How Effective Is Treatment
Direct-acting antivirals cure 9 out of 10 patients with hepatitis C.
Successful treatment does not give you any protection against another hepatitis C infection. You can still catch it again.
There’s no vaccine for hepatitis C.
If treatment does not work, it may be repeated, extended, or a different combination of medicines may be tried.
Your doctor or nurse will be able to advise you.
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.
Ive Never Used Iv Drugs Or Been Stuck With A Dirty Needle How Did I Get Hepatitis C
Hepatitis C is usually spread through direct contact with the blood of a person who has the disease. It can also be transmitted by needles used for tattooing or body piercing. In rare cases, hepatitis C can be passed from a mother to her unborn baby. This virus can be transmitted through sex and sharing razors or toothbrushes. These occurrences are also rare. Many times, the cause of hepatitis C is never found.
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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.
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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Pregnancy And Hepatitis C
Should pregnant women be tested for HCV antibodies?
Yes. All pregnant women should be screened for anti-HCV during each pregnancy, except in settings where the prevalence of HCV infection is < 0.1% . Pregnant women with known risk factors should be tested during each pregnancy, regardless of setting prevalence. Any pregnant women testing positive for anti-HCV should receive a PCR test for HCV RNA to determine current infection status.
Can a mother with hepatitis C infect her infant during birth?
The overall risk of an infected mother transmitting HCV to her infant is approximately 4%8% per pregnancy . Transmission occurs during pregnancy or childbirth, and no prophylaxis is available to protect the newborn from infection. The risk is significantly higher if the mother has a high HCV viral load, or is coinfected with HIV with which the rate of transmission ranges from 8%15% . Most infants infected with HCV at birth have no symptoms.
Should a woman with hepatitis C be advised against breastfeeding?
When should children born to HCV-infected mothers be tested to see if they were infected at birth?
What Is Hepatitis C Infection How Many People Are Infected
Hepatitis C virus infection is an infection of the liver caused by the hepatitis C virus . It is difficult for the human immune system to eliminate hepatitis C from the body, and infection with hepatitis C usually becomes chronic. Over decades, chronic infection with hepatitis C damages the liver and can cause liver failure. In the U.S., the CDC has estimated that approximately 41,200 new cases of hepatitis C occurred in 2016. When the virus first enters the body there usually are no symptoms, so this number is an estimate. About 75%-85% of newly infected people become chronically infected. In the U.S., more than 2 million people are estimated to be chronically infected with hepatitis C. Infection is most commonly detected among people who are 40 to 60 years of age, reflecting the high rates of infection in the 1970s and 1980s. There are 8,000 to 10,000 deaths each year in the U.S. related to hepatitis C infection. HCV infection is the leading cause of liver transplantation in the U.S. and is a risk factor for liver cancer. In 2016, 18,153 death certificates listed HCV as a contributing cause of death this is believed to be an underestimate.
Those who have cirrhosis from HCV also have a yearly risk of liver cancer of about 1%-5%.
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How Is Hepatitis C Treated
Hepatitis C virus is treated with all-oral medications. These pills, calledantiviral medications, are usually taken once per day. These antiviral medications are extremely good at attacking the virus and preventing it from multiplying.
Antiviral medications were not the original treatment for hepatitis C. Before 2014, the only treatment for hepatitis C was called interferon and ribavirin, taken as weekly injections under the skin, plus pills. Interferon treatment caused many unpleasant side effects and was not usually successful. Then a new generation of medications became available. These antiviral treatments are extremely successful at curing the virus and have very minimal side effects.
Ribavirin is still sometimes prescribed to be taken along with the new antiviral medicines, but it has become more and more uncommon that ribavirin is needed at all. Ribavirin has some mild-moderate side effects. Ribavirin is a pill taken twice per day, as 2 or 3 pills in the morning plus 2 or 3 pills at night, depending on the patient’s body weight. Most patients do not need ribavirin.
What Are The Side Effects Of Treatment
Back in the dark ages, protein-based injections called interferons and the antiviral drug ribavirin came with such debilitating side effects that many patients struggled to make it through a full course of treatment. But hep C drugs have drastically improved in recent years. While DAAs arent completely free of side effects, theyre tolerable, says Dr. Mufti. Headache, fatigue, diarrhea, nausea, and insomnia are the most common things we see, he says. You may also feel more run down than before treatment, but it shouldnt interfere with daily life.
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Getting Tested For Hepatitis C
A blood test, called an HCV antibody test, is used to find out if someone has ever been infected with the hepatitis C virus. The HCV antibody test, sometimes called the anti-HCV test, looks for antibodies to the hepatitis C virus in blood. Antibodies are chemicals released into the bloodstream when someone gets infected.
Test results can take anywhere from a few days to a few weeks to come back. Rapid anti-HCV tests are available in some health clinics and the results of these tests are available in 20 to 30 minutes.
How Common Is Hepatitis C
There are approximately 30,000 new cases of acute hepatitis C every year in the United States as estimated by the CDC. In 2015, it was estimated that approximately 3.5 million Americans were infected with hepatitis C.
On a global scale, the prevalence of hepatitis C is greatest in Central and East Asia, North Africa, and the Middle East. In 2016, it was estimated that 177 million people worldwide had antibodies to hepatitis C virus.
- exposure to other people who do or might have hepatitis C.
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What Are The Symptoms Of Hepatitis C
Most people infected with hepatitis C have no symptoms. Some people with an acute hepatitis C infection may have symptoms within 1 to 3 months after they are exposed to the virus. These symptoms may include
If you have chronic hepatitis C, you most likely will have no symptoms until complications develop, which could be decades after you were infected. For this reason, hepatitis C screening is important, even if you have no symptoms.
What Are The Names Of The Medications For Treating Hepatitis C
Since 2014, multiple different antiviral treatments for hepatitis C have been developed. With the many options now available, often there is more than one good choice for a patient. Some of the treatments are recommended as first-line options, some are second-line options, and others are used less commonly in light of all the available choices.
- Elbasvir/Grazoprevir
Second line hepatitis C medications:
- Sofosbuvir/Velpatasvir/Voxelaprevir
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Appeal Your Insurance Companys Decision
Some people give up when their insurance provider denies treatment for hepatitis C. But you can fight their decision by writing an appeal letter.
Keep in mind, though, that the appeals process can be lengthy. And you might have to appeal the decision more than once.
Insurance companies vary, so contact your provider for information on its appeals process.
If possible, get your doctor involved, too. They can write a letter explaining the need for treatment.
What About Patients With Hepatitis C Who Also Have Hepatitis B
Hepatitis B virus can flare in patients who are co-infected with hepatitis B and hepatitis C and are taking medication for hepatitis C. This has been reported as a potential risk for patients who are taking hepatitis C treatment and have underlying hepatitis B as well. The flare usually occurs within a few weeks after the patient starts taking medication for hepatitis C. Therefore, patients who have both hepatitis B and hepatitis C should be seen by a hepatitis expertbeforestarting treatment of the hepatitis C they may need to start taking hepatitis B treatment to avoid a hepatitis B flare.
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Disease Which Has Unchecked Transmission To Baby Can Lead To Serious Liver
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During her third pregnancy, Jamie Smith was itchy. Crazy itchy. Her obstetrician diagnosed her with cholestasis of pregnancy, a serious complication associated with liver disease. Her baby was at risk for being premature or even stillborn, so she was induced at 38 weeks.
Smiths baby was healthy, but her own problems continued. She had muscle pain, brain fog and icy white hands and feet. Maybe at age 39, she figured, she was just getting older. Her new primary care doctor suggested some tests, including for hepatitis C. It was just a precaution. Her obstetrician had said her liver enzymes were normal and the regular screening tests were negative. While walking her dog near her home in Ohio, Smith casually scanned the electronic results on her phone.
It said, positive, she recalled, And Im like, I dont even know what hep C means. Wait, positive is a bad thing, right?
At home, she searched What is hep C? online, which sent her down an Internet rabbit hole of common risk factors, including IV drug use, tattoos or piercings, having HIV or spending time in prison. She cried.
I have lived the most boring life, Smith said. So it was a shock that I had this virus that comes with this stigma.
The World Health Organization aims to eliminate hepatitis C by 2030, but only three states Connecticut, South Carolina and Washington are on track to meet that target. Inadequate perinatal screening is a key problem.
How To Find The Right Doctor
Finding the correct doctor to treat hepatitis C first involves a visit to a primary care physician . During this consultation, the PCP will recommend the type of specialist who is most qualified to treat the individual. They can also write a referral.
Gastroenterologists and hepatologists both focus on diagnosing and treating diseases that affect the liver. Due to this, they are well-placed to treat those with significant liver damage from hepatitis C.
Infectious disease specialists can also manage HCV infections. However, although they can treat the disease itself, they may not be able to treat any liver damage.
People who have severe liver damage and need a new liver will likely need treatment from a transplant surgeon.
Before choosing a specific specialist, it is advisable to check:
- the doctors experience
- the level of satisfaction of previous patients
- the doctors ability to answer questions about treatment
Other things that people should consider when choosing a doctor include their insurance coverage and how easily they can travel to the clinic.
Some people might find it helpful to seek information from patient support groups, discussion boards, and social media platforms. These allow individuals to connect with others who have hepatitis C and provide a place to share advice on treatment options.
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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
Living With Hepatitis C
Coping with hepatitis C isnt easy. You may feel sad, scared, or angry. You may not believe you have the disease. These feelings are normal, but they shouldnt keep you from living your daily life. If they do or if they last a long time you may be suffering from depression. People who are depressed have most or all of the following symptoms nearly every day, all day, for 2 weeks or longer:
- Feeling sad, hopeless and having frequent crying spells.
- Losing interest or pleasure in things you used to enjoy .
- Feeling guilty, helpless, or worthless.
- Thinking about death or suicide.
- Sleeping too much or having problems sleeping.
- Loss of appetite and unintended weight loss or gain.
- Feeling very tired all the time.
- Having trouble paying attention and making decisions.
- Having aches and pains that dont get better with treatment.
- Feeling restless, irritated, and easily annoyed.
Talk to your doctor if you notice any of these symptoms. Your doctor can help by recommending a support group or a therapist. He or she may also prescribe a medicine for you to take.
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Doctors And Specialists Who Can Treat Hepatitis
Robert Burakoff, MD, MPH, is board-certified in gastroentrology. He is the vice chair for ambulatory services for the department of medicine at Weill Cornell Medical College in New York, where he is also a professor. He was the founding editor and co-editor in chief of Inflammatory Bowel Diseases.
If you have hepatitis, you may be wondering who can treat your hepatitis. Well, a hepatitis specialist can help. But do you know the difference between the different kinds of clinicians who can treat your hepatitis? To help you understand who does what, here’s a short description of the different professionals who might work in your healthcare setting.
How Can I Get Help Paying For Treatment
For any specialized treatment, insurance companies often require proof that one drug is necessary over another, and its common for coverage approvals to be delayed. Your best strategy is to talk with your doctor about how they can help advocate for you to get a drug approved. Some pharmaceutical brands also offer special pricing for those who are uninsured or whose insurance refuses to cover a drug. The bottom line: Speak up and ask questionsits your life, after all.
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Side Effects Of Treatment
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: