Specific Hcv Rna Assays And Range Of Detectable Virus
HCV RNA tests use target amplification techniques. Several assays exist for HCV RNA testing. Methods include polymerase chain reaction , transcription mediated amplification , and branched chain DNA tests. Results are expressed as international units/mL . The different methods and different commercial assays each have a lower limit of quantification and lower limit of detection , therefore a patients results could be reported differently depending on the assay used. HCV RNA tests must have an LLOQ of 25 IU/mL or lower when used to assess treatment response with DAAs.
LLOQ = the lowest HCV RNA level that is within the linear and analytically acceptable range of the assay.
LLOD = the lowest level of HCV RNA that is detected 95% of the time.
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Prevention Is The Best Medicine
Even though hepatitis C rarely spreads within a household, if you or a family member have the disease, its 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 To Do If The Hcv Antibody Test Is Reactive
If the antibody test is reactive or positive, you need an additional test to see if you currently have hepatitis C. This test is called a nucleic acid test for HCV RNA. Another name used for this test is a PCR test.
If the NAT for HCV RNA is:
- Negative you were infected with hepatitis C virus, but the virus is no longer in your body because you were cured or cleared the virus naturally.
- Positive you now have the virus in your blood.
If you have a reactive antibody test and a positive NAT for HCV RNA, you will need to talk to a doctor about treatment. Treatments are available that can cure most people with hepatitis C in 8 to 12 weeks.
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What Your Hepatitis C Diagnosis Means
Hepatitis C is a viral infection that results in chronicinflammation of the liver. Its spread when blood from an infected personenters the bloodstream of an uninfected person. But, it doesnt always resultin symptoms right away.
Doctors use a blood test called the hepatitis C antibody test to screen for the infection. If your results come back positive on this test, thats not a diagnosis. That just means youve been exposed to the virus at some point.
A follow up test, called the hepatitis C virus RNA PCR test,can confirm whether the infection is active.
In some people, the infection goes away on its own. In otherpeople, it progresses and scar tissue develops on the liver a process calledfibrosis.
Scarring, of course, is not good. It makes it difficult for the liver to do its many jobs, which include metabolizing proteins filtering the blood and breaking down, storing and releasing carbohydrates into the bloodstream.
Over time, scarring can lead to cirrhosis, liver cancer or the development of enlarged veins in the esophagus, called portal hypertension.
Only a subset of patients will develop scarring orcirrhosis, Dr. Lindenmeyer says. Theres another subset of patients who willcontinue to have the infection but will never develop the scar tissue in theirliver.
Ask Other Patients For Recommendations
If you have friends or family members whove been treated for hepatitis C or other types of liver disease, consider asking them for recommendations. Based on their personal experiences, they might encourage you to visit one specialist or avoid another.
You can also find patient reviews of doctors and other healthcare providers online. Remember that websites offering doctor reviews arent necessarily vetted and often anyone can post reviews. Even so, you may find it helpful if you notice a specialist who has many glowing reviews.
Patient support groups, online discussion boards, and social medial platforms also allow people with hepatitis C to connect with one another and discuss their experiences with different specialists.
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What Are The Treatments For Hepatitis C
Treatment for hepatitis C is with antiviral medicines. They can cure the disease in most cases.
If you have acute hepatitis C, your health care provider may wait to see if your infection becomes chronic before starting treatment.
If your hepatitis C causes cirrhosis, you should see a doctor who specializes in liver diseases. Treatments for health problems related to cirrhosis include medicines, surgery, and other medical procedures. If your hepatitis C leads to liver failure or liver cancer, you may need a liver transplant.
What Does A Reactive Hcv Antibody Test Result Mean
A reactive or positive antibody test means you have been infected with the hepatitis C virus at some point in time.
Once people have been infected, they will always have antibodies in their blood. This is true if they have cleared the virus, have been cured, or still have the virus in their blood.
A reactive antibody test does not necessarily mean that you currently have hepatitis C and a follow-up test is needed.
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Look For A Good Personality Fit
Medical expertise is important but its not the only thing that matters when it comes to providing medical care. Its also important to find a specialist whose demeanor and attitudes are compatible with your needs and preferences.
Do you feel comfortable talking to the specialist about your health needs? Do they listen to your questions and concerns? Do they share information in a way you can understand? Do they treat you with consideration and respect?
If youre not comfortable with your specialist or their recommended treatment plan, it may be time to find another doctor. The more effectively you can communicate with your doctor, the easier it will be for you to work together to treat hepatitis C.
How Likely Am I To Become Infected With Hepatitis C From A Family Member Living In The Same House
Household transmission of hepatitis C is extremely rare. Fewer than 1 in 1,000 family members or close acquaintances becomes infected each year through common, nonsexual contact with hepatitis C-infected persons.
