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.
How Do People Get Hepatitis C
Hepatitis C virus is found in the blood of people with HCV infection. It enters the body through blood-to-blood contact.
Until reliable blood tests for HCV were developed , people usually got hepatitis C from blood products and blood transfusions. Now that blood and blood products are tested for HCV, this is no longer the typical means of infection.
Currently, people usually get hepatitis C by sharing needles for injection drug use. An HCV-infected woman can pass the infection to her baby during birth. It is also possible to get hepatitis C from an infected person through sexual contact, an accidental needlestick with a contaminated needle, or improperly sterilized medical, acupuncture, piercing, or tattooing equipment.
Vaccination Against Hepatitis A
Vaccination against hepatitis A isnt routinely offered in the UK because the risk of infection is low for most people.
Its only recommended for people at an increased risk, including:
- close contacts of someone with hepatitis A
- people planning to travel to or live in parts of the world where hepatitis A is widespread, particularly if levels of sanitation and food hygiene are expected to be poor
- people with any type of long-term liver disease
- men who have sex with other men
- people who inject illegal drugs
- people who may be exposed to hepatitis A through their job this includes sewage workers, staff of institutions where levels of personal hygiene may be poor and people working with monkeys, apes and gorillas
The hepatitis A vaccine is usually available for free on the NHS for anyone who needs it.
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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.
Getting Tested Is The Only Way To Know If You Have Hepatitis C
A blood test called a hepatitis C antibody test can tell if you have been infected with the hepatitis C viruseither recently or in the past. If you have a positive antibody test, another blood test is needed to tell if you are still infected or if you were infected in the past and cleared the virus on your own.
- Are 18 years of age and older
- Currently inject drugs
- Have ever injected drugs, even if it was just once or many years ago
- Have abnormal liver tests or liver disease
- Are on hemodialysis
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How Are Hepatitis B And C Treated
- Antiviral medications, interferon injections and a liver transplant are options for treatment of ongoing infections. Not everyone will need these treatments.
- Medicines known as direct-acting antiviral agents are now available that can lead to a cure in 8 to 12 weeks in many patients with hepatitis C, but hepatitis B may require long-term treatment.
- There is a vaccine that is used to prevent hepatitis B infection in both adults and newborns, but there is no vaccine yet for hepatitis C.
The newer direct-acting antiviral agents medications to treat HCV include:
Who Is At Risk
Your risk of infection with HCV is increased if you:
- Had tattoos or body piercings in an unclean environment using unsterile equipment
- Worked in a place where you came in contact with infected blood or needles, for example, healthcare workers
- Received a blood transfusion or organ transplant before July 1992
- Received a blood product for clotting problems made before 1987
- Needed to have your blood filtered by a machine for a long period of time because your kidneys werent working
- Were born to a mother with HCV
- Had unprotected sex with multiple partners
- Have or had a sexually transmitted disease
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What Other Tests Diagnose Hepatitis C
Once the diagnosis of hepatitis C is established, other tests may be done to determine whether the patient has developed liver fibrosis or scarring . This can be done with a needle biopsy of the liver, and examining the biopsied liver tissue under the microscope. Liver biopsy is less commonly done today because noninvasive tests are more readily available, more easily accomplished and less costly.
Liver imaging can evaluate fibrosis using ultrasound and MRI scans. Additionally, calculations using a variety of blood tests also can predict the degree of inflammation and fibrosis present. Genotype testing will typically be done to determine what subtype of hepatitis C the patient has, as this will impact what drugs are used for treatment. Testing for other infections including HIV, hepatitis A, and hepatitis B is typically done to determine if the patient might have other conditions that could impact patients treatment and prognosis.
With the newest forms of antiviral treatment, the most common types of chronic hepatitis C can be cured in most individuals.
What Are The Side Effects Of Treatments For Hepatitis C Infection
Side effects of interferon or pegylated interferon
- The most common side effects of interferon or pegylated interferon include fever, flu-like symptoms, and depression. Patients must be monitored closely for depression. Risk of suicide is a reason to avoid interferons.
