Hepatitis C Immune Globulin
Hepatitis B immune globulin has moved HBV-infected patients from the ranks of the untransplantable to ideal candidates for liver transplantation. The hope has long been that hepatitis C immune globulin will similarly ameliorate the impact of recurrence of HCV infection. Feray and colleagues demonstrated that HBIG containing anti-HCV reduced HCV reinfection in HBV/HCV-coinfected liver transplant recipients and conferred limited protection against de novo HCV infection.122 However, a randomized controlled study of HCIG in the prevention of posttransplant HCV infection found no benefit in terms of posttransplant clinical reinfection rate or HCV RNA levels.123 The availability, cost, and concerns about potential infectivity of pooled HCIG are likely to limit the impact of this therapy even if ultimately proved efficacious. A new monoclonal immune globulin directed at the envelope protein E2 and developed in the trimeric mouse model is currently in phase II trials. No preliminary results have been published to date for this preparation.
Hale Yarmohammadi, in, 2014
What Is Hepatitis C
Hepatitis C is an infection of the liver that is caused by a virus and spread through contact with the blood of an infected person. Some people can have hepatitis C for years without feeling sick, or may just have minor symptoms.
If the infection is not treated, it can cause the liver to swell and become inflamed. Over time, this can lead to cirrhosis of the liver, and possibly liver failure. As the disease develops, symptoms of liver damage may appear.
What Causes Hepatitis C
Hepatitis C is caused when blood from an infected person enters the body of an uninfected person. These are the most common methods of infection:
- An infected person shares needles or syringes for injecting intravenous drugs. Even people who have used IV drugs infrequently may be at risk for infection.
- Healthcare workers who accidentally stick themselves with needles used on infected patients are at risk of getting hepatitis C.
- Patients who received donated blood or blood products or who had organ transplants before 1992 are at higher risk for hepatitis C.
Less common ways of spreading hepatitis C include the following:
- Sexual contact with an infected person. Although the risk of getting hepatitis C through sexual intercourse is low, the risk increases for people who have several sex partners or those with HIV infections.
- Sharing a razor, toothbrush or other personal item that may have come into contact with the blood of an infected person.
- Becoming infected through body piercing or tattooing, if the facility does not use sterile equipment or does not follow infection control practices.
Babies born to mothers who have hepatitis C might become infected, although this is not common. In addition, baby boomers are at increased risk of having hepatitis C and should be screened for it.
Hepatitis C cannot be spread by simple contact or by coughing or sneezing.
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Home Screening Tests For Hepatitis C
At-home screening tests provide privacy if you prefer not to go to a doctor or clinic for testing. These tests typically look for antibodies to hepatitis C, but they may not always test for active viral infection. Make sure you know what type of test youll be taking before you buy.
Many at-home tests have close to or the same reliability as blood tests received by a medical professional.
If youve recently been exposed to hepatitis C, wait several weeks before testing at home.
If I Get Tested For Hepatitis C And The Result Is Positive Do I Need Any Other Tests To Be Sure
When your provider wants to test you for hepatitis C, the first test you will have is the hepatitis C antibody . If this test is positive, it means you were infected with the hepatitis C virus at some point in the past. But this test alone is not enough. You will still need another test to confirm if you still have the hepatitis C virus in your system. About 1 out of 5 people who get infected with hepatitis C will be able get the rid of the virus on their own, without treatment, very early after their infection. So some people will have a positive antibody test, but a negative HCV RNA .
So, the second test that your provider should request is called hepatitis C virus RNA or HCV RNA test. There are several different tests available to check the HCV RNA. What matters is that if the RNA test is positive, then you do have chronic hepatitis C virus infection. If the RNA test is negative, then you may need to have this test again to be sure. If these RNA tests are all negative, then you no longer have hepatitis C infection and do not have chronic hepatitis C.
If your hepatitis C antibody test is positive, be sure that you get tested for hepatitis C RNA to find out whether the infection has become chronic or whether it has cleared. If the infection has become chronic, there are treatments your provider can prescribe to fight off the hepatitis C virus and keep your liver healthy.
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Identifying Patterns Of Risky Behavior
Screening is an opportunity to draw attention to the clients behaviors that put him or her at risk for contracting :
- Ask for the clients perception of his or her risk for having contracted : How likely do you think it is that the test will be positive?
- Listen for and identify behaviors that put the client at risk for contracting , B, and C and HIV, especially unprotected sex and sharing injection drug paraphernalia.
- Assess the clients alcohol consumption.
