Medical Treatment For Hepatitis A B & C
Treatment for hepatitis A, B, or C is based on which type of hepatitis is present in the bloodstream and the severity of the resulting liver damage. Depending on the results of diagnostic tests, our specialists at NYU Langone may recommend antiviral medication to stop the virus from replicating and protect your liver from further damage.
When Should You Contact Doctor If You Think You Have Hepatitis
Fortunately, for some types of hepatitis , there are preventative treatments. Consequently, if a person suspects that they may have been recently exposed to any type of infectious hepatitis, they should contact their health-care professional quickly to prevent liver damage.
If a person has the following symptoms for days, they should seek medical care urgently.
What Do Doctors Do
A doctor who thinks someone may have hepatitis may ask questions like these:
- Has the person been around anyone who works in health care or childcare?
- Did the person stick himself or herself with a dirty needle or get a tattoo with a dirty needle?
- Did the person have contact with the bodily fluids of someone who has hepatitis?
- Did the person have a blood transfusion as a baby?
- Have any of the person’s family members had hepatitis?
- Could the person have eaten food that was contaminated with hepatitis A?
The doctor can order a blood test to see if someone has hepatitis and which type, then help the person get the right care.
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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.
Who Can Access The Cures
Hep C cures are now available to everyone in Australia who has hep C.* The national and state governments want everyone with hep C to be cured, including prisoners and people who inject drugs. Now is a very good time to consider testing for hep C or speaking to your doctor about the hep C cures.
*Cures are available to people who have a Medicare Card or Health Care Concession Card and who arent hospital inpatients.
You might be able to access healthcare and the cures via your computer or phone.
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How Do My Healthcare Professional And I Decide On Treatment
Your healthcare professional will look at your health history and decide if treatment is right for you. The treatment you receive and the length of treatment may depend on:
- how much virus is in your body
- your genotype of hep C
- whether you have liver damage
- whether or not youve been treated previously
When Was Epclusa Approved By The Fda
Epclusa was first approved by the FDA in June of 2016.
- It is approved for use in adults and pediatric patients at least 3 years of age with chronic hepatitis C virus genotype 1, 2, 3, 4, 5, or 6 infection.
- Epclusa is used with ribavirin in patients with advanced liver disease .
- In August 2017, the FDA also approved Epclusa to treat chronic HCV in patients co-infected with HIV.
Gilead Science’s Epclusa is a nucleotide analog polymerase inhibitor and pan-genotypic NS5A inhibitor fixed-dose combination for the treatment of chronic hepatitis C virus infection.
Epclusa was the first direct-acting antiviral to target all the major HCV genotypes 1 through 6, in patients with or without cirrhosis.
- In clinical studies, 95% to 99% of Epclusa-treated patients without cirrhosis or with mild cirrhosis had no virus detected in the blood 12 weeks after finishing a 12-week regimen.
- In patients with moderate to severe cirrhosis, some of whom also required ribavirin treatment, 94% were cleared of the virus 12 weeks after finishing treatment.
Epclusa is an oral tablet taken once a day, with or without food. It comes in two strengths: 400 mg sofosbuvir/100 mg velpatasvir and 200 mg/50 mg tablets.
Epclusa also comes as oral pellets for use in children who cannot swallow tablets. For children less than 6 years of age, administer Epclusa oral pellets with food to enhance palatability. Dosing in children is weight-based.
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How Is Hepatitis C Treated
Acute hepatitis C is a short-term illness that can occur within the first six months after being exposed to the virus. The modes of infection are via sexual intercourse, needle stick injury, infected blood transfusion, infected organ transplant, dialysis or a mother to her child during delivery. People are also at risk if they have engaged in high-risk behaviors like intravenous drug use, shared needles or had unprotected sex.
In many cases, early hepatitis C infection can clear on its own without treatment in about one in four individuals. This is especially possible in younger people. The treatment options for hepatitis C include
These are the mainstay of treatment against hepatitis C. The treatment aims to have no detected hepatitis C virus in the body at least 12 weeks after treatment.