- Interferons also reduce white blood cell and/or red blood cell counts . This may cause increased susceptibility to infection. Interferons also increase the risk of certain cancers. Death rarely occurs as a result of therapy, but may occur from progression of liver failure in patients with advanced cirrhosis.
Side effects of ribavirin
- Ribavirin most commonly causes anemia due to destruction of red blood cells . This can be severe enough that people with heart disease may suffer a heart attack from insufficient blood flow, so people with heart disease should not receive this drug. Anemia improves with a reduction in the dose of ribavirin. Injected growth factor that stimulates the production of red blood cells often is used to improve the anemia associated with ribavirin. Ribavirin also accumulates in the testicles and ovaries and causes birth defects in animals. Although no birth defects have been reported in humans, both men and women should use contraceptive measures to avoid pregnancy during and for at least six months after ribavirin treatment.
Side effects of DAAs
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Chronic Hepatitis C Symptoms
If you donât get diagnosed and treated, you could have the disease for years and not know it. Doctors call this the chronic form, because it lasts a long time. Some people who’ve had it for a while get scarring of the liver, which is called cirrhosis. or liver cancer.
In addition to the above symptoms, signs that your liver isnât working the way it should include:
- Ascites — fluid buildup in your belly
- Hepatic encephalopathy — confusion, drowsiness, and slurred speech
- Jaundice of the skin
Symptoms Of Hepatitis C In Women
Many women dont have symptoms until the disease is in a later stage. Women who have signs of the disease in the earliest stage may brush off symptoms or attribute them to other factors, such as anemia, depression, or menopause.
Early symptoms of hepatitis C in women can include:
- muscle and joint pain
Some hepatitis C infections are acute and the infection clears or improves on its own without treatment within a few months. Acute infections are more common in women .
Hepatitis C can also be chronic, meaning the infection doesnt clear on its own, but rather progresses and damages the liver. Symptoms of chronic hepatitis and liver damage include:
- bruising or bleeding
The symptoms of chronic hepatitis C occur in both men and women, but the disease can progress slower in women. However, some women experience rapid progression of the disease and liver damage after menopause.
Having these symptoms doesnt mean you have hepatitis C.
Hepatitis C spreads from person-to-person through contact with infected blood. If you work in an industry where you might come in contact with blood, theres a slight risk of exposure. This includes personal care such as:
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Symptoms Of Chronic Hepatitis C
Acute Hepatitis C Recognition and Transmission
Since the symptoms of acute Hepatitis C are so vague, more information is needed to suspect this virus as the cause of fatigue and bellyache.
The following information is important regarding acute Hepatitis C:
- Symptom time frame In those individuals who develop symptoms from acute Hepatitis C infection, the average time from exposure to symptoms ranges from 2 to 12 weeks.
- Contagious Even if a person with Hepatitis C has no symptoms, he or she can still spread the Hepatitis C virus to others.
- How you get it The Hepatitis C virus is blood-borne, meaning contaminated blood must enter your bloodstream for infection to occur.
It is important to understand how the virus is transmitted to be able to recognize what early symptoms of Hepatitis C could be.
The Hepatitis C virus itself is small and resilient. A microscopic amount of blood can transmit the virus and it can live outside of your body in open air for at least four days. Inside of a syringe, the virus can live for several weeks. As such, sharing injection drug equipment presents the highest risk for Hepatitis C transmission.
Hepatitis C transmission should be suspected if:
Hcv Treatment Can Also Cause Rashes
Tis is the frustrating part of hepatitis C treatments, the cure can also cause you to have she effects such as skin rashes. This is most commonly experienced when treatments are injected into the skin. The injection site developing a rash as an irritated response to the treatment.
Hydrocortisone creams and even cold packs and compresses can help to alleviate the th redness and itchy feeling as the rash subsides.
If you start to see rashes appear that are not at the injeption site, you MUST see your doctor as soon as possible
- cognitive problems such as memory loss, confusion or concentration difficulties.
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Easy Bruising And Bleeding
In the advanced stages of hepatitis C, you may see easy bruising and excessive bleeding for no apparent reason. Abnormal bruising is believed to be the result of the liver slowing the production of platelets, or proteins needed to clot blood.
In more serious cases, there can be excessive bleeding of the nose or gums, or blood in the urine.
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Hepatitis C is a sneaky virus. You may not have any symptoms at all. Most people donât. This is one if the reasons, along with treatability now, that all adults are recommended to get tested. Your doctor could check your liver and see only a little damage. You’re usually not diagnosed until they spot a problem with your liver enzymes after a routine blood test.
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Symptoms Of A Chronic Infection
If the hepatitis C infection progresses to a chronic infection , it can take years before symptoms develop. Symptoms of advanced liver disease caused by long-term chronic infection can include: jaundice fluid build-up and blood in stool or vomit. Sleep disturbances, depression, weight loss, dry or itchy skin, and brain fog also occur in people with chronic hepatitis C but the cause of these symptoms remains uncertain.
Who Is At Risk For Hepatitis C
You are more likely to get hepatitis C if you:
- Have injected drugs
If you have chronic hepatitis C, you probably will not have symptoms until it causes complications. This can happen decades after you were infected. For this reason, hepatitis C screening is important, even if you have no symptoms.
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Complications Of Chronic Hepatitis C
Unless successfully treated with medication, chronic Hepatitis C infection can cause other serious health problems, such as cirrhosis, liver cancer and liver failure. However, with recent advances in Hepatitis C treatment we now have higher cure rates, shorter treatment times, and all-oral treatment regimens for most people. If youre at risk for Hepatitis C, speak to your healthcare provider today about getting tested.
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According to the CDC, approximately 5 to 25 percent of people with chronic hepatitis C develop cirrhosis within 10 to 20 years.
People with cirrhosis have a 1 to 4 percent annual risk of developing liver cancer and a 3 to 6 percent risk of hepatic decompensation . Theres a 15 to 20 percent risk of death in the year following the development of decompensation.
Age and gender have been shown to affect how chronic hepatitis C progresses, warns Dr. Adalja. It doesnt advance to cirrhosis and liver cancer as quickly in premenopausal women as it does in men, according to a report.
Adalja notes that other factors may accelerate chronic hepatitis C progression, increasing the risk of liver damage. These include HIV or hepatitis B coinfection, alcohol overuse, and cigarette smoking. The symptoms of chronic hepatitis C vary depending on the type of liver damage.
Cirrhosis can produce a variety of symptoms:
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Early Hepatitis C Symptoms
Hepatitis C is typically transmitted through exposure to infected blood, which usually occurs through sharing needles. Many people with a new hepatitis C viral infection do not have any symptoms. When symptoms do occur, they can include:
These symptoms usually begin about two to 12 weeks after exposure to the virus.
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What Type Of Doctor Treats Hepatitis C
Hepatitis C is treated by either a gastroenterologist, a hepatologist , or an infectious disease specialist. The treatment team may include more than one specialist, depending on the extent of liver damage.Surgeons who specialize in surgery of the liver, including liver transplantation, are part of the medical team and should see patients with advanced disease early, before the patient needs a liver transplant. They may be able to identify issues that need to be addressed before surgery can be considered. Other persons who can be helpful in managing patients include dietitians to consult on nutritional issues and pharmacists to assist with management of drugs.
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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.
Sometimes The Infection Goes Away On Its Own
Acute hepatitis is C is a short-term illness that occurs within the first six months after being exposed to the virus. Like the human papillomavirus , early acute hepatitis C can clear on its own without treatment this happens about 25% of the time.
However, its more likely that the virus will remain in your body longer than six months, at which point its considered to be chronic hepatitis C infection.
Being younger or a woman tends to be a factor in whether the virus clears on its own, and genetics may play a role, Reau says. But we cant determine with certainty which people are certain to clear the infection and which arent.
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