What Is The Relationship Between Drug Use And Viral Hepatitis
Drug and alcohol use places people at particular risk for contracting viral hepatitis. Engaging in risky sexual behavior that often accompanies drug use increases the risk of contracting HBV and, less frequently, HCV. People who inject drugs are at high risk for contracting HBV and HCV from shared needles and other drug preparation equipment, which exposes them to bodily fluids from other infected people. Because drug use often impairs judgement, PWID repeatedly engage in these unsafe behaviors, which can increase their risk of contracting viral hepatitis. One study reported that each person who injects drugs infected with HCV is likely to infect about 20 others, and that this rapid transmission of the disease occurs within the first 3 years of initial infection.4 Drug and alcohol use can also directly damage the liver, increasing risk for chronic liver disease and cancer among those infected with hepatitis. This underscores that early detection and treatment of hepatitis infections in PWID and other people who use drugs is paramount to protecting both the health of the person and that of the community.
What Are The Treatment Guidelines For Hepatitis C
Hepatitis C treatment is best discussed with a doctor or specialist familiar with current and developing options as this field is changing, and even major guidelines may become outdated quickly.
The latest treatment guidelines by the American Association for the Study of Liver Disease and Infectious Disease Society of America recommends use of DAAs as first-line treatment for hepatitis C infection. The choice of DAA varies by specific virus genotype, and the presence or absence of cirrhosis. In the U.S., specific insurance providers also might influence the choice due to the high cost of DAAs. Although the individual, public health, and cost benefits of treating all patients with hepatitis C is clear, the most difficult barrier to treating all people with HCV is the very high cost of the drug regimens. Patients are encouraged to discuss options with their health care professional.
Treatment is recommended in all patients with chronic hepatitis C unless they have a short life expectancy that is not related to liver disease. Severe life-threatening liver disease may require liver transplantation. Newer therapies with DAAs have allowed more and more patients to be treated.
What are the goals of therapy for hepatitis C infection?
The ultimate goals of antiviral therapy are to
- prevent transmission of hepatitis C,
- prevent progression to cirrhosis and liver cancer, and
- improve survival and quality of life.
How Do I Know If I Am Infected With Viral Hepatitis
The number of new HBV and HCV infections has been declining in recent years, but the number of people living with chronic hepatitis infections is considerable, and deaths associated with untreated, chronic hepatitis infections have been on the rise. This is because most people dont know they are infected until the disease has begun to damage the liver, highlighting why screening for viral hepatitis is so important. People with a history of drug use are generally at higher risk, and should discuss their substance use with their health care provider.
Initial screening for HBV or HCV involves antibody tests, which show whether you have been exposed to the hepatitis virus, although not necessarily whether you are still infected. A positive antibody test should then be followed up with a test that measures the amount of virus in your blood. If this follow-up test is positive, then you should seek advice from a physician that specializes in viral hepatitis treatment. Because screening for hepatitis is so critical for linking people who test positive to the care they need, NIDA is studying new rapid HCV antibody tests that can be used in drug treatment settings.
The CDC recommends that people who inject drugs be tested for hepatitis B and C as part of routine medical care. To determine if you are at risk for contracting hepatitis, HHS has created an online assessment tool to help you find out.
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Stages Of Hepatitis C
The hepatitis C virus affects people in different ways and has several stages:
- Incubation period. This is the time between first exposure to the start of the disease. It can last anywhere from 14 to 80 days, but the average is 45
- Acute hepatitis C. This is a short-term illness that lasts for the first 6 months after the virus enters your body. After that, some people who have it will get rid of, or clear, the virus on their own.
- Chronic hepatitis C. For most people who get hepatitis C — up to 85% — the illness moves into a long-lasting stage . This is called a chronic hepatitis C infection and can lead to serious health problems like liver cancer or cirrhosis.
- Cirrhosis. This disease leads to inflammation that, over time, replaces your healthy liver cells with scar tissue. It usually takes about 20 to 30 years for this to happen, though it can be faster if you drink alcohol or have HIV.
