Summary Table: Most Common Causes Of Viral Hepatitis
PreventionThe incidence of new cases of viral hepatitis has decreased due to use of safer injection and sex practices and the availability of vaccines for hepatitis A and hepatitis B . Screening units of blood for hepatitis B and C has virtually eliminated infections through blood transfusions. A systematic program to screen pregnant mothers for hepatitis B and to vaccinate all newborns has greatly decreased new cases of hepatitis B.
TreatmentHepatitis ASupport and symptom relief are frequently the only treatments required for acute hepatitis A. This usually involves plenty of rest, fluids, and nutritious food. With hepatitis A, most people recover without complications.
Hepatitis BManagement of acute hepatitis B is primarily supportive and usually involves plenty or rest and fluids and good nutrition. For those who progress to the chronic form of hepatitis B, management goals include minimizing further damage to the liver, treating underlying conditions that are causing or exacerbating the condition, and preventing transmission of the virus. There are medications available to treat chronic hepatitis B, but not all people need to be treated. People with chronic hepatitis are closely monitored for the development of liver cirrhosis or cancer.
What Health Professionals Need To Know About Hepatitis C
Hepatitis C is not a vaccine-preventable disease.
Hepatitis C is reportable by laboratories and clinicians to local public health authorities in all provinces and territories.
- hepatitis C antibody and nucleic acid amplification testing methods for screening the blood supply were implemented in 1992
- prior to this implementation, thousands were infected with the hepatitis C virus after receiving blood or blood products
Consult the national case definition for additional information.
Can This Test Be Done At My Healthcare Practitioners Office
Maybe. There are rapid HCV antibody tests available that can be done at the point of care , in settings such as your healthcare practitioners office, community health clinics, and emergency rooms. They provide results in about 20 minutes. However, a positive result requires confirmation of active disease with an HCV RNA test, which is performed in a laboratory.
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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.
What Causes Hepatitis C
The hepatitis C virus causes hepatitis C. The hepatitis C virus spreads through contact with an infected persons blood. Contact can occur by
- sharing drug needles or other drug materials with an infected person
- getting an accidental stick with a needle that was used on an infected person
- being tattooed or pierced with tools or inks that were not kept sterilefree from all viruses and other microorganismsand were used on an infected person before they were used on you
- having contact with the blood or open sores of an infected person
- using an infected persons razor, toothbrush, or nail clippers
- being born to a mother with hepatitis C
- having unprotected sex with an infected person
You cant get hepatitis C from
- being coughed or sneezed on by an infected person
- drinking water or eating food
- hugging an infected person
- shaking hands or holding hands with an infected person
- sharing spoons, forks, and other eating utensils
- sitting next to an infected person
A baby cant get hepatitis C from breast milk.18
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Discussing Screening Results With Clients
The medical personnel who ordered or arranged the screening test, not counselors, usually explain the results. Hepatitis screening should be part of the intake physical examination in an opioid treatment program, and medical personnel may report the results. However, the client may want to discuss the results with the counselor or ask the counselor questions.
Anxiety might interfere with some clients ability to comprehend or retain information, which might need to be repeated.
Suggestions for conversations with clients when the test results are negative include the following:
- Explain results clearly and simply: So the HCV screening result was negative? This means that, as of 6 months ago, you did not have .
- Emphasize that a negative result to an HCV test does not indicate to and that the client should take precautions to avoid . If a relapse to drug use occurs, advise clients to avoid sharing any drug paraphernalia or equipment. Specify that this includes cookers, cotton, water, needles, syringes, pipes, and straws.
- Emphasize the importance of getting HAV and HBV vaccinations. Provide information about the availability of low- or no-cost vaccinations.
Clients whose screening test results are positive for will need additional tests and examinationsusually with doctors who specialize in diseases of the liver to get accurate diagnoses and to determine their health status and the extent of liver damage. These tests are described in .
When Is It Ordered
The CDC, the Infectious Diseases Society of America , the American Association of the Study of Liver Diseases , and the U.S. Preventive Services Task Force recommend screening with an HCV antibody test at least once in your lifetime when you are 18 years old or older . The CDC also recommends HCV screening for women with each pregnancy or for anyone who requests it.
One-time screening is recommended regardless of age if you:
- Have ever injected illegal drugs
- Received a blood transfusion or organ transplant before July 1992*
- Have received clotting factor concentrates produced before 1987
- Were ever on long-term dialysis
- Are a child born to HCV-positive women
- Have been exposed to the blood of someone with hepatitis C
- Are a healthcare, emergency medicine, or public safety worker who had needlesticks, sharps, or mucosal exposure to HCV-positive blood
- Have evidence of chronic liver disease
- Have HIVabout 21% of those with HIV are also infected with HCV .
*The blood supply has been monitored in the U.S. since 1992, and any units of blood that test positive for HCV are rejected for use in another person. The current risk of HCV infection from transfused blood is about one case per two million transfused units.
Screening at regular intervals is recommended if you have ongoing risk of HCV infection, such as current injection drug use and sharing needles or syringes.
- Loss of appetite, nausea, vomiting
- Dark urine
- Yellowing of eyes and skin
An HCV RNA test is ordered when:
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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.
