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What Are Treatments For Hepatitis C

Side Effects Of Treatment

Hepatitis C Treatment Update

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:

As Hepatitis C Proliferates States Lift Barriers To Treatment

While national efforts to eliminate hepatitis C have faced setbacks because of increased drug use, the impact of COVID-19 and insurance complications, there’s a bright spot: Some states are now making it easier for patients to treat the disease.

Hepatitis Ca viral inflammation of the liver spread through blood and other bodily fluids that infects more than 2 million adults and contributes to 14,000 deaths annuallyhas increased in recent years, with the Infectious Diseases Society of America estimating that hepatitis C infections spiked 71 percent from 2014 through 2018.

There’s a cure for it. Gilead’s two direct-acting antiviral drugsSovaldi and Harvonihave been available for nearly a decade. The Food and Drug Administration approved Sovaldi in December 2013 and Harvoni in October 2014. Since then, the FDA has approved other antivirals.

Still, a high price tag and administrative hurdles to covering and prescribing the drug have complicated uptake.

Without treatment, hepatitis C is a chronic condition that can lead to liver cancer or advanced liver disease and even be fatal. But antivirals can cure a patient in eight to 12 weeks and have been proven to be 95 percent successful at curing hepatitis C.

More recently, Centers for Disease Control and Prevention data from an August Morbidity and Mortality Weekly Report showed that infections continued to rise between January 2017 and March 2020, especially among younger adults who use injectable drugs.

Obstacles to goal

What Can People Do To Help The Medications Work Best

  • Take the medications every day
  • Stay in touch with pharmacy to be sure that all refills are ready on time
  • Take the medications exactly as prescribed
  • Do not skip doses
  • Get all blood tests done on time
  • Go to all visits with providers as recommended
  • Tell the provider about all other medications that are being taken – including over-the-counter medicines, vitamins, herbs, and supplements
  • Complete the entire course of medication

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Medication Regimens According To Hcv Genotype

The good news is that there are now more medications available to treat Hepatitis C than ever before. Based on your medical history, physical exam, laboratory and other test results, your healthcare provider will suggest which medications are right for you, as well as determine the length of time you need to be treated. This decision will depend upon a number of factors including:

  • Your Hepatitis C virus genotype
  • Whether or not you have cirrhosis, and if its mild or severe
  • If youve received treatment before and which medications were used
  • If youre waiting for or youve already had a liver transplant
  • Other health conditions you may have

Treatment regimens are usually 8 to 24 weeks, but sometimes longer, depending on your particular circumstances.

What follows is a basic outline of recommended treatment protocols organized by HCV genotype. HCV genotypes are 1 , 2, 3, 4, 5, and 6. About 75% of the people with HCV in the U.S. have either genotype 1a or 1b. Between 10% 20% of people with HCV in the U.S. have either genotype 2 or 3.

Use this information as a starting point to talk with your healthcare provider about which treatment protocol is best for you. Keep in mind that these are general guidelines and they do not cover alternative treatment protocols or special situations. Its important to follow your healthcare providers instructions regarding what, when, how and for how long to take your medication, as this will depend upon your specific circumstances.

Cost Of Hepatitis C Medicines

What Drugs Are Used For Hepatitis C Treatment?

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.

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Antiviral Medication For Hepatitis B

Doctors may recommend antiviral medication for people with chronic hepatitis B, which occurs when the virus stays in your body for more than six months.

Antiviral medication prevents the virus from replicating, or creating copies of itself, and may prevent progressive liver damage. Currently available medications can treat hepatitis B with a low risk of serious side effects.

NYU Langone hepatologists and infectious disease specialists prescribe medication when they have determined that without treatment, the hepatitis B virus is very likely to damage the liver over time. People with chronic hepatitis B may need to take antiviral medication for the rest of their lives to prevent liver damage.

