What Is Hepatitis C Infection

What Are The Types Of Hepatitis C Infection

There are two types of hepatitis C infection:

• Acute: a short-term infection that occurs within 6 months after a person is exposed to the virus. However, about 75 to 85 percent of people with the acute form go on to develop the chronic form.
• Chronic: a long-term illness that can continue throughout a persons life. It can lead to cirrhosis of the liver and other serious problems, such as liver failure or cancer. About 15,000 people a year die from liver disease associated with hepatitis C.

Genotyping And Serotyping Of Hcv

Hepatitis C genotyping is helpful in defining the epidemiology of hepatitis C, but on an individual patient basis, genotyping is crucial in regard to treatment recommendations and duration. Genotyping is based on sequence analysis by sequencing or reverse hybridization. Although viral load can vary within a 0.5- to 1-log range, HCV genotype does not change during the course of infection. In case of suspected superinfection, another genotype might rarely be detected. For reliable genotyping, 5URT alone is insufficient, including parts of the core sequence enhance genotyping reliability. Sequencing of NS5b is the gold standard.

Serotyping is the only other option to test for the type of HCV in cases of remote infection. This, however, is relevant for epidemiologic studies only and is not used clinically.

Andrea D. Branch, in, 2004

Causes And Risk Factors

THe HCV virus causes hepatitis C.

People contract the virus through blood-to-blood contact with contaminated blood. For transmission to occur, blood containing HCV must enter the body of a person without HCV.

A speck of blood, invisible to the naked eye, can carry hundreds of hepatitis C virus particles. The virus is not easy to kill.

The CDC offers advice on cleaning syringes if it is not possible to use clean and sterile ones. Although bleach might kill the HCV in syringes, it may not have the same effect on other equipment. Boiling, burning, and using alcohol, peroxide, or other common cleaning fluids to wash equipment may reduce the amount of HCV, but it might not stop a person contracting the infection.

It is extremely dangerous to inject bleach, disinfectant, or other cleaning products, so be sure to rinse the syringe thoroughly. Only ever use bleach to clean equipment if new, sterile syringes and equipment are not available.

A person cannot contract the virus from casual contact, breathing, kissing, or sharing food. There is no evidence that mosquito bites can transfer the virus.

The report the following risk factors for developing hepatitis C:

• using or having used injectable drugs, which is currently the most common route in the U.S.
• receiving transfusions or organ transplants before 1992, which is before blood screening became available
• exposure to a needle stick, which is most common in people who work in healthcare
• being born to a mother who has hepatitis C

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How Do Doctors Treat Hepatitis C

Doctors treat hepatitis C with antiviral medicines that attack the virus and can cure the disease in most cases.

Several newer medicines, called direct-acting antiviral medicines, have been approved to treat hepatitis C since 2013. Studies show that these medicines can cure chronic hepatitis C in most people with this disease. These medicines can also cure acute hepatitis C. In some cases, doctors recommend waiting to see if an acute infection becomes chronic before starting treatment.

Your doctor may prescribe one or more of these newer, direct-acting antiviral medicines to treat hepatitis C:

• peginterferon alfa-2a or peginterferon alfa-2b

You may need to take medicines for 8 to 24 weeks to cure hepatitis C. Your doctor will prescribe medicines and recommend a length of treatment based on

• which hepatitis C genotype you have
• how much liver damage you have
• whether you have been treated for hepatitis C in the past

Your doctor may order blood tests during and after your treatment. Blood tests can show whether the treatment is working. Hepatitis C medicines cure the infection in most people who complete treatment.

Hepatitis C medicines may cause side effects. Talk with your doctor about the side effects of treatment. Check with your doctor before taking any other prescription or over-the-counter medicines.

For safety reasons, talk with your doctor before using dietary supplements, such as vitamins, or any complementary or alternative medicines or medical practices.

Can You Catch Diseases From Toilet Water Splash

Even in the case that you do come into contact with a germ or virus, there has to be a fair amount of it for it to have any effect. If you sit on urine or get sprayed by toilet water as you flush besides being completely revolted there is a small chance of infection, just like any other bacteria in the washroom.

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Tests After The Diagnosis

Once the doctor knows you have hep C, theyâll do tests to find out more about your condition. This will help determine your treatment. They could include:

• Genotype tests to find out which of the six kinds of hepatitis C you have.
• Liver function tests. They measure proteins and enzymes levels, which usually rise 7 to 8 weeks after youâre infected. As your liver gets damaged, enzymes leak into your bloodstream. But you can have normal enzyme levels and still have hepatitis C.
• Tests to check for liver damage. You might get:
• Elastography. Doctors use a special ultrasound machine to feel how stiff your liver is.
• Liver biopsy. The doctor inserts a needle into your liver to take a tiny piece to examine in the lab.
• Imaging tests. These use various methods to take pictures or show images of your insides. They include:

Should I Be Screened For Hepatitis C

Doctors usually recommend one-time screening of all adults ages 18 to 79 for hepatitis C. Screening is testing for a disease in people who have no symptoms. Doctors use blood tests to screen for hepatitis C. Many people who have hepatitis C dont have symptoms and dont know they have hepatitis C. Screening tests can help doctors diagnose and treat hepatitis C before it causes serious health problems.

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How Can I Tell If I Have Hepatitis C Virus Infection

After exposure to HCV, antibodies to the virus appear in your blood around 5-10 weeks later. You need a blood test to detect the antibodies. A positive HCV antibody test means that you have been infected with the virus at some point. You should get another blood test to determine if you still have the virus and are infectious to others.

About 1 in 4 people infected will naturally clear the virus from their body and recover the other 75% will develop chronic infection. Over decades, around 15 to 25% of those with chronic HCV infection will develop significant liver disease including liver failure and liver cancer, and may need a liver transplant.

How Common Is Hepatitis C

There are approximately 30,000 new cases of acute hepatitis C every year in the United States as estimated by the CDC. In 2015, it was estimated that approximately 3.5 million Americans were infected with hepatitis C.

On a global scale, the prevalence of hepatitis C is greatest in Central and East Asia, North Africa, and the Middle East. In 2016, it was estimated that 177 million people worldwide had antibodies to hepatitis C virus.

• exposure to other people who do or might have hepatitis C.

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What Are The Treatment Guidelines For Hepatitis C

Hepatitis C treatment is best discussed with a doctor or specialist familiar with current and developing options as this field is changing, and even major guidelines may become outdated quickly.

The latest treatment guidelines by the American Association for the Study of Liver Disease and Infectious Disease Society of America recommends use of DAAs as first-line treatment for hepatitis C infection. The choice of DAA varies by specific virus genotype, and the presence or absence of cirrhosis. In the U.S., specific insurance providers also might influence the choice due to the high cost of DAAs. Although the individual, public health, and cost benefits of treating all patients with hepatitis C is clear, the most difficult barrier to treating all people with HCV is the very high cost of the drug regimens. Patients are encouraged to discuss options with their health care professional.

Treatment is recommended in all patients with chronic hepatitis C unless they have a short life expectancy that is not related to liver disease. Severe life-threatening liver disease may require liver transplantation. Newer therapies with DAAs have allowed more and more patients to be treated.

What are the goals of therapy for hepatitis C infection?

The ultimate goals of antiviral therapy are to

• prevent transmission of hepatitis C,
• prevent progression to cirrhosis and liver cancer, and
• improve survival and quality of life.

How Do You Get Hepatitis C

Hepatitis C spreads when blood or body fluids contaminated with the hepatitis C virus get into your bloodstream through contact with an infected person.

You can be exposed to the virus from:

• Sharing injection drugs and needles
• Having sex, especially if you have HIV, another STD, several partners, or have rough sex
• Being stuck by infected needles
• Birth — a mother can pass it to a child
• Sharing personal care items like toothbrushes, razor blades, and nail clippers
• Getting a tattoo or piercing with unclean equipment

You canât catch hepatitis C through:

• Breastfeeding
• Casual contact

• Have been on long-term kidney dialysis
• Have abnormal liver tests or liver disease
• Have HIV
• Were born to a mother with hepatitis C

Since July 1992, all blood and organ donations in the U.S. are tested for the hepatitis C virus. The CDC says it is now rare that someone getting blood products or an organ would get hepatitis C. That said, The CDC recommends that anyone over the age of 18 get tested for Hepatitis C. If you haven’t been screened, you should consider having it done.

Learn more about the risk factors for hepatitis C.

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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.

Hepatitis C And Liver Transplantation

Some people with advanced hepatitis C infection and severe liver damage undergo a liver transplant, but that doesn’t eradicate the infection. Patients with active infection at the time of the transplant will develop hepatitis C in the new liver. Sometimes the infection recurs even when patients are on antiviral treatment. Those who have achieved sustained virologic response – meaning no detectable virus in the blood 6 months after treatment – have a very low risk of developing hepatitis C infection in the new liver.

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What Are The Symptoms

Most people who have HCV infection feel well, have no symptoms, and may not know they have the disease. Some people may have a brief illness with symptoms around 6 weeks after being infected with HCV.

Symptoms of acute HCV infection may include:

• Tiredness
• Nausea and vomiting
• Jaundice

Most people will have no symptoms and may not know that they have the virus. People with HCV infection may feel tired, have a low mood or stomach pains. About 75% of people living with HCV infection will develop a chronic infection.