The “direct-acting” antiviral medications are given over 12 weeks. These are combination medications and will cure early acute hepatitis C in more than 90 percent of people. They are
- Viekira Pak
The choice of medications and length of treatment depend on the
- Hepatitis C genotype
- Presence of existing liver damage
- Co-existing medical conditions
Who Is More Likely To Get Hepatitis C
People more likely to get hepatitis C are those who
- have injected drugs
- had a blood transfusion or organ transplant before July 1992
- have hemophilia and received clotting factor before 1987
- have been on kidney dialysis
- have been in contact with blood or infected needles at work
- have had tattoos or body piercings
- have worked or lived in a prison
- were born to a mother with hepatitis C
- are infected with HIV
- have had more than one sex partner in the last 6 months or have a history of sexually transmitted disease
- are men who have or had sex with men
In the United States, injecting drugs is the most common way that people get hepatitis C.13
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How Can I Prevent Spreading Hepatitis C To Others
If you have hepatitis C, follow the steps above to avoid spreading the infection. Tell your sex partner you have hepatitis C, and talk with your doctor about safe sex practices. In addition, you can protect others from infection by telling your doctor, dentist, and other health care providers that you have hepatitis C. Dont donate blood or blood products, semen, organs, or tissue.
How To Protect Yourself Against Hepatitis B
Dr. Fried emphasizes that hepatitis B infection can be prevented by avoiding risky behaviors involving sex and drugs and by getting vaccinated. The hepatitis B vaccination is required for infants at birth, and subsequent vaccinations for adults are also important. There are separate vaccines for hepatitis A and B, but there is also a combination A and B vaccine so you can take care of both types at once. In North Carolina, newborn vaccinations have been required since 1994. Anyone born before this year should talk to their health care provider about being vaccinated for hepatitis B.
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What Are The Symptoms Of Hepatitis B
Many people with hepatitis B dont have any symptoms. If you do get symptoms you may not notice them until two or three months after infection and they can last up to three months. There are two types of infection acute and chronic.
Acute symptoms include:
- flu-like symptoms, including tiredness, fever and aches and pains
- feeling and/or being sick
- jaundice, meaning your skin and the whites of your eyes turn yellow
- dark urine
- pale faeces .
People who cant fight off acute infection after six months, such as babies, young children and people with a weakened immune system because of HIV, can go on to develop chronic hepatitis B. This is when people are at higher risk of liver failure, liver disease and cancer of the liver.
But Even If You’ve Been Cured It Can Have Lifelong Health Implications
“Hepatitis C is a lot more than just a liver disease,” Reau says. “It has been associated with many medical conditions, such as an increased risk of developing diabetes, kidney disease and cancer.”
While curing hepatitis C significantly reduces the risk of serious complications, like liver failure, liver cancer and the need for transplantation, it doesn’t completely eliminate the health risks associated with the disease.
“Hep C is linked to scarring of the liver or cirrhosis and the more scar tissue that develops, the greater the likelihood of complications,” Reau says. “If there is a lot of scarring, you will need lifelong monitoring.”
Reau also recommends leading a healthy lifestyle to help prevent re-infection and further liver damage: Limit alcohol consumption, control your weight, avoid high-risk activities and manage diabetes if you have it.
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Autoimmune Hepatitis Vs Hepatitis C
Having nothing to do with hepatitis A, B or C, autoimmune hepatitis is caused by an autoimmune reaction that tells the body to attack its liver. Although it is a distinct condition from hepatitis C, people sometimes confuse the two as symptoms do overlap . The causes of the diseases are quite different: AIH may have a genetic component, according to the National Institute of Diabetes and Digestive and Kidney Diseases meanwhile, hepatitis C is caused by a viral infection with no known genetic component.
How To Protect Yourself Against Hepatitis C
Unfortunately, there is no vaccine available for hepatitis C, but you can protect yourself by avoiding behaviors such as sharing needles and syringes. In addition, the CDC recommends people born between 1945 and 1965 get tested for hepatitis C. Testing is also recommended for people who were treated for blood-clotting problems before 1987 and recipients of blood transfusions or donated organs before 1992.
The UNC Liver Center has a clinic in Chapel Hill that specializes in hepatitis B and C, incorporating the latest clinical trials and most up-to-date therapies. Treatment for hepatitis is also available at our locations in Asheville, High Point, Raleigh and Wilmington. To learn more, call 966-2516.
Michael Fried, MD, is the director of the UNC Liver Center and a professor of medicine at the UNC School of Medicine.
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What Is Hepatitis A
For kids, hep A is the most common type of hepatitis to get. The virus lives in poop from people who have the infection. That’s why it’s so important to wash your hands before eating and after going to the bathroom. If you don’t, and then go make yourself a sandwich, hep A virus might end up on your food, and then in you!
Vegetables, fruits, and shellfish also can carry hepatitis if they were harvested in contaminated water or in unsanitary conditions. Hepatitis A affects people for a short time, and when they recover, it does not come back.
Choosing The Right Treatment
Treatments for hepatitis C continuously evolve in response to new research and improvements in medical technology. Today, people have access to numerous medicines that can cure the infection quickly and safely.