There are many different types of antiviral medications available, and your doctor recommends the right type for you based on your symptoms, your overall health, and the results of diagnostic tests. A doctor may take a wait-and-see approach with a person who has a healthy liver and whose blood tests indicate a low viral load, the number of copies of the hepatitis B virus in your bloodstream.

Someone with HIV infection or AIDS may have a weakened immune system and is therefore more likely to develop liver damage. The U.S. Centers for Disease Control and Prevention strongly recommends that people with HIV infection who are diagnosed with hepatitis B immediately begin treatment with antiviral medication.

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.

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What Causes Hepatitis C

The hepatitis C virus causes hepatitis C. The hepatitis C virus spreads through contact with an infected persons blood. Contact can occur by

  • sharing drug needles or other drug materials with an infected person
  • getting an accidental stick with a needle that was used on an infected person
  • being tattooed or pierced with tools or inks that were not kept sterilefree from all viruses and other microorganismsand were used on an infected person before they were used on you
  • having contact with the blood or open sores of an infected person
  • using an infected persons razor, toothbrush, or nail clippers
  • being born to a mother with hepatitis C
  • having unprotected sex with an infected person

You cant get hepatitis C from

  • being coughed or sneezed on by an infected person
  • drinking water or eating food
  • hugging an infected person
  • shaking hands or holding hands with an infected person
  • sharing spoons, forks, and other eating utensils
  • sitting next to an infected person

A baby cant get hepatitis C from breast milk.18

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Sofosbuvir, Velpatasvir, and Dasabuvir – Hepatitis C Treatment
  • Recent advances in antiviral treatment have led to the development of new highly effective drugs for the treatment of all types of hepatitis C.
  • The new hepatitis C treatments are sofosbuvir with ledipasvir sofosbuvir daclatasvir and ribavirin .
  • These new treatments are now available on the Pharmaceuticals Benefits Scheme.

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Standard Infection Control Precautions

A nurse who has contact with a hepatitis C patient needs only to maintain standard infection control precautions required for contact with any patient. Gowns and masks are generally not required gloves are required when drawing blood, starting IVs or handling any bodily fluids. Needles and other contaminated objects must be properly contained or disposed of. Nurses should wash their hands between patients, even if they wear gloves, and use a new pair of gloves for each patient. Blood spills should be cleaned with solutions of one part bleach to 10 parts water.

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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Symptoms Of Hepatitis C

Hepatitis C often doesn’t have any noticeable symptoms until the liver has been significantly damaged. This means many people have the infection without realising it.

When symptoms do occur, they can be mistaken for another condition. Symptoms can include:

  • flu-like symptoms, such as muscle aches and a high temperature
  • feeling tired all the time
  • loss of appetite

Read more about the complications of hepatitis C.

Can Hepatitis C Be Prevented

The changing HCV treatment cascade

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

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Treatment Of Hepatitis C

  • Sammy SaabCorrespondenceRequests for reprints should be addressed to Sammy Saab, MD, MPH, The Pfleger Liver Institute, 200 Medical Plaza, Suite 214, Box 957302, Los Angeles, CA 90095-7302. ContactAffiliationsDepartments of Medicine and Surgery at the University of California Los Angeles David Geffen School of Medicine, Los Angeles, California

If You Have Hepatitis C Should You Get A Flu Shot

Yes. Having chronic hepatitis C is actually a good reason to get the flu shot. Chronic hepatitis C is a condition that can increase your risk of complications if you do get influenza. Thats why it is recommended for people with hepatitis C, and most chronic liver diseases, to be vaccinated against the flu.

To stay up to date with your influenza vaccinations, you need to be vaccinated every yearideally, early in the flu season or as soon as the vaccine becomes available. Typically, flu season is considered to be October to March. Its best to get vaccinated annually because the vaccine is designed differently each year to target the strains of influenza that are expected to circulate during that particular flu season.

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Hepatitis C Treatment Today

In 2016, sofosbuvir/velpatasvir was developed as the first drug therapy to treat all hepatitis C genotypes in tablet form. The side effects are considered low . The cure rate is as high as 98 percent in those without severe liver scarring and 86 percent in those with cirrhosis.