Patient Discussion About Hepatitis C
Q. Is Hepatitis C contagious? My Girlfriend is a carrier for Hepatitis C. She got infected from a blood transfusion as a kid. Can I catch it from her?
Q. What is the difference between hepatitis c and hepatitis b? and also can it be possible to have a false positive on a Hepatitis B test?
Q. What is the difference between hepatitis c and hepatitis b? and also can it be possible to have a false positive on a Hepatitis B test?
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Explanation Of Test Results:
If this test result is positive, it means your body was exposed to the hepatitis C virus and made antibodies . However, it does not tell you whether you are still infected with hepatitis C. If the antibody test result is positive, you should be tested for hepatitis C RNA , which determines whether you are chronically infected. The lab will perform this RNA test automatically if your hepatitis C antibody test is positive.
If the antibody test result is negative, it means you have not been infected with the hepatitis C virus, and further testing for hepatitis C usually is not needed.
Results From The Qualitative Test
Doctors use the qualitative HCV RNA PCR test to determine whether or not the hepatitis C virus is present in the blood.
If the virus is present, the test will be positive. If the test does not detect the virus, the result will be negative.
If the result is positive, a person will then need a quantitative HCV RNA PCR test. For this reason, many doctors now prefer to skip the first test and use the quantitative test straight away.
The quantitative test results show how much HCV is in the body. However, whether low or high, the viral load does not reflect levels of damage to the liver.
Other blood tests, ultrasounds, and, rarely, a liver biopsy will help a doctor determine overall liver health.
After using an HCV RNA PCR test to confirm the presence of HCV, doctors will work out which strain of the virus is active in the body. This helps a doctor plan the course of treatment.
The primary goal of treatment is to bring down the viral load in the body until it is entirely free of the virus. Doctors know this as a sustained virologic response .
SVR occurs when the virus is undetectable for 12 weeks or longer after treatment.
Achieving SVR is the best outcome of treatment, as it often means the person is free from hepatitis C, or that treatment has cured hepatitis C.
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Who Should Get Tested For Hepatitis C
The CDC recommends that you get tested at least once no matter what. Definitely get screened if any of these things apply to you:
- You were born between 1945 and 1965.
- You use or inject drugs.
- You have ever injected drugs — even if it was just once or a long time ago.
- Youâre on kidney dialysis.
- You have abnormal alanine aminotransferase levels .
- You had a blood transfusion, blood components, or an organ transplant before July 1992.
- Youâve ever gotten clotting factor concentrates made before 1987.
- You received blood from a donor who later tested positive for hepatitis C virus.
- Youâre a health care worker, first responder, or have another job that exposes you to HCV-infected needles.
- You were born to a mother with HCV.
What Are The Chances Of Persons With Hcv Infection Developing Long Term Infection Chronic Liver Disease Cirrhosis Liver Cancer Or Dying As A Result Of Hepatitis C
Of every 100 persons infected with HCV about:
75 to 85 persons may develop long-term infection
70 persons may develop chronic liver disease
15 persons may develop cirrhosis over a period of 20 to 30 years
Less than 3% of persons may die from the consequences of long term infection
Hepatitis C is a leading indication for liver transplants.
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Can You Have A Normal Liver Enzyme Level And Still Have Chronic Hepatitis C
Yes. It is common for persons with chronic hepatitis C to have a liver enzyme level that goes up and down, with periodic returns to normal or near normal. Some persons have a liver enzyme level that is normal for over a year but they still have chronic liver disease. If the liver enzyme level is normal, persons should have their enzyme level re-checked several times over a 6 to 12 month period.
Can A Transplant Cure Hepatitis C
If you develop chronic hepatitis C and it leads to liver cancer or liver failure, you may need a liver transplant. Hepatitis C is one of the most common reasons for a liver transplant.
A liver transplant removes a damaged liver and replaces it with a healthy one. However, theres a high likelihood that the hepatitis C virus will be transmitted to the new liver in time.
The virus lives in your bloodstream, not just your liver. Removing your liver wont cure the disease.
If you have active hepatitis C, continued damage to your new liver is very likely, especially if hepatitis C remains untreated.
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What Foods Should I Avoid
Everyone should avoid eating a lot of fat, cholesterol, salt and processed sugar, even if their liver is healthy. In addition, those with HCV should limit or avoid alcohol. Drinking alcohol will speed up liver damage.
Eating properly can help decrease some of the symptoms of Hepatitis C, like feeling tired and sick. Drink lots of water for general health benefits. HCV is not a digestive disease diet will not affect the disease. Your provider may put you on a special diet if you have advanced liver disease.