There are many possible ways by which hepatitis C could be passed from one person to another. Because the virus is carried in the blood, it could be transmitted between household members if a mucous membrane were to come in contact with blood or body fluids containing hepatitis C. Family members sometimes share razors, toothbrushes, or toothpicks, perhaps unknowingly. If an item were contaminated with hepatitis C-infected blood from one person, the virus could be passed to a second person if it were to tear the lining of the mouth or break through the skin.
Although these sorts of possibilities are often discussed as potential ways for hepatitis C to infect family members, such events occur very rarely.
If you arent sure of your hepatitis C status, get tested. If you test negative and have lived in a household with an infected family member or close acquaintance, you shouldnt worry that any more contact will put you at risk.
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Appendix: International Conquer C Coalition
This analysis was led by the International Conquer C Coalition , an international, interdisciplinary group of physicians involved in the treatment and care of patients infected with the hepatitis C virus . Its goal is increasing the understanding of the epidemiology, diagnosis, side effect management, and treatment options. The group also seeks to facilitate an exchange of knowledge, analyze trends, and share best practices. I-C3 was formed in 2009 through an educational grant by Schering-Plough/Merck and was led by Drs. N. Afdhal and S. Zeuzem. Workgroups within I-C3 were responsible for the analysis and publication of key findings on a variety of topics including barriers to care. The work presented here is the result of the barriers to care workgroup.
Hepatitis C And Health
How can health-care personnel avoid exposure to HCV?
Avoiding occupational exposure to blood is the primary way to prevent transmission of bloodborne illnesses among health-care personnel. To promote blood safety in the workplace, health-care personnel should consult infectious-disease control guidance from the National Institute for Occupational Safety and Health and from CDC. Depending on the medical procedure involved, Standard Precautions may include the appropriate use of personal protective equipment .
What is the risk of acquiring hepatitis C after being accidentally exposed to HCV-contaminated blood or body fluids in the workplace?
Although sharps injuries have decreased in recent decades due to improved prevention measures, they continue to occur, placing health-care personnel at risk for several bloodborne pathogens like hepatitis C. A recent analysis of several studies revealed an overall 0.2% risk for infection among those exposed to HCV-antibody-positive blood through needlestick or sharps injuries . Updated guidelines for management and treatment of hepatitis Cexternal icon are available to provide guidance for health-care personnel who become infected via exposure to contaminated blood at the workplace.
Other than needlesticks, do other exposures place health-care personnel at risk for hepatitis C?
Should HCV-infected health-care personnel be restricted in their work?
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How To Get Tested
Hepatitis C testing is performed by a doctor. Testing requires a blood sample, which can be collected in a hospital, lab, or other medical setting. Blood is often drawn from a vein in the arm or, in children, taken by pricking the skin. After blood is collected, the sample is sent to a laboratory for analysis.
Finding A Hep C Specialist
Hep C treatments can be prescribed by many different Hep C Specialists, including gastroenterologists, general practitioners, nurse practitioners, and addiction medicine specialists.
To find a Hep C Specialist near you, enter your city and state or ZIP code.
A gastroenterologist is a doctor who specializes in the treatment of diseases that affect the digestive system.
A hepatologist is a doctor who specializes in the treatment of diseases that affect the liver.
Other specialists who treat Hep C may include, but are not limited to, infectious disease specialists, primry care physicians , internal medicine specialists , family doctors, nurse practitioners , and physician assistants .
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Life With Hepatitis C
Hepatitis C is a bloodborne disease, so its perfectly safeto share a drink or kiss someone you cant spread the infection that way.
To avoid infecting someone else, its recommended that youtake these steps:
- Do not share toothbrushes or razors with others.
- Do not use intravenous drugs.
- Use barrier protection during sexual intercourse.
- Avoid sex during menstruation.
If you have hepatitis C, its also important to avoid taxing the liver even more with drugs and alcohol. There is no hepatitis C-specific diet, but its good to maintain a healthy diet to keep your liver functioning as well as it can, Dr. Lindenmeyer says.
Once treatment is complete, your doctor will continue to monitor your viral load with blood tests. In some people, the virus relapses a few weeks after treatment ends. But, if it hasnt relapsed by three months, we can say confidently that the virus wont come back, Dr. Lindenmeyer says. At that point, you would have whats called a sustained virological response and be considered cured.
But once youve been cured, its not a guarantee you wontcontract the virus again, Dr. Lindenmeyer notes. There are many strains andmutations of hepatitis C, so its important to take the following steps to avoidputting yourself at risk again:
- Never share needles.
- Dont share razors or toothbrushes.
- Take precautions to avoid direct exposure toblood if you are a healthcare worker.
