How Will I Know If My Treatment Works
The goal of treatment is to reduce the amount of the hepatitis C virus in your blood to levels that cant be detected after 24 weeks of therapy. The amount of the virus in your blood is called your viral load. At the end of your treatment, your doctor will need to measure your viral load and find out how healthy your liver is. He or she may repeat many of the same tests that were done when you were first diagnosed with hepatitis C.
If your blood has so few copies of the virus that tests cant measure them, the virus is said to be undetectable. If it stays undetectable for at least 6 months after your treatment is finished, you have what is called a sustained virologic response . People who have an SVR have a good chance of avoiding serious liver problems in the future.
Treatment may not reduce your viral load. You may not have an SVR after treatment. If thats true, your doctor will discuss other treatment options with you. For example, if 1 round of treatment did not decrease your viral load enough, your doctor may recommend a second round. Even if treatment doesnt keep you from having active liver disease, lowering your viral load and controlling chronic liver inflammation may help you feel better for a longer time.
Hepatitis A B And C: Whats The Difference
Hepatitis is often caused by a virus that comes in different strains. The most common strains of hepatitis are hepatitis A, B, and C. They all are contagious, but they differ primarily by the way they are spread.
Table: Differences among hepatitis A, B, and C
Table: Differences among hepatitis A, B, and C
Viral Hepatitis Definition And Overview
Hepatitis means inflammation of the liver. Many illnesses and conditions can cause inflammation of the liver, for example, drugs, alcohol, chemicals, and autoimmune diseases. Many viruses, for example, the virus causing mononucleosis and the cytomegalovirus, can inflame the liver. Most viruses, however, do not attack primarily the liver the liver is just one of several organs that the viruses affect. When most doctors speak of viral hepatitis, they are using the definition that means hepatitis caused by a few specific viruses that primarily attack the liver and are responsible for about half of all human hepatitis. There are several hepatitis viruses they have been named types A, B, C, D, E, F , and G. As our knowledge of hepatitis viruses grows, it is likely that this alphabetical list will become longer. The most common hepatitis viruses are types A, B, and C. Reference to the hepatitis viruses often occurs in an abbreviated form The focus of this article is on these viruses that cause the majority of human viral hepatitis.
Hepatitis viruses replicate primarily in the liver cells. This can cause the liver to be unable to perform its functions. The following is a list of major functions of the liver:
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Hepatitis C Virus Structure
Researchers determined the structure of a protein on the surface of the hepatitis C virus that allows it to gain entry into cells. The finding may aid in the development of a vaccine to prevent the liver disease.
Hepatitis C is an infectious disease caused by a virus. The hepatitis C virus attacks the liver, leading to inflammation. Most infections become chronic, as the body is unable to get rid of the virus. In the United States, more than 3 million people have chronic HCV infection. Worldwide, approximately 160 million people are estimated to have chronic hepatitis C. Doctors recommend that people who are at higher risk of getting hepatitis C should be tested for HCV infection.
Left untreated, chronic hepatitis C can cause severe liver disease or liver cancer. If the organ becomes extremely damaged, liver failure may occur and require a transplant. Several medicines are available to treat various types of the disease, but the response to treatment can vary.
HCV is not related to hepatitis viruses A, B, D, and E. While vaccines are available for hepatitis A and B, currently no vaccine is available to prevent hepatitis C infection.
The researchers compared the structure of the HCV core domain with other protein structures in the NIH-supported Protein Data Bank. One major region was similar to those commonly found in viral and cellular proteins, but another was novel.
by Carol Torgan, Ph.D.
How Should I Identify The Organism
The Hepatitis C virus is a positive-strand RNA virus with the primary site of replication being hepatocytes. The entire virus life cycle takes place within the cellular cytoplasm. Unlike retroviruses, such as HIV-1, there is no DNA intermediate or integrated form of HCV from which to create a viral archive.
Testing for the virus relies on two techniques: detection of antibody to the virus and direct detection of viral RNA.
HCV serologic testing
Testing for the presence of HCV antibodies in blood is the first step is assessing a patient for possible HCV infection.
- HCV antibody detection via enzyme immunoassay is the standard screening test
Greater than 98% sensitivity for third-generation assays
Detectable about 2 months after infection
False negatives during early acute infection and severely immunosuppressed
False positives if low risk populations are screened
DOES NOT indicate active infection
Appearance of HCV AB may be delayed in immunosuppressed persons.