Can The Results Of Liver Panel Tests Point To The Presence Of Hepatitis C
A “liver panel” usually includes tests called AST, ALT, bilirubin, alkaline phosphatase, and some others. Abnormal results could show up in many different conditions, not just hepatitis C. And even if the results of a liver panel are normal, you might still have hepatitis C. So, the liver panel alone cannot tell your provider the answer.
Hepatitis C can be diagnosed only by blood tests that are specific to hepatitis C:
In short, if the results of one or more tests on a liver panel are abnormal, generally speaking, the tests should be repeated and confirmed. If the results remain abnormal, your provider should be prompted to look for the cause.
More important than using the liver panel, if you have risks of having been infected with hepatitis C then you should have the specific hepatitis C antibody test to determine if you have hepatitis C infection.
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Dried Blood Spot Testing
Dried Blood Spot testing uses drops of blood from the end of your finger. It doesnt use a needle and syringe and you can do it free of charge in the privacy of your home. Your details and the results are kept private. If your test result shows you have hep C, the people who give your results can help you access hep C treatment and cure.
What Other Information Should Patients With Hepatitis C Be Aware Of
Sneezing, hugging, coughing, food or water does not spread HCV nor does sharing eating utensils or drinking glasses, or casual contact.
Persons should not be excluded from work, school, play, child-care or other settings on the basis of their HCV infection status.
Involvement with a support group may help patients cope with hepatitis C.
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How Can I Cover Medication Costs
New therapies called direct-acting antivirals are effective and can achieve cures of over 90%. Because these new therapies are very new, they remain very expensive. As such, drug coverage from both government and private companies may require that your liver disease has progressed to a certain stage before they are willing to cover the cost of these drugs.
Talk with your healthcare provider about financial support that may be available.
Below are useful resources when looking for financial assistance:Private health insurance or drug plansIf you have private health insurance or a drug plan at work, you may be able to have the medication paid through your plan. Please consult your private health insurance or drug plan provider to see if your drug is covered.
Publicly funded plansEach provincial and territorial government offers a drug benefit plan for eligible groups. Some are income-based universal programs. Most have specific programs for population groups that may require more enhanced coverage for high drug costs. These groups include seniors, recipients of social assistance, and individuals with diseases or conditions that are associated with high drug costs. For more details, please contact your provincial or territorial health care ministry, or click on the appropriate link below.
Available Patient Assistance Programs for Hepatitis C treatment Holkira Pak Maviret
MerckCare Hepatitis C Program 1 872-5773 Zepatier
Can I Drink Alcohol Once In A While If I Have Hepatitis C
Alcohol can clearly contribute to worsening liver disease. You must discuss with your health care provider if any amount of alcohol is safe for you.
Alcohol can cause inflammation and scarring in the liver. If you have any underlying liver condition, such as hepatitis C or hepatitis B or damage from long-term alcohol use, your liver will be more sensitive to alcohol. When you have hepatitis C virus, alcohol on top of the hepatitis C can cause the inflammation and scarring to be worse, and overall damage to the liver may happen much faster when you drink alcohol.
Here is some helpful information about alcohol and hepatitis:
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Myth: Teenagers Are More Likely To Have Hepatitis C
Fact: Baby boomers â those born between 1945 and 1965 â are most likely to get hep C. It could be because they were infected years ago when blood wasnât screened as well as it is now.
The CDC recommends that all baby boomers be tested for the hep C virus. They also suggest testing for anyone who:
- Has problems with their liver
- Had a blood transfusion before 1992
Children born to mothers with hep C should also be tested.
If You Have Hepatitis C Can You Have Sex Without Infecting Your Partner
Hepatitis C is a virus that is transmitted by blood. The most common ways people become infected with hepatitis C are through needle sharing, such as during injection drug use, or from blood transfusions received before 1992.
Becoming infected from sex is not common, but it does happen. If you have hepatitis C, the chance of infecting a sex partner is higher if you are with a new partner or if you have had many different partners over time. If you have hepatitis C, the chance of infecting a sex partner is lower if you are with a longtime stable partner and if you are in a monogamous relationship.
If your sex partner is new to you, or if you have many different partners, it is safer if you use condoms during sex to reduce the chance of transmitting hepatitis C.
It is always best to talk directly with your health care provider to assess whether you should start using condoms. If you are in a sexual relationship and either you or your partner has hepatitis C, the other partner should be tested for hepatitis C and other sexually transmitted viruses once a year, or as advised by your provider.
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