- Liver cancer. Cirrhosis makes liver cancer more likely. Your doctor will make sure you get regular tests because there are usually no symptoms in the early stages.
Learn more about the stages and progression of hepatitis C.
What Happens During A Percutaneous Biopsy
Before this medical procedure, a doctor will explain what is going to happen and talk about any risks involved. A person needing a liver biopsy should tell the doctor about any prescribed and over-the-counter medicines or supplements they are taking, as they may need to stop taking them before the procedure.
For the procedure itself, the person lies face-up on the bed, with their right arm above their head. After administering a local anesthetic to the appropriate area, the doctor will make a small cut to the skin and insert the biopsy needle.
Doctors take the tissue sample as the person exhales. So the doctor may ask them to breathe out and hold their breath.
Once the doctor removes the needle, they apply pressure to the wound and ask the person to lie on their right-hand side for up to 2 hours. Medical staff will continue to monitor the person and check for signs of bleeding for at least another 2 hours.
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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.
Life Expectancy And Prognosis
Can you die from hepatitis? Technically, the complications of chronic hepatitis C are fatal. About 30,000 people in the U.S. die each year from cirrhosis.
How long can you live with untreated hep C? The disease affects everyone differently, so thereâs no rule. But about 70% to 80% of people with will get chronic help C. Within 20 years, about 20% to 30% of those people will get cirrhosis. From there, it depends on what type of cirrhosis you have, your treatment, and if you can get a liver transplant.
Can hepatitis C go away on its own? Yes. From 15% to 20% of people with hep C clear it from their bodies without treatment. Itâs more likely to happen in women and people who have symptoms. But it usually happens between 4 and 18 months after symptoms start.
American Liver Foundation Hep C 123: âFrequently Asked Questions.â
Gastroenterology: âExtrahepatic morbidity and mortality of chronic hepatitis C.â
National Institute of Diabetes and Digestive and Kidney Diseases: âHepatitis C.â
Therapeutic Advances in Infectious Disease: âExtrahepatic Manifestations of Chronic Hepatitis C Virus Infection.â
The Hepatitis C Support Project: âAn Overview of Extrahepatic Manifestations of Hepatitis C.â
BioDrugs: âManagement of hepatitis C virus-related arthritis.â
Frontiers in Endocrinology: âDiabetes and Hepatitis C: A Two-Way Association.â
U.S. National Library of Medicine: âAtherosclerosis,â âPreventing Hepatitis B or C.â
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Taking Control Of Your Health With Hepatitis C Screening And Treatment
Hepatitis C may be known as a silent virus, but there are things you can to do protect your health, whether youve been diagnosed with HCV or youre in a high-risk group for HCV infection. If youre unsure of your status, your first step is getting screened.
The primary care physicians at Crystal Run Healthcare provide world-class care in state-of-the-art facilities. They act as your first point of contact and will work with you to schedule appropriate screenings and coordinate your care with our renowned team of specialists.
Who Is At High Risk And Should Be Tested For Hepatitis C Infection
The U.S. Preventive Health Services task force recommends that all adults born between 1945 and 1965 be tested once routinely for hepatitis C, regardless of whether risk factors for hepatitis C are present. One-time testing also is recommended for:
- People who currently inject drugs or snort drugs, or ever did so, even once many years previously
- People with persistently elevated alanine aminotransferase level, a liver enzyme found in blood
- People who have HIV infection
- Children born to HCV- or HIV-infected mothers
- People who were ever on long-term hemodialysis
- People who got a tattoo in an unregulated setting, such as prison or by an unlicensed person
- People who received clotting factor produced before 1987
- People who received transfusions or organ transplants before July 1992, or who were notified that they received blood from a donor who later tested positive for hepatitis C infection
- Health care, emergency medical, and public safety workers after a needlestick, eye or mouth exposure to hepatitis C-infected blood
People who may have been exposed to hepatitis C in the previous 6 months should be tested for viral RNA load rather than anti-HCV antibody, because antibody may not be present for up to 12 weeks or longer after infection, although HCV RNA may be detectable in blood as soon as 2-3 weeks after infection.
