Can You Apply For Disability If You Have Hepatitis C
Getting Social Security disability benefits with hepatitis C depends on the severity of your condition. Hepatitis C alone doesnt qualify you for disability, but you might qualify if you reach end-stage liver disease and HCV affects cognitive function and causes severe fatigue, explains Hassanein.
Youll have to prove that your disease prevents work-related activity, so be prepared to provide written documentation from your doctor, as well as copies of your medical records, advises the Hepatitis C Association.
Living With Hepatitis C Infection
Many people are living with hepatitis C. If you have hepatitis C, there are several important things that you can do to help yourself and others such as:
- Eat a healthy diet and get plenty of rest.
- To avoid further liver damage:
- Do not drink alcohol.
- Do not take medicine that can cause liver damage .
- Get vaccinated against hepatitis A & B if you are not already immune.
- Do not to pass the infection to anyone else by taking the following precautions, such as:
- Do not share toothbrushes or razors with others.
- Do not to let anyone else come into contact with your blood, urine or feces.
- Use condoms during sexual activity.
- Limit the number of sex partners you have.
- If you use injection drugs, do not share needles or syringes with anyone else.
- It is best to not get tattoos or body piercings.
Although often uncomfortable, you should notify your partner of your hepatitis C prior to having sex. You also must notify all your health care professionals of your infection, so they can take precautions.
How Do Doctors Treat Autoimmune Hepatitis
Doctors treat autoimmune hepatitis with medicines that suppress, or decrease the activity of, your immune system, reducing your immune systems attack on your liver. The medicines doctors most often prescribe are corticosteroidsprednisone or prednisolonewith or without another medicine called azathioprine.
Doctors typically start with a relatively high dose of corticosteroids and then gradually lower the dose. Your doctor will try to find the lowest dose that works for you. Your doctor will use blood tests to find out how you are responding to the treatment. A decrease in levels of the liver enzymes alanine transaminase and aspartate transaminase shows a response to treatment. ALT and AST falling to normal levels shows a full response. In some cases, a doctor may repeat a liver biopsy to confirm the response to treatment and find out whether the damage has resolved.
Treatment can relieve symptoms and prevent or reverse liver damage in many people with autoimmune hepatitis. Early treatment of autoimmune hepatitis can lower the chances of developing cirrhosis and other complications. A minority of people who have no symptoms or only a mild form of the disease may or may not need medicines.
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Appropriate Uses Of The Hcv Rna Test
There are 4 major reasons that HCV RNA tests are used:
More rarely, HCV RNA is used when either very acute HCV infection is suspected or a false HCV Ab is suspected.
It would not be appropriate to repeatedly order HCV RNA viral load screening for a patient who is not on or was recently on HCV treatment, or to use the HCV viral load to determine the severity of the patient’s infection or the patient’s risk of developing significant liver disease.
Do Medicines Used To Treat Autoimmune Hepatitis Have Side Effects
Medicines for autoimmune hepatitis can cause side effects. Your doctor will monitor any side effects and help you manage them while you take these medicines. Your doctor also may adjust the doses or change the medicines you take. You may need to stop taking corticosteroids or azathioprine if you have severe side effects.
Side effects of corticosteroids may include
- changes in how you look, which may include weight gain, a fuller face, acne, or more facial hair
- liver damage
Corticosteroids and azathioprine suppress, or decrease the activity of, your immune system, which increases your risk for infections. These medicines can also increase your risk of developing cancers, especially skin cancers.
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Medication Prices For Hepatitis C
The cost of treating hepatitis C varies depending on the type of medication and the length of treatment. One report estimated the lifetime cost of treating a hepatitis C infection at $64,490. Some people pay more, though.
According to other data, published in September 2018 in the Journal of Health & Biomedical Law, a single sofosbuvir pill costs $1,000, in which case a 12-week treatment costs $84,000. Meanwhile, treatment with Olysio could cost as much as $23,600 per month. Because the treatment length is 24 to 48 weeks, the total cost is $100,000 for a full course of treatment.
Unfortunately, because of high drug costs, some people have limited access to treatment, and some insurance companies dont cover certain medications.
Before starting a treatment for hepatitis C, contact your insurer to make sure its covered under your policy.
Traveling With Hepatitis C
Hepatitis C wont prevent you from traveling, but going away on vacation can be challenging if youre managing medications or dealing with fatigue.
Before you leave home, compile a list of pertinent medical information just in case. This includes a copy of your current prescriptions, your doctors name and number, and emergency contact information, recommends the Centers for Disease Control and Prevention . Keep this information in your wallet.
Bring enough medication for the entire trip, and identify pharmacies in your destination city before leaving home, in case something happens with your medication, suggests Adalja. Also, never pack your medication in a checked bag. Keep it in your carry-on luggage, advises the CDC.
