Do I Have To Have Drug Treatment
The choice is up to you and your doctor. The decision to use drug therapy can be hard to make because of the potential side effects. Your doctor will closely monitor your symptoms and the amount of the virus in your body. He or she will also consider your overall health. This includes looking at blood test results. All are important factors to consider before you and your doctor start drug treatment for your hepatitis C.
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.
How Common Is Hepatitis C
The exact number of people infected is not known. There are around 200,000 people chronically infected with hepatitis C in the UK. Worldwide, over 180 million people are infected. Rates of infection have been relatively stable in recent years, but deaths from hepatitis C have reduced, thought to be because treatment options have become better.
Most cases are in people who inject illegal drugs. It is estimated that up to half of injecting drug users become infected with hepatitis C.
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Treatment Of Hepatitis C
Hepatitis C is treated with antiviral medications that aim to clear the virus from your body.
New all-tablet treatments have greatly improved the outcomes for people with hepatitis C. These treatments can cure more than 95% of individuals with chronic hepatitis C. There are several new tablets that are used in combination to treat all hepatitis C strains . They are effective for people with no liver damage and those who have more advanced liver damage or cirrhosis.
These new tablet medications are available and subsidised on the Pharmaceutical Benefits Scheme, and can be prescribed by specialists, general practitioners and specialised nurse practitioners.
There are no restrictions on accessing treatment it is available for all adults with a Medicare card. People under 18 are able to access treatment and it is recommended they are referred to a pediatrician experienced in the treatment of hepatitis C.
For more information on the new medications for the treatment of hepatitis C, see our video: Hepatitis C Cure what it means for Victorians.
If your doctor does not know about the new treatments, you can call the LiverLine on for information, and to find a GP who can help you.
Talk with your doctor about treatment options and the potential for interactions with other medications, herbal preparations and other drugs. If you take prescribed medication this will be managed so you can access treatment.
In general, if you have hepatitis C you will feel better if you:
Do Medical Conditions Outside The Liver Occur In Persons With Chronic Hepatitis C
A small percentage of persons with chronic hepatitis C develop medical conditions outside the liver . These conditions are thought to occur due to the body’s natural immune system fighting against itself. Such conditions include: glomerulonephritis associated with kidney disease, essential mixed cryoglobulinemia, and porphyria cutanea tarda-a skin condition.
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When Should I Get Hepatitis C Testing
When used for early detection in patients without symptoms of hepatitis C, screening is recommended at least once for all adults aged 18 years or older, except in locations with very low prevalence of HCV. Screening is also recommended during pregnancy and for patients of any age with risk factors for HCV infection. In patients with risk factors, periodic screening is recommended for as long as risk factors persist.
Risk factors for HCV include:
- Current or past injectable drug use
- Having a blood transfusion or organ transplant before July 1992
- Receiving kidney dialysis
- Pain in the abdomen or joints
- Nausea, vomiting, or loss of appetite
- Jaundice or yellowish skin and eyes
Hepatitis C testing may also be performed when liver tests are abnormal or when diagnosing the cause of existing liver damage.
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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What Are The Symptoms And How Does Hepatitis C Progress
Many people with hepatitis C feel entirely well and have few or no symptoms. Any symptoms that may be present are often initially thought to be due to another illness. This may mean that hepatitis C may be diagnosed when you have had the virus for some time. Many people have hepatitis C without knowing it.
It is helpful to think of two phases of infection with HCV. An acute phase when you first become infected and a chronic phase in people where the virus remains long-term.
Addressing Hepatitis For The First Time
It is crucial that a treatment counselor or health professional use a nonjudgmental and compassionate tone. Clients need to feel comfortable disclosing information about their health and risky behaviors. The following strategies can help initiate the conversation:
- Display posters, literature, or other -related items that could help prompt the client to ask questions about hepatitis. .
- Assess clients ability to discuss , based on their degree of openness in the counseling session, the amount of detail they provide in their responses, and the length of the therapeutic relationship.
- Raise the subject in a way that avoids making clients feel defensive or afraid. Consider introducing the subject by making parallels with other conditions that have been discussed. Say, for example, You said you were tested for HIV several times. Were you ever tested for viral ? or You mentioned that your friend is sick with HIV. Have you been tested for HCV or HIV? Tell me about those tests.
- Be patient and allow time for multiple, short conversations about the subject. This might ease feelings of fear, anxiety, or shame.
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Using Elisa And Hcv Rna Tests Together:
- Negative ELISA = No hepatitis C antibodies found in blood. You are probably not infected with HCV.
- Positive ELISA = You may have HCV infection. However, it is possible this is a false-positive. More testing is required.
- Negative HCV RNA = No active HCV infection.
- Positive HCV RNA = Active HCV infection.
What Are The Recommendations For Follow
Anti-viral agents or immune globulin should not be used for postexposure prophylaxis.
For the source, baseline testing for anti-HCV.
For the person exposed to an HCV-positive source, baseline and follow-up testing including baseline testing for anti-HCV and ALT activity and follow-up testing for anti-HCV and ALT activity.
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What Is Hepatitis A
Hepatitis A, also called hep A, is a contagious liver infection caused by the hepatitis A virus. Some people have only a mild illness that lasts a few weeks. Others have more severe problems that can last months. You usually get the disease when you eat or drink something contaminated by poop from a person who has the virus.
The hepatitis A virus usually isnât dangerous. Almost everyone who has it gets better. But because it can take a while to go away, youâll need to take care of yourself in the meantime.
Hepatitis C Testing And Diagnosis
Doctors will start by checking your blood for:
Anti-HCV antibodies: This blood test is the first — and sometimes only — one you may get. Also called the ELISA screen, it checks for antibodies that your body releases to fight the virus. These are proteins your body makes when it finds the hep C virus in your blood. They usually show up about 12 weeks after infection. Your test will be either negative or positive for antibodies. It usually takes a few days to a week to get results, though a rapid test is available in some places.
What the results mean
Negative . This is when your blood shows no signs of HCV antibodies. Most of the time, thatâs because you never came in contact with the virus and you do not have hep C.
Sometimes, your negative result can be false, meaning you have HCV. That may happen if you:
- Took the test too soon after your exposure. This test checks for only HCV antibodies, which can take several months to appear.
- Have HIV, a donated organ, or other conditions that weaken your immune system, which can suppress your antibodies
- Get hemodialysis for kidney problems
If youâve been exposed in the last 6 months, youâll need to be retested.
Positive . This means youâve been infected with HCV. But false positives are surprisingly common. More than 1 in 5 people who test positive donât actually have hepatitis C. Possible reasons include:
What the results mean
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What Are The Side Effects Of Drug Treatment
Common side effects for some treatments for hepatitis C may include the following:
Side effects are usually worst during the first few weeks of treatment. They become less severe over time. If you are having trouble dealing with the side effects of your medicine, talk to your doctor. He or she can suggest ways to relieve some of the side effects. For example, if your medicine makes you feel nauseated, it may help to take it right before you go to sleep.
Who Is Most At Risk Of Contracting Hepatitis C
You have a high risk of contracting hepatitis C if you:
- use or have used injection drugs even if it was just once or many years ago
- have received blood or blood products or an organ transplant before July 1990 in Canada
- have been in jail or
- have been injected or scratched during vaccination, surgery, blood transfusion or a religious/ceremonial ritual in regions where hepatitis C is common.
You have a high moderate risk of contracting hepatitis C if you:
- have tattoos or body piercing
- have multiple sexual partners
- have a sexually transmitted infection , including HIV or lymphogranuloma venereum
- have experienced traumatic sex or rough sex or have used sex toys or fisting that can tear body tissue
- have vaginal sex during menstruation
- have received a kidney treatment
- have received an accidental injury from a needle or syringe
- have another infectious disease
- were born to a hepatitis C infected mother or
- have a sexual partner infected with hepatitis C.
