6 The CDC recommends that everyone born between 1945 and 1965 get tested at least once for hepatitis C because it is so common in this age group.8
How Does Hepatitis C Affect Your Body
Hepatitis C is an inflammation of the liver. The hepatitis C virus is most often transmitted through infected blood, such as by sharing needles, says Alexander Kuo, MD, medical director of liver transplantation at Cedars-Sinai in Los Angeles.
Sexual transmission is very uncommon, he says. In healthy adults, youre more likely to catch HCV by sharing a toothbrush or razor than through sexual contact. Using barrier methods during sex decreases the risk further.
People who contract HCV often dont realize they have it. During the early stages of infection, the vast majority of people are symptom free, Dr. Kuo says, so it can be difficult to diagnose before it has already done lasting damage to your liver.
People who may have been exposed children of women who have hepatitis C people who have gotten at-home tattoos and those whove used intravenous drugs should get a onetime blood test to screen for HCV even before they experience symptoms, according to the Centers for Disease Control and Prevention . People who actively inject drugs should have routine screenings.
Over time, the chronic inflammation from untreated hepatitis C can lead to fibrosis, or scarring, in the liver. Kuo cautions that if this continues for 20 or more years, there is a risk that the liver can become hard from severe fibrosis, resulting in a condition called cirrhosis.
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Can Hepatitis C Be Prevented
There is no vaccine for hepatitis C. But 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
- Using a latex condom during sex. If your or your partner is allergic to latex, you can use polyurethane condoms.
NIH: National Institute of Diabetes and Digestive and Kidney Diseases
What Are The Types Of Hepatitis B
There are two types of hepatitis B infection: acute and chronic.
An acute infection happens at the beginning, when you first get infected with hepatitis B. Many people are able to clear it from their bodies and recover. In fact, this is true of about 4 in 5 adults who are infected.
If you are not able to clear the infection within six months or longer, you have chronic hepatitis B. It is chronic hepatitis B that leads to inflammation and the serious, and possibly fatal, illnesses of cirrhosis of the liver and liver cancer. Treatment can slow disease progress, reduce the chance of liver cancer and increase your chances of surviving.
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Treatment Of Hepatitis C
Hepatitis C is treated with antiviral medications that aim to clear the virus from your body.
New all-tablet treatments have greatly improved the outcomes for people with hepatitis C. These treatments can cure more than 95% of individuals with chronic hepatitis C. There are several new tablets that are used in combination to treat all hepatitis C strains . They are effective for people with no liver damage and those who have more advanced liver damage or cirrhosis.
These new tablet medications are available and subsidised on the Pharmaceutical Benefits Scheme, and can be prescribed by specialists, general practitioners and specialised nurse practitioners.
There are no restrictions on accessing treatment it is available for all adults with a Medicare card. People under 18 are able to access treatment and it is recommended they are referred to a pediatrician experienced in the treatment of hepatitis C.
For more information on the new medications for the treatment of hepatitis C, see our video: Hepatitis C Cure what it means for Victorians.
If your doctor does not know about the new treatments, you can call the LiverLine on for information, and to find a GP who can help you.
Talk with your doctor about treatment options and the potential for interactions with other medications, herbal preparations and other drugs. If you take prescribed medication this will be managed so you can access treatment.
In general, if you have hepatitis C you will feel better if you: