Severe Mental Health Issues With Hepatitis C
Some people with hepatitis C also face severe mental health issues. The prevalence of hepatitis C infection in people with severe mental illness, including psychosis, may be as high as 17 times that of the general North American population, according to a study published in January 2016 in The Lancet Psychiatry.
Mental health treatment is crucial in these cases.
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.
How Is Hepatitis C Spread
The hepatitis C virus is spread through contact with infected blood and bodily fluids, such as semen and vaginal fluid. You will only be infected if the virus enters your bloodstream.
In Canada, most people are infected by:
- using or sharing drug paraphernalia contaminated with infected blood, including:
If you have hepatitis C, you can pass the virus to your baby during:
- breastfeeding if your nipples are cracked and bleeding, and your baby also has bleeding in or on the mouth
- it can be hard to tell if a baby has bleeding in or on the mouth
- cracked nipples may not be bleeding but may begin to during breastfeeding
You can also be infected if you receive contaminated:
- blood products
Although rare, hepatitis C can also be spread through unprotected sex especially if it involves blood contact, such as:
- contact with:
- open sores, cuts or wounds
- semen or vaginal fluid if blood is present
Unprotected sex means having sex without using a condom or other barrier safely.
Hepatitis C is not spread through:
- breast milk
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What If I’m Pregnant And I Have Hepatitis C
Hepatitis C can be passed from a mother to her child during pregnancy and during delivery. Per the Centers for Disease Control and Prevention , approximately 6 of every 100 infants born to HCV-infected mothers become infected with the virus. The risk is two to three times greater when the mother has HIV as well.
You and your doctor should discuss and decide if you should receive treatment for hepatitis C during your pregnancy.
How Can I Protect Myself From Hepatitis C Infection
If you dont have hepatitis C, 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 persons 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
Hepatitis C can spread from person to person during sex, but the chances are low. People who have multiple sex partners, have HIV or other sexually transmitted diseases, or who engage in rough or anal sex have a higher chance of getting hepatitis C. Talk with your doctor about your risk of getting hepatitis C through sex and about safe sex practices, such as using a latex or polyurethane condom to help prevent the spread of hepatitis C.
If you had hepatitis C in the past and your body fought off the infection or medicines cured the infection, you can get hepatitis C again. Follow the steps above, and talk with your doctor about how to protect yourself from another hepatitis C infection.
If you think you may have been exposed to the hepatitis C virus, see your doctor as soon as possible. Early diagnosis and treatment can help prevent liver damage.
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How Will I Know If My Treatment Works
The goal of treatment is to reduce the amount of the hepatitis C virus in your blood to levels that cant be detected after 24 weeks of therapy. The amount of the virus in your blood is called your viral load. At the end of your treatment, your doctor will need to measure your viral load and find out how healthy your liver is. He or she may repeat many of the same tests that were done when you were first diagnosed with hepatitis C.
If your blood has so few copies of the virus that tests cant measure them, the virus is said to be undetectable. If it stays undetectable for at least 6 months after your treatment is finished, you have what is called a sustained virologic response . People who have an SVR have a good chance of avoiding serious liver problems in the future.
Treatment may not reduce your viral load. You may not have an SVR after treatment. If thats true, your doctor will discuss other treatment options with you. For example, if 1 round of treatment did not decrease your viral load enough, your doctor may recommend a second round. Even if treatment doesnt keep you from having active liver disease, lowering your viral load and controlling chronic liver inflammation may help you feel better for a longer time.
Can Hepatitis C Be Prevented Or Avoided
The only way to prevent hepatitis C is to avoid coming in contact with an infected persons blood. Always have protected sex . Dont do intravenous drugs. Dont share personal care items with a person who has hepatitis C. If youre a health care worker, follow your workplaces standard safety practices.
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Spread Of Hepatitis C
Hepatitis C is spread through blood-to-blood contact when blood from a person with hepatitis C enters another persons bloodstream.
The most common way people become infected with hepatitis C in Australia is by sharing injecting equipment such as needles, syringes, spoons and tourniquets. It is possible to be infected with hepatitis C after only one risk event.
Hepatitis C may also be spread through:
- tattooing and body piercing with equipment that has not been properly cleaned, disinfected or sterilised such as backyard tattoos’. Registered parlours with appropriate infection control procedures are not a risk
- needlestick injuries in a healthcare setting
- receiving blood transfusions in Australia prior to 1990 before hepatitis C virus testing of blood donations was introduced
- medical procedures, blood transfusions or blood products and mass immunisation programs provided in a country other than Australia
- pregnancy or childbirth there is a 5% chance of a mother with chronic hepatitis C infection passing on the virus to her baby during pregnancy or childbirth.
Breastfeeding is safe, however if nipples are cracked or bleeding cease breastfeeding until they have healed.
Less likely possible routes of transmission of hepatitis C include:
Hepatitis C cannot be transmitted by:
- sharing food, cups or cutlery
- shaking hands or day-to-day physical contact.
What Medications Cure Hepatitis C Infection
Interferons, for example, Roferon-A and Infergen, and pegylated interferons such as Peg-IntronT, Pegasys, were mainstays of treatment for years. Interferons produced sustained viral response of up to 15%. Later, peglatedll forms produced SVR of 50%-80%. These drugs were injected, had many adverse effects, required frequent monitoring, and were often combined with oral ribavirin, which caused anemia. Treatment durations ranged up to 48 weeks.
Direct-acting anti-viral agents are antiviral drugs that act directly on hepatitis C multiplication.
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Cost Of Hepatitis C Medicines
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.
Relation Between Hepatitis C And Hepatocellular Carcinoma
Hepatocellular carcinoma accounts for 85 to 90% of the cases of primary liver cancer. Chronic hepatitis and cirrhosis constitute the major preneoplastic conditions in the majority of HCC. The risk of developing HCC for a patient with HCV-related cirrhosis is approximately 2-6% per year. HCC risk increases to 17-fold in HCV-infected patients compared to HCV-negative subjects. In general, HCC develops only after two or more decades of HCV infection and the increased risk is restricted largely to patients with cirrhosis or advanced fibrosis.
Multiple steps are required in the induction of all cancers it would be mandatory for hepatocarcinogenesis that genetic mutations accumulate in the hepatocytes. In HCV infection, however, some of these steps might be skipped in the development of HCC, in presence of the core protein. The overall effects achieved by the expression of the core protein would be the induction of HCC, even in the absence of a complete set of genetic aberrations, required for carcinogenesis. By considering such a non-Vogelstein type process for the induction of HCC, a plausible explanation might be given for many unusual events happening in HCV carriers.
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How Is Hepatitis C Treated
Significant progress has been made in treating and even curing hepatitis C. Older hepatitis C treatments usually required weekly injections, had serious side effects, and often were not effective.
New and better oral medicines now can cure HCV for many people within 3 months. The new medicines were very expensive at first, but their prices have come down, a trend that health experts hope will continue as the incidence of HCV rises and increased screening brings more cases to light.
These medicines successfully cure about 90% of HCV patients. A new oral medicine under development looks promising for the 10% who don’t respond to the standard treatment. This new antiviral combination pill is currently under review by the U.S. Food and Drug Administration .
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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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
- Are pregnant
- Currently inject drugs
- Have ever injected drugs, even if it was just once or many years ago
- Have HIV
- Have abnormal liver tests or liver disease
- Are on hemodialysis
Coping With The Mental Aspects Of Hepatitis C
Depression and anxiety are common in people who have hepatitis C. But seeking social support and treating the disease with new medications can improve your mental health and quality of life.
Living with the hepatitis C virus doesnt just take a toll on your liver. It can also affect your mental health.
People with hepatitis C are at increased risk for mental health issues compared with people in the general population, says Andrew J. Muir, MD, MHS, a professor of medicine and chief of the division of gastroenterology at the Duke University School of Medicine in Durham, North Carolina.
Here are the psychological challenges you might face from having and treating hepatitis C and what you can do to feel better, mind and body.
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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
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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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.
Preventing The Spread Of Hepatitis C
There is no vaccine available to prevent a person from being infected with hepatitis C. Recommended behaviours to prevent the spread of the virus include:
- Always use sterile injecting equipment. This can be accessed from your local needle and syringe program service.
- Avoid sharing personal items such as toothbrushes, razors, nail files or nail scissors, which can draw blood.
- If you are involved in body piercing, tattooing, electrolysis or acupuncture, always ensure that any instrument that pierces the skin is either single use or has been cleaned, disinfected and sterilised since it was last used.
- If you are a healthcare worker, follow standard precautions at all times.
- Wherever possible, wear single-use gloves if you give someone first aid or clean up blood or body fluids.
- Although hepatitis C is not generally considered to be a sexually transmissible infection in Australia, you may wish to consider safe sex practices if blood is going to be present, or if your partner has HIV infection. You may wish to further discuss this issue and personal risks with your doctor.
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Easy Bleeding And Bruising
Tell your dentist or other doctors before you have any medical procedure. Treat cuts with pressure bandages and get to the doctor right away. In an emergency, youâll get platelets to replace what you lost and Vitamin K to help your blood clot. View a slideshow on the basics of bruises.
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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