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:
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.
How Much Does The Test Cost
The cost of hepatitis C testing depends on the tests that are performed, where the test is conducted, and a patients health insurance coverage. When testing is ordered by a doctor, patients with health insurance may find it helpful to discuss the cost of hepatitis C testing with their insurance company. In addition to the cost of testing, there may be other out-of-pocket costs such as copays and deductibles.
For patients without health insurance, or for whom insurance doesnt cover the cost of testing, it may be helpful to discuss the cost of hepatitis C testing with a doctor or hospital administrator.
At-home hepatitis C testing starts around $49. Some at-home kits test for multiple types of viral hepatitis at once, with the cost of these panels starting around $80.
What Do I Ask The Doctor
When you visit the doctor, it helps to have questions written down ahead of time. You can also ask a family member or friend to go with you to take notes. Print this list of questions and take it to your next appointment.
- Do I need to get tested for hepatitis C?
- What puts me at risk for hepatitis C?
- How will you test me for hepatitis C?
- How long will it take to get my test results?
- How will I find out my test results?
- If I have hepatitis C, what will happen next?
- Can you give me some information about hepatitis C to take home with me?
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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.
Risk Factors For Hepatitis C
You are at a greater risk of having the hepatitis C virus if you:
- Are a current or former injection drug user
- Received a blood transfusion or organ donation before 1992, or clotting factor replacement therapy before 1987
- Are on dialysis for kidney failure
- Are HIV positive
- Have a mother with hepatitis C
- Have undergone body modification without the use of sterile instruments
- Were born between 1945 and 1965
The Centers for Disease Control and Prevention recommends that anyone born between 1945 and 1965 take a hepatitis C antibody test at least once. If you have never done testing for the hepatitis C virus, our at-home hep C test makes it easy to collect a small sample of blood from the convenience of home and send it to a lab for testing. Our HCV antibody test, sometimes called an anti-HCV test, checks if the infection is present in your body by looking for antibodies released by the immune system in response to the hepatitis C virus.
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Treatments Can Suppress Or Even Wipe Out The Virus
Hepatitis C is treated with a combination of medications called antivirals. For many people, they get rid of the virus completely. They do have serious side effects and they donât work for everyone. New drugs recently approved by the FDA are more effective and have fewer side effects. But some are expensive.
Strategies For Improving Linkage To Care
Attempts at the public health level to implement an HCV testing and linkage-to-care program have shown that additional funds can be used to leverage existing program and provider networks. The CDC and other organizations are actively working to explore strategies, such as the Hepatitis Testing and Linkage to Care initiative, to enhance linkage to care for persons infected with HCV. It should also be noted that patients who have been previously diagnosed many years ago in the interferon era may have been counseled to not seek treatment given the relatively poor efficacy, long duration, and high rate of adverse effects associated with interferon-based therapy. These patients may require more intensive outreach efforts to educate and update on new greatly improved medications that are now available.
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Rna Or Viral Load Test
If you test positively for hepatitis C antibodies, you will need to get a RNA or viral load test. The RNA test is a blood test that checks to see if hepatitis C is active in your body.
- If your RNA test result is negative, you do not have hepatitis C.
- If your RNA test result is positive, you may have chronic hepatitis C. Talk to your doctor right away about a treatment plan.
Potential Sites For Screening For Hepatitis C
Screening for hepatitis C can be offered in several venues the most likely are primary care offices, emergency rooms, urgent care clinics, and public health fairs.
Following the CDC recommendation, 3 studies were presented at the 2013 meeting of the American Association for the Study of Liver Diseases in Washington, DC. One study was conducted in an emergency department, the second in the outpatient clinics of the US Department of Veterans Affairs, and the third involved individuals undergoing screening colonoscopies for colorectal cancer at a community hospital.- All 3 studies confirmed the higher prevalence of positive serum anti-HCV in individuals born in the years 1945-1965.
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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.
The Treatment Programs Role In The Screening Process
Medical staff members at substance abuse treatment programs might assume the primary role for screening individuals for and explaining the screening process and test results. Opioid treatment programs with medical staff members should screen for and C at intake and periodically as indicated. In programs without onsite medical staff, clients may be referred elsewhere for screening with minimal involvement of the substance abuse treatment program.
Regardless of the type of program, counselors should have a basic understanding of the importance of screening, the screening process, and the meaning of the results. Counselors can encourage clients referred for screening to follow through and complete the screening and evaluation process . Clients might feel anxious about being diagnosed with hepatitis, and they might delay or avoid getting screened.
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Gap In Linkage To Care
Unfortunately, many individuals diagnosed with HCV infection do not get linked to appropriate care for their HCV infection. Multiple reasons for the gap in linkage to care have been cited, including failure of the medical provider to make the referral, lack of medical insurance, and substance use or mental health disorders that interfere with making or keeping the referral appointment. Linkage to care rates have been lower among racial and ethnic minorities. Failure to link to care negatively impacts health outcomes in persons living with HCV infection. With highly effective HCV treatment now available for all HCV genotypes, referral for evaluation and management of HCV has taken on even greater importance.
Can Hepatitis Patients Spread The Infection To Others
Patients can spread hepatitis infection and the spread depends on the type and stage of the hepatitis infection. Those suffering from viral hepatitis can easily spread the infection even while being asymptomatic. Those with hepatitis A can spread the infection from the time they are infected. Those with hepatitis B are contagious as long as the virus is present in the blood. Those with hepatitis C infection are contagious and can transmit the infection.
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How To Get Tested
Hepatitis C testing is performed by a doctor. Testing requires a blood sample, which can be collected in a hospital, lab, or other medical setting. Blood is often drawn from a vein in the arm or, in children, taken by pricking the skin. After blood is collected, the sample is sent to a laboratory for analysis.
Cdc Recommendations For Hepatitis C Screening Among Adults In The United States
- Universal hepatitis C screening:
- Hepatitis C screening at least once in a lifetime for all adults aged 18 years and older, except in settings where the prevalence of HCV infection is less than 0.1%*
- Hepatitis C screening for all pregnant women during each pregnancy, except in settings where the prevalence of HCV infection is less than 0.1%*
- Any person who requests hepatitis C testing should receive it, regardless of disclosure of risk, because many persons may be reluctant to disclose stigmatizing risks
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You Can Protect Your Family And Friends
You can pass the hepatitis C virus to others through your blood, even if you don’t have any symptoms. To prevent this, cover wounds carefully and avoid sharing:
- Razors, nail clippers, toothbrushes, or diabetes supplies
- Needles for injecting drugs, or steroids
- Tools for body piercings or tattoos
Hepatitis C doesn’t spread through kissing, coughing, sneezing, or sharing eating utensils. Although it’s uncommon, you can get it from unprotected sex.
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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Who Should Get Tested
You should consider getting tested for hepatitis C if you’re worried you could have been infected or you fall into one of the groups at an increased risk of being infected.
Hepatitis C often has no symptoms, so you may still be infected if you feel healthy.
Some groups of people are at an increased risk of hepatitis C, including:
- ex-drug users and current drug users, particularly users of injected drugs
- people who received blood transfusions before September 1991 or blood products before 1986 in the UK
- UK recipients of organ or tissue transplants before 1992
- people who have lived or had medical treatment in an area where hepatitis C is common high-risk areas include Africa, the Middle East and central Asia
- babies and children whose mothers have hepatitis C
- anyone accidentally exposed to the virus, such as health workers
- people who have received a tattoo or piercing where equipment may not have been properly sterilised
- sexual partners, family members and close contacts of people with hepatitis C
If you continue to engage in high-risk activities, such as injecting drugs frequently, regular testing may be recommended. Your doctor will be able to advise you about this.
How Hepatitis C Is Diagnosed
To determine a hepatitis C diagnosis, your doctor will:
- Get your medical history .
- Perform a physical exam, especially checking for changes in skin color, swelling in your lower extremities, and tenderness in your abdomen.
- Order certain diagnostic blood tests.
The first diagnostic tool in the screening process is a blood test that screens for HCV antibodies proteins the body produces in response to the virus. An enzyme immunoassay is used to perform this test.
A negative result for the antibody test means that you’ve never had HCV in your blood, while a positive result means you were exposed to the virus at some point in your life. Up to a quarter of people spontaneously clear the virus from their blood within six months of contracting it.
Because EIA sometimes produces false-positive results, a test called recombinant immunoblot assay may be used to confirm that you have the HCV antibody. This test is not necessary for most patients, and it is more commonly performed by blood banks to check for the virus in donated blood.
A negative EIA result may just mean that your body has not yet produced the HCV antibody , and you may need to be tested again in a few months.
If you have a positive antibody test, your doctor will then use another blood sample to conduct a qualitative polymerase chain reaction test or a process called transcription-mediated amplification , which looks for the presence or absence of RNA of HCV in your blood.
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Interpreting Hcv Rna Test Results
It is essential that the provider understands how to interpret HCV RNA test results, especially during the course of HCV treatment.
|Result of HCV RNA Test
|A quantified viral load — any exact number
|Ongoing HCV infection
|The HCV RNA is detectable but the number of international units is so low that it cannot be quantified accurately. This indicates extremely low level of virus is present.
|“< 12 IU/mL” or “< 15 IU/mL” or “< 25 IU/mL” All of these are “less than the LLOQ”
|HCV RNA is undetectable. No virus is detected at all in the patient’s serum specimen.
Recommendations Regarding Linkage To Care
All persons identified with active hepatitis C infection should be linked to a medical provider who can provide competent and comprehensive management of HCV. Available data suggest that in the current era, nonspecialists can effectively manage HCV, especially with back up and consultation for more complicated issues. The management of patients with decompensated cirrhosis should always involve a hepatologist. In addition, persons with HCV who have renal insufficiency or extrahepatic complications of HCV infection will likely require referral to a specialist. An individual with a positive HCV antibody test but negative HCV RNA level does not require a referral for further evaluation and management of HCV infection.
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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.
Counseling Practices That Educate Support And Motivate Clients Undergoing Screening
Clients might need help deciding whether to get screened, understanding the test results, and determining their next steps. Even when services offered through the substance abuse treatment program are limited, discussing testing with clients presents an opportunity for counselors to motivate clients for change by confronting substance use and by making choices that improve their overall health. However, this may also be true when services are offered on-site through substance abuse treatment programs. A study at one methadone clinic that offered hepatitis screening and vaccination revealed that although the majority of clients completed screening , only 54.7 percent of clients who lacked for hepatitis A received vaccinations and only 2.9 percent of clients who lacked immunity for received vaccinations .
The Consensus Panel makes the following general recommendations while recognizing that, in some programs, the counselors role may be limited:
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