What Kind Of Doctor Do You See For Hepatitis C

How Will I Be Tested For Hep C

There are several blood tests that healthcare professionals can perform to find out if you have hep C, including:

• The hep C antibody test, which can tell if you’ve ever been infected with the virus.
• The hep C virus RNA test, which can tell if you have a current infection. RNA is the virus’ genetic material.

Prevention Is The Best Medicine

Even though hepatitis C rarely spreads within a household, if you or a family member have the disease, it’s wise to take precautions to prevent its spread especially if anyone in your home is immune compromised, or has cuts or open sores that increase the risk of infection.

In general, use these common sense preventive tips:

• Unless you are in a long-term, monogamous relationship, practice safe sex.
• Clean up spilled or dried blood with a bleach-based cleaning solution and wear rubber gloves.
• Do not share razors.
• Do not share toothbrushes. “Though hepatitis C is not transmitted through saliva, there might be blood on the toothbrush,” Reau says.

Note that hepatitis C is not transmitted by sharing eating utensils, hugging, kissing, coughing or sneezing.

Antiviral Medication For Hepatitis B

Doctors may recommend antiviral medication for people with chronic hepatitis B, which occurs when the virus stays in your body for more than six months.

Antiviral medication prevents the virus from replicating, or creating copies of itself, and may prevent progressive liver damage. Currently available medications can treat hepatitis B with a low risk of serious side effects.

NYU Langone hepatologists and infectious disease specialists prescribe medication when they have determined that without treatment, the hepatitis B virus is very likely to damage the liver over time. People with chronic hepatitis B may need to take antiviral medication for the rest of their lives to prevent liver damage.

There are many different types of antiviral medications available, and your doctor recommends the right type for you based on your symptoms, your overall health, and the results of diagnostic tests. A doctor may take a wait-and-see approach with a person who has a healthy liver and whose blood tests indicate a low viral load, the number of copies of the hepatitis B virus in your bloodstream.

Someone with HIV infection or AIDS may have a weakened immune system and is therefore more likely to develop liver damage. The U.S. Centers for Disease Control and Prevention strongly recommends that people with HIV infection who are diagnosed with hepatitis B immediately begin treatment with antiviral medication.

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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

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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How Do You Get Hepatitis C

Hepatitis C is only contracted through contact with another person who is infected with the hepatitis C virus . It is not acquired through contact with animals or insects.

Hepatitis C is present primarily in the blood, and to a lesser degree in specific other body fluids, of an infected person. Today, it is passed most commonly through the sharing of used needles by injection drug users. Prior to 1990, it was commonly passed through blood transfusions. However, since 1990, all donated blood is tested for hepatitis C virus, so it is extremely rare for hepatitis C to be acquired through a blood transfusion.

Transmission of hepatitis C occasionally occurs in healthcare settings, such as hospitals and clinics, when established infection control protocols are not followed. Health care professionals who do not follow these protocols can become infected if they sustain a needle stick from a patient who carries hepatitis C virus.

While uncommon, one mode of transmission is through organ transplantation when the donated organ comes from a person who carries the hepatitis C virus. The use of HCV-positive organs is currently reserved for the most serious cases requiring transplantation.

How Does Hepatitis C Spread?

Tattooing and body piercing have been documented to transmit the hepatitis C virus when recommended sterilization and infection control procedures are not followed.

Learn If A Specialist Is Covered By Your Insurance

If you have health insurance, its important to learn which specialists and services are covered by your plan. In most cases, its less expensive to visit a specialist whos in your network of coverage. If you visit an out-of-network specialist, you may have to pay more.

To learn if a specialist is covered by your insurance plan, contact your insurance provider. They can help you learn how much youll have to pay out of pocket to visit the specialist. They can also share the names of other specialists who are in your network.

Its also a good idea to contact the specialists office to ask if they accept your insurance. It never hurts to double-check.

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Reduce Your Chance Of Infection

You can reduce your chance of hepatitis B 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
• not sharing personal items, such as toothbrushes, razors, or nail clippers
• using a latex or polyurethane condom during sex

How Effective Is Treatment

Direct-acting antivirals cure 9 out of 10 patients with hepatitis C.

Successful treatment does not give you any protection against another hepatitis C infection. You can still catch it again.

There’s no vaccine for hepatitis C.

If treatment does not work, it may be repeated, extended, or a different combination of medicines may be tried.

Your doctor or nurse will be able to advise you.

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Try To Control Itching

People who have hepatitis sometimes have itchy skin. You can control itching by keeping cool and out of the sun, wearing cotton clothing, or using over-the-counter antihistamines such as a non-drowsy one like loratadine or one that may make you sleepy like diphenhydramine . Talk to your doctor before taking these medicines.

I Tested Positive For Hepatitis C Now Who Do I See

Often, when the tests are positive, the person completing the tests is someone who is more generally trained. When you test positive, they will want to refer you to a specialist in order to complete the additional testing and to begin treatment. Typically, the referral is either for a gastroenterologist or for a hepatologist.

A gastroenterologist specializes in the bodys digestive system and its processes, which include the liver, intestines, gallbladder, and pancreas. Hepatologists are considered to be a sub-specialty within the gastroenterology world, and are people who focus on the gallbladder, biliary tree, liver, and pancreas. Although some recommend one over the other, many in the medical world believe that both gastroenterologists and hepatologists are equally skilled and able to treat patients with hepatitis C.

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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.

What If I Want To Get Pregnant After Hcv Treatment

You should be OK, Dr. Terrault says. If you have mild fibrosis, pregnancy after HCV treatment should be very straightforward.

If you have stage F4 scarring, or cirrhosis, you do have potential risks of increased complications during pregnancy, but its pretty rare. If this is you, you might want to see a high-risk obstetrical group during your pregnancy. Not that the Hep C is causing any issuesits gone and its not going to be at any risk to the babybut you have underlying liver disease and do need a higher level of monitoring, says Dr. Terrault.

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Questions To Ask Your Doctor

• Do I need treatment?
• What treatment is best for me?
• What medicines should I take?
• Are there any medicines I should avoid?
• How can I cope with the side effects of treatment?
• Is there a therapist I can talk to?
• How long will my treatment last?
• Can hepatitis C be cured?
• Are organ transplants and blood transfusions safe?
• Is it safe for me to get pregnant?

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Can Hepatitis C Be Treated

Yes, since 2010 enormous progress has been made in the treatment of chronic hepatitis C. New therapies called direct-acting antivirals are pills that act on the virus itself to eradicate it from the body, unlike older medicines like interferon injections which work by stimulating an immune response. These new treatments are very effective and can achieve cure rates of over 90%. In most situations now, there is no need for interferon, which was responsible for many of the side effects previously associated with HCV treatment. The new treatment combinations require shorter treatment durations , have reduced side effects and appear to be effective at all stages of the disease.

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.

Your primary care physician may refer you to a specialist to determine whether you are eligible for treatment. A specialist will help you decide which drug therapy is best for you based on the severity of your liver disease, your virus genotype and whether or not you have been treated in the past.

What If I Am Pregnant And I Have Hepatitis C

Hepatitis C can be passed from a mother to her child during pregnancy and during delivery. Per the Centers for Disease Control and Prevention , approximately 6 of every 100 infants born to HCV-infected mothers become infected with the virus. The risk is 2-3 times greater when the mother has HIV as well.

You and your doctor should discuss and decide if you should receive treatment for hepatitis C during your pregnancy.

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Preparing In Advance Can Help You Maximize Your Telehealth Appointment

If your hep C doctor recommends you try a telehealth appointment, take some time before your call to get ready. Write down any questions you have about your hepatitis C management, along with any symptoms youve been experiencing. Gather your existing medications to refer to if your doctor asks about them, and make sure you download any videoconferencing apps you need before your appointment time. Find a quiet, private space in your home where you wont be distracted, and ensure your computer, smartphone, or tablet is charged so your call can go off without a hitch. Your doctor wont be able to give you a physical exam, of course, but in many ways, your telehealth appointment for hep C will be similar to an in-person appointment.

Specific Hcv Rna Assays And Range Of Detectable Virus

HCV RNA tests use target amplification techniques. Several assays exist for HCV RNA testing. Methods include polymerase chain reaction , transcription mediated amplification , and branched chain DNA tests. Results are expressed as international units/mL . The different methods and different commercial assays each have a lower limit of quantification and lower limit of detection , therefore a patient’s results could be reported differently depending on the assay used. HCV RNA tests must have an LLOQ of 25 IU/mL or lower when used to assess treatment response with DAAs.

LLOQ = the lowest HCV RNA level that is within the linear and analytically acceptable range of the assay.

LLOD = the lowest level of HCV RNA that is detected 95% of the time.

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What Other Tests Diagnose Hepatitis C

Once the diagnosis of hepatitis C is established, other tests may be done to determine whether the patient has developed liver fibrosis or scarring . This can be done with a needle biopsy of the liver, and examining the biopsied liver tissue under the microscope. Liver biopsy is less commonly done today because noninvasive tests are more readily available, more easily accomplished and less costly.

Liver imaging can evaluate fibrosis using ultrasound and MRI scans. Additionally, calculations using a variety of blood tests also can predict the degree of inflammation and fibrosis present. Genotype testing will typically be done to determine what subtype of hepatitis C the patient has, as this will impact what drugs are used for treatment.

Testing for other infections including HIV, hepatitis A, and hepatitis B is typically done to determine if the patient might have other conditions that could impact patient’s treatment and prognosis.

With the newest forms of antiviral treatment, the most common types of chronic hepatitis C can be cured in most individuals.

Build Your Medical Team

You dont have to be treated at the same clinic who diagnosed you. In fact, you may want to find a specialist whos comfortable managing hepatitis C, Dr. Fenkel explains.

You can ask for a referral to a hepatologist , gastroenterologist , infectious disease specialist, or doctor or nurse practitioner whose clinic frequently works with people who have hepatitis C.

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