When To Get Tested
For screening: at least once when you are age 18 years or older when you are pregnant when you have risk factors for HCV infection, regardless of age
For diagnosis: when you may have been exposed to the hepatitis C virus, such as through injection drug use, or when you have signs and symptoms associated with liver disease
For monitoring: before, during, and after hepatitis C treatment
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Benefits Of Screening For Hepatitis C
If individuals with chronic hepatitis C are identified before they develop advanced fibrosis, cirrhosis, or hepatocellular carcinoma, 90%-100% can now be expected to respond to treatment, whereas previously only 66%-75% of individuals responded to treatment.-,- Thus, detecting individuals with hepatitis C before they develop signs or symptoms of the disease can have an important impact on their subsequent clinical course. Sustained virologic clearance for more than 6 months after treatment of hepatitis C is also associated with a reduction in all-cause mortality.
Hepatitis C Is Often Asymptomatic
Offer testing to anyone with a risk factor or clinical indication.
- shared drug-use equipment, even once
- received personal services , with nonsterile equipment
- exposed to blood during sexual activity
- received blood, blood products, or organ transplant before 1992
- received medical care where non-sterile equipment may have been used
- born, travelled, or lived in a region where hepatitis C is common
- born to a mother with hepatitis C
- diagnosis of HIV or hepatitis B
- clinical clues or symptoms of liver disease
- occupational exposure
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Taking A Hepatitis C Test
Hepatitis C testing is conducted on a sample of blood. Blood samples can be collected by a doctor, nurse, technician, or other health care provider from an adult patients vein using a small needle or a skin prick on a childs heel.
For an at-home hepatitis C test, patients collect a blood sample according to the manufacturers directions. Instructions provided in the test kit detail the steps to obtain a small sample of blood and mail it for testing.
Can I Take The Test At Home
At-home hepatitis C tests are available that allow patients to collect a blood sample at home and mail it to a laboratory for testing. Test samples are collected through pricking a finger with a sharp object, called a lancet, thats included in the test kit.
At-home HCV testing is a form of hepatitis C antibody testing and does not test for hepatitis C RNA or the strains genotype. Testing for hepatitis C at home is not a substitute for testing performed by a health care professional, and positive test results may need to be confirmed by laboratory-based testing.
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How Does Hepatitis C Spread
The most common way to contract Hepatitis C is through needles . Pregnant women infected with Hepatitis C can spread the virus to their children at the time of birth. Less common ways to spread Hepatitis C include sexual contact, sharing personal care items like razors, and getting body modification procedures, such as tattoos and piercings, in non-sterile environments.
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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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.
Other Related Uspstf Recommendations
This recommendation statement was first published in JAMA. 2020 323:970975.
The Update of Previous USPSTF Recommendation,Supporting Evidence, and Recommendations of Others sections of this recommendation statement are available at .
The USPSTF recommendations are independent of the U.S. government. They do not represent the views of the Agency for Healthcare Research and Quality, the U.S. Department of Health and Human Services, or the U.S. Public Health Service.
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Positive Hcv Antibody And Negative Hcv Rna
Individuals with a positive HCV antibody test and a negative HCV RNA should be informed they do not have evidence of current hepatitis C infection. It should be explained to the patient that most likely they were infected at some time with HCV, but cleared the infection on their own and they do not have current infection. They do not need further follow-up HCV testing, unless they had recent exposure to HCV. A single negative HCV RNA value does not prove that a patient is not infected, given the potential fluctuations of the viral level early in HCV infection a follow-up HCV RNA level would be indicated depending on the clinical case. Patients should be reevaluated if they have exposure to HCV in the future. In addition, they should receive counseling that prior infection does not make them immune to reinfection with HCV.
Hepatitis C Screening Test
Hepatitis C is a liver infection caused by the hepatitis C virus. Hepatitis C can range from a mild illness lasting a few weeks to a serious, lifelong illness. Hepatitis C is often described as acute, meaning a new infection or chronic, meaning lifelong infection.
- Acute hepatitis C occurs within the first 6 months after someone is exposed to the hepatitis C virus. Hepatitis C can be a short-term illness, but for most people, acute infection leads to chronic infection.
- Chronic hepatitis C can be a lifelong infection with the hepatitis C virus if left untreated. Left untreated, chronic hepatitis C can cause serious health problems, including liver damage, cirrhosis , liver cancer, and even death.
Who is at risk
Your risk of hepatitis C infection is increased if you:
- Are a healthcare worker who has been exposed to infected blood, which may happen if an infected needle pierces your skin
- Have ever injected or inhaled illicit drugs
- Have HIV
- Received a piercing or tattoo in an unclean environment using unsterile equipment
- Received a blood transfusion or organ transplant before 1992
- Received clotting factor concentrates before 1987
- Received hemodialysis treatments for a long period of time
- Were born to a woman with a hepatitis C infection
- Were ever in prison
- Were born between 1945 and 1965, the age group with the highest incidence of hepatitis C infection
What you can do
Protect yourself from hepatitis C infection by taking the following precautions:
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How To Test For Hep C
If you suspect you may have a hepatitis C infection, taking a hepatitis C test can be a great start in addition to consulting your healthcare provider for next steps. Our at-home hepatitis C test is a convenient way to check for this virus. To check for hepatitis C with this test, you just collect a small sample of blood with a simple finger prick, then ship the sample to a lab for testing with the prepaid shipping label that comes with the kit.
If your results from our hepatitis C test indicate that you do have this viral infection, share your results with your healthcare provider right away so you can take the next steps they recommend.
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.
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