What Are The Symptoms Of Hepatitis C
Symptoms of Acute Hepatitis C Infection
The majority of newly-infected patients identified with HCV do not have symptoms. The minority of patients who have symptoms typically have complaints of
Symptoms of Chronic Hepatitis C Infection
Chronic hepatitis C usually causes no symptoms until very late in the disease. Over the years or decades, chronic inflammation may cause scarring . Extensive scarring in the liver is called cirrhosis.
Becoming infected with another viral hepatitis or other exposures that damage the liver in addition to hepatitis C can increase liver damage or even cause severe hepatitis. Having HIV infection along with HCV accelerates the progression of chronic hepatitis C to end-stage liver disease, sometimes shortening the course to a few years instead of decades.
Protease Inhibitor Antiviral Medications
Protease inhibitors work by preventing the spread of infection within the body by stopping viruses from multiplying.
Grazoprevir is a protease inhibitor for hepatitis C genotypes 1 and 4. Its only available in combination with elbasvir and sold as grazoprevir/elbasvir.
The drug combination is sold under the brand name Zepatier.
How Can I Prevent Spreading Hepatitis C To Others
If you have hepatitis C, follow the steps above to avoid spreading the infection. Tell your sex partner you have hepatitis C, and talk with your doctor about safe sex practices. In addition, you can protect others from infection by telling your doctor, dentist, and other health care providers that you have hepatitis C. Dont donate blood or blood products, semen, organs, or tissue.
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Why Should People Take Antiviral Medications For Hepatitis C
The purpose of taking antiviral medications for hepatitis C is to:
- remove all the hepatitis C virus from your body permanently
- stop or slow down the damage to your liver
- reduce the risk of developing cirrhosis
- reduce the risk of developing liver cancer
- reduce the risk of liver failure and the need for a liver transplant
Limitations Of Drug Treatments
Though the latest generation of hepatitis C drugs can effectively cure the disease, patients whose hepatitis C infection has progressed to the point of causing advanced cirrhosis or liver failure may require a liver transplant to fully recover.
Its important to let your doctor know what other medications and supplements youre taking so you can avoid harmful interactions. If youre nursing or pregnant, youll also want to let your healthcare provider know, as this can affect your treatment options.
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Pregnancy And Hepatitis C
The new hepatitis C medicines have not been tested in pregnancy.
You should not become pregnant while taking treatment as it could be harmful to unborn babies.
If you’re pregnant, you must delay treatment until after your baby is born.
Speak to your doctor before starting hepatitis C treatment if you’re planning to become pregnant in the near future.
You’ll need to wait several weeks after treatment has ended before trying to get pregnant.
Women taking ribavirin should use contraception during treatment and for another 4 months after the end of treatment.
Men taking ribavirin should use a condom during treatment and for another 7 months after the end of treatment. This is because semen can contain ribavirin.
If you become pregnant during treatment, speak to your doctor as soon as possible to discuss your treatment options.
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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Antiviral Medication For Hepatitis C
For people with hepatitis C, the goal of treatment with antiviral medication is to prevent the virus from replicating, or copying itself, and to eliminate the virus from the bloodstream. If the hepatitis C virus has been in the body for more than six months, the infection is considered chronic. Without treatment, most people with acute hepatitis C develop the chronic form of the disease.
Your doctor decides which antiviral medicationor combination of medicationsto prescribe based on the results of a blood test called a genotype test. There are six genotypes, or strains, of the hepatitis C virus, and people with certain genotypes respond more quickly to medical treatment.
For many years, the standard treatment for chronic hepatitis C consisted of the antiviral medications pegylated interferon and ribavirin. Ribavirin is taken by mouth every day, and interferon is an injection that you or a caregiver can administer once a week at home.
In 2013 and 2014, the U.S. Food and Drug Administration approved a group of new medications for the treatment of hepatitis C. These medications, which include sofosbuvir, are very effective and have fewer side effects than older medications, particularly interferon.