How Can I Best Prepare For Treatment
There are a number of things you can do to improve your health and increase your chances of being able to take your medications as prescribed:
- Avoid alcohol and drugs. If you cannot quit, seek help.
- Talk to your doctor about getting the Hepatitis A and Hepatitis B vaccines.
- Aim for 7-9 hours of sleep every night and rest when tired.
- Maintain a healthy weight.
- Eat healthy meals: Strive for a diet low in fat and high in fiber. Include fruit, vegetables, and whole grains. Avoid trans fatty acids and saturated fats.
- Avoid dietary supplements that may harm the liver, such as iron or vitamin A, kava, and valerian. Take only the medications recommended by your doctor.
- Drink 6-8 glasses of water per day.
- Exercise: Be as physically active as possible on a regular basis, balancing rest and activity.
- Avoid or reduce stress. Some people find meditation, prayer, or simply a quiet walk to be helpful.
- Engage in activities that give you pleasure and make you laugh.
- Discuss your feelings with family and close friends.
- Join a Hepatitis C support group.
In addition, its important to become an effective healthcare consumer and advocate for yourself. You can do this by:
- Learning all you can about your disease and its treatment. Seek information from Hepatitis C related organizations.
- Getting all your medical and insurance information organized in one place. This should include:
- Recent test results
- Emergency contact numbers
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Talking To Your Healthcare Professional About Treatment
Before visiting your healthcare professional to discuss treatment options, its a good idea to prepare a list of questions so that you make the best use of your time during the appointment. Some questions to ask include:
- How much Hepatitis C virus do I have in my body?
- What is my genotype?
- Has the virus damaged my liver?
- With treatment, can I be cured of the Hepatitis C virus?
- What treatment options are available?
- What are the benefits and risks of each option?
- Do I have any conditions that affect my options?
- Which option do you think is best for me and why?
- How long will treatment last?
- What side effects will I have? Are the side effects different between the treatment options?
- Will my past medical history have any impact on how I will react to the different treatments ?
- How will treatment affect my daily life?
- Will treatment affect my ability to work?
- What will the treatment cost and will my insurance cover it?
- What else can I do to keep healthy and minimize damage to my liver?
- What is the next step?
Why Is It Important To Test Persons Born Between 1945 And 1965
- According to the Centers for Disease Control and Prevention , more than 75% of adults infected with hepatitis C are people born from 1945 through 1965 .
- The reason that baby boomers have high rates of hepatitis C is not completely understood. However, it is believed that most baby boomers became infected in the 1970s and 1980s when rates of hepatitis C and drug use were highest. Since people with hepatitis C can live for decades without symptoms, many baby boomers are unknowingly living with an infection they got many years ago that can lead to liver disease, liver failure and cancer.
- Hepatitis C is primarily spread through contact with blood from an infected person. Many baby boomers could have gotten infected from contaminated blood and blood products before widespread screening of the blood supply began in 1992 and universal precautions were adopted. Still, many baby boomers do not know or remember how or when they were infected.
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Check The Specialists Credentials
Before you visit a new specialist, you may consider checking their credentials.
To learn if a doctor is licensed to practice medicine in your state, visit DocInfo.org. This database provides information about doctors education, certifications, and medical licenses. It also provides a public record of disciplinary action that a doctor might have faced from licensing boards.
Besides Hcv Testing What Other Tests Might Be Done
Healthcare practitioners may also order a liver panel, which is a group of tests that help assess the health of your liver. Liver tests such as ALT and AST may be used to detect ongoing liver injury. You will likely be checked to see if you are immune to hepatitis A and hepatitis B, and if not, you will be offered vaccination, since infection with these other viruses can further damage your liver. Other tests such as albumin, prothrombin time, and bilirubin can also be used. They are typically normal unless you have developed cirrhosis. Sometimes a liver biopsy may be performed to determine the severity of liver damage. If you are going to be treated, you will be checked for exposure or infection with hepatitis B virus, as HCV treatment can cause a flare-up of hepatitis B.
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How To Find A Doctor That Specializes In Hep C
Doctors who treat hepatitis C include primary care providers, physicians, doctors who specialize in liver diseases , doctors who specialize in stomach and intestinal diseases , and doctors who specialize in infectious disease.
If you or a loved one has been diagnosed with hepatitis C or feel you may be at risk for hepatitis C, request an appointment below to meet with one of our hep C doctors in Wichita and learn more about our integrated approach to hep C treatment.
What Questions Should I Ask
Writing down a list of questions will help you make the best use of your time during your appointment. List your questions from most important to least important, in case time runs short. Some basic questions to ask your doctor include:
In addition to the questions youve prepared, dont hesitate to ask other questions during your appointment when you dont understand something.
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