In July 2017, sofosbuvir/velpatasvir/voxilaprevir was approved by the U.S. Food and Drug Administration to treat chronic hepatitis C of all genotypes. This fixed-dose combination pill prohibits the development of the specific protein NS5A. In recent research, this troublesome protein has been associated with growth and progression of hepatitis C. In its earliest drug trials, this combination drug had a 96 to 97 percent cure rate, and hopes are high for it today.

Most recently, glecaprevir/pibrentasvir was approved in August 2017. This treatment is for adults with chronic hepatitis C genotypes 1 through 6, and treatment duration can be as little as eight weeks. Results from early trials showed that

Reasons To Delay Treatment

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Hepatitis C treatment is generally not recommended during pregnancy. There is not a lot of information on the effects of DAAs during pregnancy. Research is being done on taking DAAs during pregnancy so this may change in the future.

Treatment that includes ribavirin can cause severe birth defects and must not be taken during pregnancy. When a couple wants to have a baby, both partners should avoid using ribavirin for at least six months before trying to get pregnant.

A healthcare provider can help determine a treatment plan and timeline for a person who has hepatitis C and wants to have a baby.

Children and adolescents

Hepatitis C treatment for children over the age of 12 is available in Canada. It is recommended that children who require treatment for hepatitis C be connected to a specialist with experience treating the pediatric population.

Resources for service providers

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Prevention Of Hepatitis C

Exclusion from childcare, preschool, school and work is not necessary.

There is currently no vaccine for protection against hepatitis C virus infection. People with hepatitis C should ensure they are vaccinated against hepatitis A and hepatitis B.

There is no evidence that giving immunoglobulin after exposure to hepatitis C will prevent infection.

Infected health care workers must comply with the requirements of their professional boards.

Everyone has a responsibility to help prevent the spread of hepatitis C and to take care of themselves and others. This means:

For more information about Hepatitis C read the Get tested, get treated, eliminate Hepatitis C infographic.

Surgical And Anesthetic Concerns

Patients with liver disease are at particularly high risk for morbidity and mortality due to both the stress of surgery and the effects of general anesthesia. Decompensated liver disease increases the risk of postoperative complications . With cirrhosis, the reciprocal flow relation between the hepatic artery and the portal vein is not well maintained, and the liver architecture is disrupted by fibrosis and regenerative nodules. These pathologic alterations of the normal patterns of liver blood flow make the cirrhotic liver more prone to ischemia.12

Of all the inhaled anesthetics, halothane and enflurane appear to reduce hepatic artery blood flow the most because of systemic vasodilation and a mild negative inotropic effect.15 Halothane is also associated with the greatest risk of hepatotoxicity. Isoflurane is a safer choice than halothane in patients with liver disease because it may increase hepatic blood flow. Newer haloalkanes, such as sevoflurane and desflurane, also undergo less hepatic metabolism than halothane or enflurane. Atracurium has been recommended as the neuromuscular blocking agent of choice because it relies on neither the liver nor the kidneys for excretion. Likewise, drugs such as morphine, meperidine, benzodiazepines and barbiturates should be used with caution because of their dependence on the liver for metabolism.

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Ribavirin Can Cause Birth Defects

Ribavirin may cause birth defects if its taken before or during pregnancy. If you or your partner are taking ribavirin, its important to avoid pregnancy while taking the drug. In addition, pregnant people should not have sexual intercourse with a person assigned male at birth who is taking ribavirin.

If you are planning to try to become pregnant, it is important to wait until after you have stopped taking ribavirin. People assigned female at birth must wait 9 months after stopping ribavirin before starting a pregnancy. People assigned male at birth must wait 6 months after stopping the drug before they attempt pregnancy with their partner.

Hepatitis C And Injecting Drugs

Treating Hepatitis C â Midway Specialty Care Center

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.

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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.

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