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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What Can People Do To Help The Medications Work Best
- Take the medications every day
- Stay in touch with pharmacy to be sure that all refills are ready on time
- Take the medications exactly as prescribed
- Do not skip doses
- Get all blood tests done on time
- Go to all visits with providers as recommended
- Tell the provider about all other medications that are being taken – including over-the-counter medicines, vitamins, herbs, and supplements
- Complete the entire course of medication
Can Hepatitis C Be Cured
Considerable progress has been made by past clinical trials in the medical treatment of hepatitis C. The rate of cure has increased with the development of direct-acting, all-oral antiviral regimens, and the length of therapy is much shorter. Treatment recommendations continue to change as new medicines become available. Treatment helps to reduce progression of liver damage to cirrhosis, may prevent liver cancer, and may prevent spread of the infection to other people.
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Can You Drink Alcohol If You Have Hepatitis C
Hepatitis is inflammation of the liver. Hepatitis C viral infection causes this inflammation. There are several risk factors for contracting HCV infection due to the hepatitis C virus. One serious risk factor is drinking alcohol with HCV infection. The combination of HCV and alcohol can cause complications, and may result in more severe and serious liver injury including chronic cirrhosis . It also increases your chances of developing liver cancer having an alcohol induced increase in viral replication and rapid mutation of the hep C virus,which creates complications like:
- Greater viral capacity
Hepatitis refers to any cause of liver inflammation, with or without scarring of the liver . It is contagious, and is spread from person-to-person by blood-to-blood contact. Other viral causes of hepatitis include hepatitis A, B, C, and E. Other types of noninfectious causes of hepatitis include:
- Excessive alcohol intake
- Medications such as some prescription medications or even acetaminophen, for example, Tylenol liver damage and drug induced liver disease.
- Bacteria and viruses other than the hepatitis viruses
How are hepatitis A, B, and E spread?
- Transmission of hepatitis A and E: These forms of the virus are acquired from improper hygiene during food or drink preparation by someone who’s infected.
- Transmission of hepatitis B: This form is spread by blood-to-blood or sexual contact.
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.
Available Patient Assistance Programs for Hepatitis C treatment Holkira Pak Maviret
MerckCare Hepatitis C Program 1 872-5773 Zepatier
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What Drugs Cure Hepatitis C Infection
Most hepatitis C is currently treated with all-oral medical regimens of “direct-acting antivirals” or DAAs. DAAs is a term used to distinguish these hepatitis C drugs from an older generation of injected medicines that act indirectly on the immune response to the hepatitis C virus. DAAs act directly on the virus to block different steps in its life cycle. There are several DAAs that are used in combinations that have been scientifically proven to cure hepatitis C. They are not interchangeable, and some are only available combined in one pill or dose pack as a specific combination. DAAs are not used as single-drug therapy because of the high risk of the virus developing resistance and because they work best in combinations. The choice of which regimen to use depends upon the genotype of the virus, the level of liver fibrosis , and any drug resistancethat may be present .
Examples of combination DAAs with cure rates between 91%-100% include:
Genotype 1a and 1b are the commonest genotypes in the United States. Of all the genotypes, genotype 3 has been the most difficult to treat with DAAs alone and required the use of ribavirin, which has significant side effects. All genotypes can now be treated with oral DAAs without ribavirin. Some genotypes may still require the use of injected pegylated interferon and/or ribavirin if there is no response to DAAs.
Preemptive Hcv Treatment Before Immunotherapy Or Chemotherapy
The risk of vertical transmission in mothers with an HCV monoinfection is 5% and is not diminished by cesarean section. Mothers are not advised against breastfeeding either.
There is an urgent indication for preemptive antiviral treatment in patients with a chronic hepatitis B infection before they undergo certain types of immunotherapy or chemotherapy . There is insufficient evidence at present for any recommendation of an analogous procedure for patients with chronic hepatitis C.
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Is There A Vaccine For Hepatitis C
There are no vaccinations that prevent the hepatitis C virus. Vaccinations for hepatitis A and B, however, are given to patients with HCV to prevent the possibility of acquiring another hepatitis virus. Getting hepatitis A or hepatitis B on top of hepatitis C can add liver damage or even cause severe hepatitis. People with hepatitis C should be screened for past infection with hepatitis A and B. If they have no evidence of antibodies, they should receive vaccines for hepatitis A and/or B.