Hepatitis C is NOT passed from person to person by:
- coughing, sneezing
- breastfeeding unless your nipples are cracked and bleeding or
- oral sex, unless blood is present.
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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.
Hepatitis A Vaccine And Travel
If youâre going to a country where hepatitis A is common and youâve never had the virus or the vaccine, start the vaccination process as soon as you can. It takes 2 to 4 weeks after the first dose for the vaccine to work, but even one shot a few days before you leave will give you some protection.
People who are allergic to something in the vaccine and children younger than 6 months might instead get a shot of immune globulin , which will protect against hepatitis A for up to 2 months.
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What Is A False Positive
A false-positive result means that a test indicated that you have a disease or condition when you actually dont.
One drawback is that the anti-HCV test cant differentiate between an active infection versus a chronic or previously acquired infection.
A positive anti-HCV test doesnt necessarily mean that you have hepatitis C. Antibodies picked up by the test may have been triggered by an infection other than HCV, leading to a positive result.
This phenomenon is known as cross-reactivity, and it often results in a false positive. The results may be verified through a second blood test.
The hepatitis C viral load test, also called an RNA test, will show whether you have chronic hepatitis C or a false positive.
2017 report , 22 percent of 479 subjects received a false-positive anti-HCV test.
According to a 2020 report, the rate of false-positive test results among 1,814 reactive serum samples was 10 percent.
How Is A Person Tested For Hepatitis C
A viral-load test is used to check for hepatitis C in the bloodstream. Usually, hepatitis C virus can be found in a persons bloodstream two weeks after he or she becomes infected.
*Except in case of recent risk or in people with a weakened immune system**During the first six months after HCV infection, a person may spontaneously clear the virus if there was a recent risk, repeat viral-load testing to confirm chronic hepatitis C infection
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What Does A Negative Hcv Antibody Test Result Mean
A negative antibody test result usually means that the person has not been infected with hepatitis C .
The body needs at least two months to make antibodies. People with weakened immune systems are not always able to produce antibodies. This might happen in people with autoimmune disorders , HIV-positive people with a CD4 cell count below < 200 cells/mm3, and people taking immunosuppressants.
Antibody Testing After Treatment
For many years, we have said that people will always have antibodies present when tested, even after being cured. It has mostly been in the context of a person being tested in some future medical investigation unrelated and showing a positive antibody test result. Some who have been cured have shared some confusion when they are informed they have hep C, despite being cured. As this is not always understood well in healthcare, there is no good explanation in that instance from the care provider.
To be fair, I am hearing this less from people, but I suspect it may still occur. I have had a few tests done in recent years as part of my work in testing and linkage to care. The most recent test was with a proven testing mode commonly used, point of care testing . In the process of filming an instructional video to show how these POCTs are done, I was the testing subject. I expected a positive result, as I had lived with hep C and I was cured 10 years ago. My test showed up as negative to my surprise. I retested and got the same result.
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What Blood Tests Are Available To Check For Hepatitis C
There are several blood tests that can be done to determine if you have been infected with HCV. You may need to be tested with one or two of the tests listed below to confirm the diagnosis: a) Anti-HCV
EIA This test is usually done first. If positive, it should be confirmed
RIBA A supplemental test used to confirm a positive EIA test Anti-HCV does not tell whether the infection is new , chronic or is no longer present. In most cases, this test is no longer used.
b) Qualitative tests to detect presence or absence of virus This test will be reported as either positive or negative c) Quantitative tests to detect amount of virus A single positive PCR test indicates infection with HCV. A single negative test does not prove that a person is not infected. Virus may be present in the blood and just not found by PCR. Also, a person infected in the past who has recovered may have a negative test. When hepatitis C is suspected and PCR is negative, PCR should be repeated. This test will be reported as a viral load, determining the amount of virus present. This viral load becomes most important during treatment to determine if the is a response to therapy.