Why A False Positive Happens
A doctor will consider two factors when reviewing the accuracy of a test result. These two factors are the tests specificity and sensitivity.
Specificity refers to the ability of a test to correctly identify those who do not have a disease. This is called the true negative rate.
Sensitivity reflects the ability of a test to correctly identify those who do have a disease. This is called the true positive rate.
According to a , third-generation anti-HCV tests have an average specificity of 97.5% to 99.7%. The sensitivity of these tests varies from 61.0% to 81.8%.
These findings indicate that anti-HCV tests detect true negatives more accurately than true positives .
A person may receive a false-positive test result if they have HCV antibodies from a previous active infection. They may have received successful treatment for this infection, or their body may have cleared it without treatment.
In either case, the antibodies from the previous infection can remain in the body and lead to positive results on anti-HCV tests.
False-positive results can also occur in children who had HCV transmitted to them during birth from a mother with hepatitis C virus infection.
Ultimately, a person who receives a positive result from an anti-HCV test may not have an active hepatitis C infection. This is why a doctor then typically performs another test the HCV RNA RT-PCR test before making a definitive diagnosis.
People who do not have hepatitis C can often prevent exposure to it by:
Treatment For Acute And Chronic Hepatitis C Infection
Some people are diagnosed with hepatitis C when the infection is in the acute phase . About one in four people will clear the hepatitis C virus from their body on their own within six months. When a person is diagnosed with hepatitis C in the acute phase, a healthcare provider might recommend waiting to see if their body clears the virus on its own.
Current treatment guidelines in Canada focus on treatment for chronic hepatitis C infection . The treatment guidelines recommend that treatment of acute hepatitis C infection be assessed on an individualized basis. In many cases, a person has to progress to chronic hepatitis C infection before they can receive public or private drug coverage for hepatitis C treatments.
What Do Hepatitis C Symptoms Look Like
Hepatitis C infection can go through two stages: acute and chronic. In the early, or acute stage, most people don’t have symptoms. If they do develop symptoms, these can include:
- flu-like symptoms, tiredness, high temperature and aches and pains
- loss of appetite
- tummy pain
- jaundice, meaning your skin and the whites of your eyes turn yellow
While for some people, the infection will clear without treatment, in most cases, acute infection will develop into long-term chronic infection. Chronic infection may not become apparent for a number of years until the liver displays signs of damage. These symptoms can include:
- mental confusion and depression these are specific to hepatitis C
- constantly feeling tired
- nausea, vomiting or tummy pain
- dark urine
- feeling bloated
- joint and muscle pain
Without treatment, chronic hepatitis C can cause scarring of the liver , which can cause the liver to stop working properly. A small number of people with cirrhosis develop liver cancer and these complications can lead to death. Other than a liver transplant, theres no cure for cirrhosis. However, treatments can help relieve some of the symptoms.
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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.
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 Long Does It Take To Cure Hepatitis C
Depending on the drug combination, the specific genotype of hepatitis C that is to be treated, any prior treatment, and whether the person has cirrhosis, the duration of medical therapy may be as few as 8 weeks, or up to 24 weeks. Most regimens are for 12 consecutive weeks. This is much shorter than the interferon-based treatments years ago that lasted up to 48 weeks. Generally, a person is not considered “cured” until the “RNA viral load” is undetectable for 24 weeks after therapy is stopped. This is called “sustained virologic response” or SVR.
The presence of cirrhosis or liver fibrosis is determined by liver biopsy, noninvasive fibrosis scans, or formulas that estimate liver fibrosis based on blood tests, such as AST-to-platelet Ratio Index or Fibrosis-4 Index.3
A very important aspect of treatment is the elimination of all alcohol consumption. Alcohol adds fuel to the fire when it comes to chronic hepatitis. Drinking alcohol greatly worsens liver fibrosis and speeds progression to cirrhosis, and there is no “safe” amount to drink for someone with chronic hepatitis. Drinking alcohol also makes it harder for the medications to be effective and may interfere with proper dosing.
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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Which Drugs Can Cure Hepatitis C Virus
Several agents are available by prescription in the U.S. that can lead to a sustained virologic response , considered a cure for HCV.
Drug combination antivirals for HCV treatment, often taken as one daily dose, are now approved to ease treatment regimens and tend to be more tolerable.
The newer direct-acting antiviral agents medications to treat HCV include:
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Hepatitis C virus is transmitted through contact with infected blood. It can lead to chronic liver disease like cirrhosis, liver cancer, and death. Symptoms of chronic HCV may not appear for 20 to 30 years after infection.
It is important to seek medical testing and treatment for hepatitis C so you can help prevent its spread and have adequate medical care, if needed. Fifteen to twenty percent of people may eliminate the HCV virus completely from their body within 6 months, but most people remain infected and develop chronic hepatitis C.
If you were born from 1945 through 1965, or are at increased risk for HCV infection for other reasons like sharing drug injection equipment, speak to your doctor about being tested for HCV.
The US Centers for Disease Control and Prevention now recommends a one-time hepatitis C test for all adults 18 years of age and older and all pregnant women for each pregnancy. CDC continues to recommend people with risk factors, including people who inject drugs, be tested regularly.
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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Drug Cost And Reimbursement
Many organizations are involved with hepatitis C drug distribution and each can impact costs as well as decisions about which regimens are reimbursed . The roles these organizations have in determining the actual price paid for drugs and who has access to treatment include the following:
Except for mandated rebates, negotiated drug prices are considered confidential business contracts. Therefore, there is almost no transparency regarding the actual prices paid for hepatitis C drugs . However, the average negotiated discount of 22% in 2014 increased to 46% less than the WAC in 2015, implying that many payers are paying well below the WAC for HCV medications .
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 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.
If I Have Hepatitis C Infection Does This Mean I Am Going To Have Other Health Problems
Hepatitis C can cause scarring of the liver leading to cirrhosis and liver cancer. Other conditions have also been linked to hepatitis C and are known as extra-hepatic manifestations of hepatitis C. They include diabetes mellitus, arthritis, hypothyroid, and aplastic anemia among other conditions. Talk to your provider for more information.
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What Are The Different Types Of Blood Tests How Often Should I Get These Tests Done
There are several different blood tests, or “labs” that your provider may order for you. The tests measure the amounts of various proteins and enzymes that the liver produces. This is a way of finding out how damaged the liver is. Your provider can determine how often each test needs to be done. Please see Understanding Lab Tests for more details about the tests you may have.
Is It Safe To Take Aspirin Or Tylenol If I Have Hepatitis C
Tylenol is an over-the-counter pain killer. It can be harmful in high doses. If you have hepatitis or liver disease, then you can take Tylenol, but no more than 2,000 mg total over 24 hours. In general, this could be one 500 mg tablet every 6 hours, at the most. Acetaminophen is also included as an ingredient in some opiate medications and in some over-the-counter cold/flu medications, so please be aware of the dose of acetaminophen you may be taking from some combination medicines.
Aspirin, ibuprofen , naproxen , and other nonsteroidal anti-inflammatory drugs , can be harmful if you have cirrhosis. They are safe in hepatitis patients who do not have cirrhosis. But, if a patient has cirrhosis, then NSAIDs cannot be taken at all. If you are not sure, always check with your provider.
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What Does High/low Viral Load Mean
Viral load is the amount of virus present in the bloodstream. It is expressed as the amount of viral genetic material per milliliter of blood. The amount of virus does not predict how severe the liver disease is or will become. The level of the viral load does not tell us anything about the risk of liver damage or how sick someone is. In hepatitis C, it matters if virus is present or absent. Some treatment regimens can be shortened if the patient has a low viral load to start with, but most often, treatment regimens are the same for people with high hepatitis C viral loads or low viral loads.
The RNA test is essential for making the diagnosis of hepatitis C infection–having a positive RNA test is the definition of having infection. After the diagnosis is made, the RNA level does not need to be checked over and over unless it is checked during the time that the patient is undergoing treatment. During treatment, regular RNA tests are done to follow the dropping virus level until it reaches an undetectable state. But before treatment and after treatment, repeated RNA testing is not necessary.
Sharing Toothbrushes Scissors And Razors
There’s a potential risk that hepatitis C may be passed on through sharing items such as toothbrushes, razors and scissors, as they can become contaminated with infected blood.
Equipment used by hairdressers, such as scissors and clippers, can pose a risk if it has been contaminated with infected blood and not been sterilised or cleaned between customers. However, most salons operate to high standards, so this risk is low.
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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:
- nausea
- fatigue
- depression
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.
What Is A Biopsy
A biopsy is a medical procedure. A tiny piece of liver is removed and examined to find out the extent of damage. It involves a large needle and local anesthetic, as well as some risk of bleeding. A pathologist looks at the piece of liver under microscopes to determine how much damage has occurred in the liver. This is a very useful test and used to be done very commonly. However, the procedure is done much less frequently than in the past. For most patients with hepatitis B and C, liver biopsy is not required. Today, other tests can be used to try to estimate the fibrosis in the liver.
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The Challenges Of Early Diagnosis
HCV infection can be difficult to detect, for several reasons.
Many early symptoms of HCV infection, such as fatigue and joint pain, are non specific and may not catch the attention of patients or their doctors. Furthermore, Lok adds, most patients with hepatitis C do not have any symptoms until they have cirrhosis and even when they have early cirrhosis, they may not have symptoms.
As a result, many individuals with HCV infection dont even know they are infected. Dr. Lok adds that screening for high-risk groups in particular needs to be improved, so they can benefit from new treatments.
One of Dr. Loks current research projects addresses this very issue. Working with MiChart,the University of Michigans electronic health record system, Dr. Loks team placed electronic alerts indicating the need for HCV testing in all patients born between 1945 and 1965 a group that is five times more likely to be infected who have never been tested. The alert links to an order set and provides educational information on HCV infection for primary care physicians, medical staff and patients.
We just completed the pilot phase of this study, and we observed a marked increase in screening rates, Dr. Lok says.