Mean time to detectability about 6 months in HIV co-infected
Reports of antibody appearance delayed out to greater than 1 year
HCV RIBA is a confirmatory test that detects antibody to specific HCV antigens.
Historically used to confirm a positive HCV EIA
Limited role now with widely available HCV RNA assays
DOES NOT indicate active infection
HCV ribonucleic acid detection
HCV is difficult to grow in cell culture, and cell culture is not used clinically for virus isolation/diagnosis.
Liver disease staging
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Protection Of Hepatitis B
The discovery of variation in the epitopes presented on the surface of thevirions and subviral particles identified several subtypes of HBV which differin their geographical distribution. All isolates of the virus share a commonepitope, a, which is a domain of the major surface proteinwhich is believed to protrude as a double loop from the surface of the particle.Two other pairs of mutually exclusive antigenic determinants, dor y and w or r, are alsopresent on the major surface protein. These variations have been correlated withsingle nucleotide changes in the surface ORF which lead to variation in singleamino acids in the protein. Four principal subtypes of HBV are recognized:adw, adr, ayw andayr. Subtype adw predominates in northernEurope, the Americas and Australasia and also is found in Africa and Asia.Subtype ayw is found in the Mediterranean region, easternEurope, northern and western Africa, the near East and the Indian subcontinent.In the Far East, adr predominates. But the rarerayr occasionally may be found in Japan and Papua NewGuinea.
Immunization against hepatitis B is now recognized as a high priority inpreventive medicine in all countries and strategies for immunization are beingrevised and universal vaccination of infants and adolescents is underexamination as a possible strategy to control the transmission of thisinfection. About 30 countries including the United States now offer hepatitis Bvaccine to all children.
Can Hepatitis C Be Prevented
There is no vaccine for hepatitis C. But 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 person’s 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
- Using a latex condom during sex. If your or your partner is allergic to latex, you can use polyurethane condoms.
NIH: National Institute of Diabetes and Digestive and Kidney Diseases
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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.
How Do You Get Hepatitis A
The main way you get hepatitis A is when you eat or drink something that has the hep A virus in it. A lot of times this happens in a restaurant. If an infected worker there doesn’t wash their hands well after using the bathroom, and then touches food, they could pass the disease to you.
Food or drinks you buy at the supermarket can sometimes cause the disease, too. The ones most likely to get contaminated are:
- Ice and water
Another way you can get hep A is when you have sex with someone who has it.
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Diagnosis Of Hcv Infection
Successful cloning of portions of the viral genome permitted the development ofnew diagnostic tests for infection by the virus. Since the original antigen wasdetected by antibodies in the serum of an infected patient it was an obviouscandidate for the basis of an ELISA to detect anti-HCV antibodies. A largerclone, C100, was assembled from a number of overlapping clones and expressed inyeast as a fusion protein using human superoxide dismutase sequences tofacilitate expression, and this fusion protein formed the basis of firstgeneration tests for HCV infection. The 5-1-1 antigen comprises amino acidsequences from the non-structural, NS4, region of the genome and C100 containsboth NS3 and NS4 sequences.
It is now known that antibodies to C100 are detected relatively late following anacute infection. Furthermore, the first generation ELISAs were associated with ahigh rate of false positive reactions when applied to low incidence populations,and there were further problems with some retrospective studies on stored sera.Data based on this test alone should, therefore, be interpreted withcaution.
The availability of the nucleotide sequence of HCV made possible the use of thepolymerase chain reaction as a direct test for the genome of the virus.There is considerable variation in nucleotide sequences among different isolatesof HCV, and the 5 non-coding region, which seems to be highlyconserved, is the preferred target for the PCR.
What Are The Different Types Of Hepatitis C
Hepatitis C can be acute or chronic. How long you experience symptoms will depend on the type you have.
Acute hepatitis C involves more short-term symptoms that typically last 6 months or less but acute hepatitis often leads to chronic hepatitis. When hepatitis C lasts longer than 6 months, its considered chronic.
Without treatment, you may have chronic hepatitis your whole life, since your body often cant get rid of the virus easily. Some people do get better without treatment, although treatment can go a long way toward improving the outlook.
Hepatitis C wont necessarily become chronic.
As a matter of fact, for anywhere from 15 to 45 percent of people with acute hepatitis C, the virus will clear up without treatment. In other words, if you dont have any symptoms, hepatitis C could improve on its own before you ever know you have it.
However, if your body cant get rid of the hepatitis C virus, the infection wont go away. Instead, it will become chronic, or long-term.
Experts arent sure why some people develop the chronic form of the disease and others dont. But more than half of all people with the hepatitis C virus will eventually develop the chronic form, according to the
Since hepatitis C symptoms can resemble those of other health conditions, your symptoms alone if you have any may not make it clear that you have hepatitis C.
A doctor or other healthcare professional may recommend getting tested if you:
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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
How Does Hepatitis C Affect The Liver
When infected, the liver becomes inflamed, which may cause the healthy, soft tissues in the liver to harden and scar. If not stopped, inflammation and scarring can lead to serious liver diseases such as cirrhosis of the liver or liver tumors. If the damage is severe enough, the liver may not perform all of its functions normally.
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Control And Prevention Of Hepatitis A
In areas of high prevalence, most children are infected early in life and suchinfections are generally asymptomatic. Infections acquired later in life are ofincreasing clinical severity. Less than 10% of cases of acute hepatitis A inchildren up to the age of six are icteric, but this increases to4050% in the 614 age group and to 7080% inadults.
Of 115,551 cases of hepatitis A in the USA between 1983 and 1987, only 9% of thecases, but more than 70% of the fatalities, were in those aged over 49. It isimportant, therefore, to protect those at risk because of personal contact withinfected individuals or because of travel to a highly endemic area. Other groupsat risk of hepatitis A infection include staff and residents of institutions forthe mentally handicapped, day care centers for children, sexually active malehomosexuals, intravenous drug abusers, sewage workers, certain groups of healthcare workers such as medical students on elective studies in countries wherehepatitis A is common, military personnel, and certain low socio-economic groupsin defined community settings. Patients with chronic liver disease, especiallyif visiting an endemic area, should be immunized against hepatitis A. In somedeveloping countries, the incidence of clinical hepatitis A is increasing asimprovements in socio-economic conditions result in infection later in life, andstrategies for immunization are yet to be developed and agreed.
Complications Of Hepatitis C
If the infection is left untreated for many years, some people with hepatitis C will develop scarring of the liver .
Over time, this can cause the liver to stop working properly.
In severe cases, life-threatening problems, such as liver failure, where the liver loses most or all of its functions, or liver cancer, can eventually develop.
Treating hepatitis C as early as possible can help reduce the risk of these problems happening.
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How Should I Take Care Of Myself If I Have Hepatitis C
Good health habits are essential for those who have hepatitis C. You should especially avoid alcohol and medicines and drugs that can put stress on the liver. You should eat a healthy diet and start exercising regularly. Your family doctor can help you plan a diet that is healthy and practical.
Talk to your doctor about any medicines that you are taking, including over-the-counter medicine. Many medicines, including acetaminophen , are broken down by the liver. Because of this, they may increase the speed of liver damage. You should also limit alcohol use. It speeds the progression of liver diseases like hepatitis C. An occasional alcoholic drink may be okay, but check with your doctor first.
Who Should Be Tested For Hepatitis C
- All people born between 1945 and 1965
- Anyone who has ever injected drugs, even if once or many years ago
- People with HIV infection
- People who had a blood transfusion organ transplantation before 1992
- People who have been exposed to blood on the job through a needle stick or other injury
- People receiving hemodialysis
- People who have abnormal liver tests or liver disease
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Hepatitis C Antibody Test
Certain foreign substances that enter your body trigger your immune system to make antibodies. Antibodies are specifically programmed to only target the foreign substance they were made to fight.
If youve ever had a hepatitis C infection, your body will make hepatitis C antibodies as part of its immune response.
Your body only makes these antibodies if you have hepatitis C or had it in the past. So the hepatitis C antibody test can confirm whether you have the virus by testing for these specific antibodies.
If the antibody test is positive, an HCV RNA test can show whether the infection is current.
While people of any gender experience the same hepatitis C symptoms, 2014 research suggested some effects of the virus may differ, depending on the sex you were assigned at birth.
Researchers noted that:
- women have a higher chance of clearing the virus without treatment
- liver disease may progress more rapidly in men
- men have a higher chance of developing cirrhosis