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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.
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 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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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 person’s 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
The Effects Of Hepatitis C On Your Body
You may have seen numerous literature and commercials about chronic hepatitis C and for good reason. According to the Centers for Disease Control and Prevention , up to 3.9 million people in the United States may have the chronic form of this virus. According to the World Health Organization , over 70 million people are affected worldwide.
What exactly is chronic HCV? In a nutshell, it refers to ongoing inflammation of your liver. But it can lead to symptoms throughout your body. Over time, living with this condition can cause your body to be especially vulnerable to serious health complications.
HCV is transmitted through contact with the blood. Its rarely transmitted through sexual contact from someone infected with the virus. Ultimately, this infection leads to liver inflammation and a host of other issues that can severely damage your health.
The virus has two stages, acute and chronic. The acute stage happens within six months of being exposed to the virus. For some, this is a short-term illness. But according to the CDC, most people about 75 to 80 percent will develop chronic HCV. This means it can be lifelong. Most people dont realize they have the virus until other symptoms within their body start.
Although the hepatitis A, B, and C viruses all cause hepatitis, they are three different and distinct viruses.
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Complications Of Hepatitis C
If the infection is left untreated for many years, some people with hepatitis C will develop scarring of the liver .
Over time, this can cause the liver to stop working properly.
In severe cases, life-threatening problems, such as liver failure, where the liver loses most or all of its functions, or liver cancer, can eventually develop.
Treating hepatitis C as early as possible can help reduce the risk of these problems happening.
Viral Hepatitisa Very Real Consequence Of Substance Use
Hepatitis is an inflammation of the liver. It can be caused by a variety of toxins , autoimmune conditions, or pathogens .1 Viral hepatitis is caused by a family of viruses labeled A, B, C, D, and E. To learn more about the route of transmission and prognosis for each virus, visit the Centers for Disease Control and Preventions Division of Viral Hepatitis. Hepatitis B and hepatitis C are the most common viral hepatitis infections transmitted through the sometimes risky behaviors of people who use drugsparticularly among people who inject drugs. An estimated 862,000 people are living with HBV chronic infections, with about 22,000 acute infections recorded in 2017. An estimated 2.4 million Americans are living with HCV based on 2013-2016 annual average, with an estimated 44,700 new cases of acute HCV in 2017. In fact, new cases of acute HCV have increased rapidly in the US since 2010, and have most often been associated with injection drug use.6 Three out of four people living with HCV are baby boomers born between 1945 and 1965.7
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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.
Who Is More Likely To Get Hepatitis C
People more likely to get hepatitis C are those who
- have injected drugs
- had a blood transfusion or organ transplant before July 1992
- have hemophilia and received clotting factor before 1987
- have been on kidney dialysis
- have been in contact with blood or infected needles at work
- have had tattoos or body piercings
- have worked or lived in a prison
- were born to a mother with hepatitis C
- are infected with HIV
- have had more than one sex partner in the last 6 months or have a history of sexually transmitted disease
- are men who have or had sex with men
In the United States, injecting drugs is the most common way that people get hepatitis C.13
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Hepatitis C Testing And Diagnosis
Doctors will start by checking your blood for:
Anti-HCV antibodies: These are proteins your body makes when it finds the hep C virus in your blood. They usually show up about 12 weeks after infection.
It usually takes a few days to a week to get results, though a rapid test is available in some places.
The results can be:
- Nonreactive, or negative:
- That may mean you donât have hep C.
- If youâve been exposed in the last 6 months, youâll need to be retested.
If your antibody test is positive, youâll get this test:
HCV RNA: It measures the number of viral RNA particles in your blood. They usually show up 1-2 weeks after youâre infected.
- The results can be:
- Negative: You donât have hep C.
- Positive: You currently have hep C.
You might also get:
Liver function tests: They measure proteins and enzyme levels, which usually rise 7 to 8 weeks after youâre infected. As your liver gets damaged, enzymes leak into your bloodstream. But you can have normal enzyme levels and still have hepatitis C. Learn the reasons why you should get tested for hepatitis C.