What Drugs Treat And Cure Hepatitis C

The treatment of chronic hepatitis C has gone through several generations of medications. Not long ago, treatment was limited to interferon alpha-2b or pegylated interferon alpha-2b , and ribavirin . Interferon and pegylated interferon need to be injected under the skin , while ribavirin is taken by mouth. This combination therapy is infrequently used today, being recommended for only the least common genotypes of hepatitis C virus .

Since 2010, direct-acting antiviral drugs have been in use. The second generation of antivirals for HCV was the protease inhibitors telaprevir and boceprevir , both taken by mouth. These were used in combination with the earlier drugs to increase effectiveness . These drugs are also no longer in common use, and have been replaced by better options.

As more has been learned about how hepatitis C virus multiplies within the liver cells, new drugs continue to be developed to interfere with this multiplication at different stages. As such, we no longer think in terms of generations of drugs, but rather categories of action. Research and development of these direct-acting antivirals continue, with new agents coming to market every few months. Each category is improved and expanded by the addition of new drugs, which are safer and more effective.

Currently available and commonly used direct-acting antiviral drugs include:

• simeprevir

• Muscle aches

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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.

Yukon

Available Patient Assistance Programs for Hepatitis C treatment Holkira Pak Maviret

MerckCare Hepatitis C Program 1 872-5773 Zepatier

How Is Hepatitis C Treated

There is no vaccine for hepatitis C. The aim of treatment for hepatitis C is to eradicate the virus from the blood completely, and to protect the liver from developing cirrhosis or liver cancer.

Several medications are available to treat hepatitis C. The hepatitis C virus has six different types or strains . The type and length of treatment may vary. Some hepatitis strains do not respond to antiviral medications as well as others. Some medications may not be suitable for all patients with hepatitis C, because of the side effects or the patients other medical conditions.

These are the medications approved for treatment of hepatitis C infection:

• Sofosbuvir : Tablet taken once a day. Used in combination with other antiviral drugs.
• Ledipasvir/sofosbuvir : Pill taken once a day for 12 to 24 weeks, depending on how serious the disease is.
• Simeprevir : Capsule taken once a day with other medications called peginterferon alfa and ribavirin
• Combination of paritaprevir/ombitasvir/ritonavir/dasabuvir
• Daclatasvir : Used in combination with other drugs
• Elbasvir/grazoprevir : Tablet taken once a day
• Sofosbuvir/velpatasvir : Tablet taken once a day
• Glecaprevir/pibrentasvir : Three pills a day in one dose
• Sofosbuvir/velpatasvir/voxilaprevir : Tablet taken once a day
• Ombitasvir/paritaprevir/ritonavir : Two tablets once a day in the morning, in combination with ribavirin

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Stages Of Hepatitis C

The hepatitis C virus affects people in different ways and has several stages:

• Incubation period. This is the time between first exposure to the start of the disease. It can last anywhere from 14 to 80 days, but the average is 45
• Acute hepatitis C. This is a short-term illness that lasts for the first 6 months after the virus enters your body. After that, some people who have it will get rid of, or clear, the virus on their own.
• Chronic hepatitis C. For most people who get hepatitis C — up to 85% — the illness moves into a long-lasting stage . This is called a chronic hepatitis C infection and can lead to serious health problems like liver cancer or cirrhosis.
• Cirrhosis. This disease leads to inflammation that, over time, replaces your healthy liver cells with scar tissue. It usually takes about 20 to 30 years for this to happen, though it can be faster if you drink alcohol or have HIV.
• Liver cancer. Cirrhosis makes liver cancer more likely. Your doctor will make sure you get regular tests because there are usually no symptoms in the early stages.

Learn more about the stages and progression of hepatitis C.

Hepatitis C And Injecting Drugs

If you inject drugs, avoid sharing needles, syringes or other equipment such as tourniquets, spoons, swabs or water.

Where possible, always use sterile needles and syringes. These are available free of charge from needle and syringe programs and some pharmacists. To find out where you can obtain free needles, syringes and other injecting equipment, contact DirectLine

Try to wash your hands before and after injecting. If you cant do this, use hand sanitiser or alcohol swabs from a needle and syringe program service.

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Hepatitis C And Blood Spills

When cleaning and removing blood spills, use standard infection control precautions at all times:

• Cover any cuts or wounds with a waterproof dressing.
• Wear single-use gloves and use paper towel to mop up blood spills.
• Clean the area with warm water and detergent, then rinse and dry.
• Place used gloves and paper towels into a plastic bag, then seal and dispose of them in a rubbish bin.
• Wash your hands in warm, soapy water then dry them thoroughly.
• Put bloodstained tissues, sanitary towels or dressings in a plastic bag before throwing them away.