The number of available treatments can seem overwhelming to people. However, with the help of a doctor, a person can narrow down the treatment options best suited to their needs.
A doctor will consider several factors before prescribing treatment. These include:
- the viral load, or amount of virus in the body
- the extent of liver damage, such as scarring, or cirrhosis
- a persons response to any previous hepatitis C treatments
- the presence of other health conditions
- the genotype of the hepatitis C virus
Hepatitis C has six distinct genotypes. A genotype refers to the combination of genes in an organism, including viruses. Identifying the genotype of the hepatitis C virus is a crucial first step in the treatment process.
How Do You Test For Hepatitis B
A simple blood test carried out by a healthcare professional will show whether you have the virus. You may also be given extra tests to see if your liver is damaged.
If youve got hepatitis B you should be tested for other STIs. Its important that you tell your recent sexual partner/s so they can also get tested and treated. Many people who have hepatitis B dont notice anything wrong, and by telling them you can help to stop the virus being passed on. This can also stop you from getting the infection again.
How Do Doctors Treat The Complications Of Hepatitis C
If hepatitis C leads to cirrhosis, you should see a doctor who specializes in liver diseases. Doctors can treat the health problems related to cirrhosis with medicines, surgery, and other medical procedures. If you have cirrhosis, you have an increased chance of liver cancer. Your doctor may order an ultrasound test to check for liver cancer.
If hepatitis C leads to liver failure or liver cancer, you may need a liver transplant.
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How To Prevent Hepatitis C
Cured of hepatitis C, however, doesnt mean immune. Hepatitis C is not a one-and-done illness like, say, the chickenpox. If you engage in the same behaviors that led to your hepatitis C infection the first time, you are likely to find yourself back in the same predicament.
Prevention, then, is all about avoiding that list of things that cause the viral infection. That means being super cautious with any activity that involves blood contact, including not sharing needles if you use drugs, avoiding tattoos and piercings at places that do not practice proper hygiene with the equipment, and only using your own personal items like razors and toothbrushes at home. Safe sex is recommended .
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
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How Do You Get Hepatitis B
Hepatitis B is really contagious. Its transmitted through contact with semen , vaginal fluids, and blood. You can get it from:
having vaginal, anal, or oral sex
sharing toothbrushes and razors
sharing needles for shooting drugs, piercings, tattoos, etc.
getting stuck with a needle that has the Hep B virus on it.
Hepatitis B can also be passed to babies during birth if their mother has it.
Hepatitis B isnt spread through saliva , so you CANT get hepatitis B from sharing food or drinks or using the same fork or spoon. Hepatitis B is also not spread through kissing, hugging, holding hands, coughing, sneezing, or breastfeeding.
Treatment For Suspected Exposure
Anyone who has had potential exposure to HBV can undergo a postexposure prophylaxis protocol.
This consists of HBV vaccination and hepatitis B immunoglobin . Healthcare workers give the prophylaxis after the exposure and before an acute infection develops.
This protocol will not cure an infection that has already developed. However, it decreases the rate of acute infection.
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What Are Most Common Adverse Reactions With Epclusa
- The most common side effects of Epclusa in adults and children 6 years and older include headache and tiredness.
- When used with ribavirin in advanced liver disease in adults, common side effects also include anemia , upset stomach , trouble sleeping, and diarrhea.
- In children less than 6 years old, vomiting and spitting up the drug are the most common side effects.
This is not all of the side effects that can occur with Epclusa, including serious side effects. Review the full listing of side effects here and discuss them with your doctor.
What Are The Signs Of Hepatitis C
Heres the thing about your liver: Its a strong, stubborn bugger. It takes a lot to knock your liver off its gamewhich is why it isnt easy to spot the signs of hepatitis C. The liver is a huge organ and it can compensate well, says Dr. Menon. Until you lose 50 to 60 percent of your liver function, you cant detect hepatitis C that easily. In fact, he adds, you can take half a liver from someone who is healthy and give to someone with liver failure and both people can go back to their regularly scheduled lives without a hiccup .
For that reason, many people do not start showing symptoms of the virus until hepatitis C has progressed to an advanced stage. Sometimes people come in and theyre in bad shapethey have liver failure or even liver cancer, says Dr. Dieterich. But most of them dont have symptoms at all. Instead, during a routine exam or while screening for another health problem, a doctors blood panel may show signs of elevated liver enzymesand early indication of the hepatitis C virus.
When there are signs of hepatitis C, heres what you can expect, according to the Cleveland Clinic:
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