Hepatitis A vaccine may be given alone or in combination with hepatitis B vaccine, depending on whether the patient needs one or both. Hepatitis A vaccine is inactivated hepatitis A virus that stimulates the immune system to develop antibodies against hepatitis A. These antibodies kill the virus before it can cause infection. It is given in 2 doses intramuscularly 6 months apart.
Hepatitis B vaccine is made with hepatitis B antigens that stimulate antibodies against the hepatitis B virus. There is no live virus in the vaccine. It is given in 3 doses intramuscularly the second dose is given 1-2 months after the first, and the last is given 6 months after the first dose. The A and B vaccine is a combination of the above and is dosed in the same way as the Hepatitis B vaccine. It is available under the brand name Twinrix.
What Will My Doctor Need To Know To Treat Me
If you want to be assessed for treatment, you need to make an appointment with a doctor. They will be mostly interested in the condition of your liver. Your doctor will organise, if possible, for you to have a Fibroscan examination. If Fibroscan is not available, your doctor will probably use an APRI test. This is an online calculator that estimates the health of your liver. It involves a blood test called a liver function test.
Dont forget, its very important to get a PCR test 12 weeks after finishing treatment this will mean the doctor can make sure you are cured.
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Cost Of Drug Treatments
The newer direct-acting antiviral medicines for hepatitis C can be very expensive listed at tens of thousands of dollars.
While pricing is often negotiated by insurance companies and other agencies, the process is not especially transparent and can be confusing.
If you need help paying for medicines, speak with your doctor. For more information about available financial assistance, visit the American Liver Foundation.
Additional reporting by Deborah Shapiro.
The Treatment Of Acute Hepatitis C
The basis of current, interferon-free treatment is a combination of directly acting antiviral drugs with high antiviral efficacy, resistance barriers, and different sites of attack.
In the multicenter German Acute HCV IV trial, six weeks of treatment with sofosbuvir/ledipasvir resulted in a sustained viral eradication rate of 100% in patients acutely infected with HCV genotype 1 . It should be noted, however, that the combination of sofosbuvir and ledipasvir is available in Germany only in packages of 28 tablets, so that taking a single tablet per day for six weeks is unreasonable in terms of drug economics. Until further data are available, patients with acute hepatitis C should be treated for eight weeks, analogously to the recommendations for previously untreated patients with acute hepatitis C. As the rate of HCV transmission to health care workers via needle stick injury is very low, no post-exposure prophylaxis is recommended in this situation .
RNA-dependent RNA polymerase inhibitors are categorized as either nucleotide inhibitors or non-nucleoside inhibitors . The generic names of all HCV polymerase inhibitors end in -buvir.
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What Happens If Hep C Meds Dont Work
In rare cases , the body wont respond to either medication. If this happens, your doctor may prescribe a more potent combination of antivirals such as those found in Vosevi.
This medication blends three anti-viral meds: sofosbuvir, velpatasvir, and voxilaprevir. Because its more powerful, it may have a higher burden of side effects like headache, fatigue, diarrhea, and nausea.
Dosage entails one pill taken once a day with food for 12 weeks. Your doctor may also keep you on the meds longer to clear the infection.
What Is Hepatitis C Again
Hepatitis C is a liver infection caused by the hep C virusand the disease is quite common. Its the most common chronic blood-borne infection in the United States. According to the U.S. Department of Health and Human Services, anywhere from 2 million to 2.8 million Americans live with chronic hepatitis C. That number could be much higher, given that many people who have hep C are asymptomatic and unaware that they are even infected.
You cant catch it from kissing, holding hands, or even if someone sneezes in your face. Hep C is passed on when infected blood gets into your bloodstream, which can happen in different ways, but typicals modes of transmission are:
Sharing needles or sharing straws to snort drugs
Working in healthcare
Sharing razors, toothbrushes, or nail clippers with an infected person
Getting a body pierce or tattoo in an unsterile environment
Getting a blood transfusion or organ transplant before the virus was discovered in 1989, or prior to 1992, when blood wasnt as thoroughly screened
Being born to a mother who had hep C when she was pregnant
While 30% of people who have hep C clear the infection through their own immune system, 70% dont, and treatment is crucial. When its left to linger, hep C can lead to serious liver complications.
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