You might get sick while away, so contact your health insurance company to see if your policy covers urgent care or emergency room visits in a different state. U.S. health insurance policies dont typically provide coverage outside the country, so consider travelers insurance if youre traveling abroad.
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How Do Doctors Test For Hepatitis C
Doctors check for hepatitis C through a blood test called an HCV antibody test.
When a person contracts HCV, their immune system releases HCV antibodies into the bloodstream. The HCV antibody test looks for the presence of these proteins.
A negative, or nonreactive, result shows that the person does not currently have an HCV infection. A positive, or reactive, result indicates that the person contracted HCV at some point.
It is important to note that a positive antibody test does not necessarily mean that the individual currently has hepatitis C. Once someone has had hepatitis C, they will always have hepatitis C antibodies.
For this reason, if a blood test returns a positive HCV result, the doctor will order another blood test to check for an active infection. This test, called the nucleic acid test , detects HCV genetic material called RNA, which will be present if the person has an active HCV infection.
A negative NAT result means that the person previously had an HCV infection but that the virus is no longer in their body. If the result is positive, the person currently has the virus in their body, and it can transmit to other people.
A person will need to receive treatment for an acute HCV infection. However, this may not be possible if they are pregnant. Experts recommend against taking HCV drugs during pregnancy, as they may damage the developing baby.
Anyone with chronic hepatitis C should visit a doctor regularly to monitor their liver health.
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.
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Who Is More Likely To Get Hepatitis C
People more likely to get hepatitis C are those who
- have injected drugs
- had a blood transfusion or organ transplant before July 1992
- have hemophilia and received clotting factor before 1987
- have been on kidney dialysis
- have been in contact with blood or infected needles at work
- have had tattoos or body piercings
- have worked or lived in a prison
- were born to a mother with hepatitis C
- are infected with HIV
- have had more than one sex partner in the last 6 months or have a history of sexually transmitted disease
- are men who have or had sex with men
In the United States, injecting drugs is the most common way that people get hepatitis C.13
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.
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Diagnosing Hepatitis A B & C
At NYU Langone, hepatologists, or liver specialists, and infectious disease specialists use blood tests to diagnose hepatitis A, B, and C. These viral infections cause inflammation of the liver.
If the results of a blood test confirm a diagnosis of viral hepatitis, your doctor may recommend imaging tests or a liver biopsy to determine the extent of liver disease.
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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Are There Ways To Cure Hepatitis C Other Than With Medications
Patients sometimes ask whether there are ways to treat hepatitis C other than taking medicines. Currently, there are no vaccines to prevent hepatitis C. Once a person is infected, the only way to treat it is with prescribed antiviral medications.
Some patients worry that having hepatitis C means they will need a liver transplant. Only a very small fraction of people with hepatitis C require a liver transplant. By far, most people with hepatitis C never need a liver transplant. A transplant is performedonlywhen damage to the liver is extremely advanced and the liver is unable to perform its basic functions. A transplant provides a new working liver, but a transplant does not get rid of the hepatitis C virus in the patient. Patients with a liver transplant still need antiviral medication to cure their virus.
Acute And Chronic Hepatitis C
Hepatitis C is a viral liver infection that is spread through contaminated blood and bodily fluids.
Acute Hepatitis CAcute hepatitis C can cause mild to no symptoms and can resolve in a short period of time, sometimes without you knowing you have it.
Chronic Hepatitis CNearly 75% of acute hepatitis C cases turn into chronic hepatitis C. Symptoms of this ongoing infection may take years to appear. Left untreated or poorly managed, chronic hepatitis C can lead to irreversible liver damage and liver cancer.
Do I Only Need One Doctor For Treating My Hepatitis C If Not Who Else Should I Include In My Treatment
This depends on your individual body and your treatment plan and experience. This is because medical histories and the occurrence of medication side effects can vary widely between patients, as can how strictly the patient follows the treatment plan. One of the first tests after the bloodwork has been completed is to test the liver to see if or how much the hepatitis C virus has damaged it. If the liver has been damaged, in some cases, the patient may see an additional doctor during the process for testing the liver the first time, as well as for additional tests throughout the treatment process. In other cases, their gastroenterologist or hepatologist may perform the liver tests personally.
Patients who experience medication side effects may see other doctors, based on the side effects, including a dermatologist if there are skin issues, an ear/nose/throat doctor if there are concerns regarding sore throats or dry mouth, and/or a mental health professional if there are concerns regarding the patients mental health due to the medication or due to the processing of receiving a hepatitis C diagnosis.
When undertaking the treatment plan for hepatitis C, there may be other professionals included in the execution of the plan. For most patients, these professionals will likely include your pharmacist and a dietician .
How To Find A Liver Specialist Who Really Knows Hepatitis B
If you have chronic hepatitis B or are newly-diagnosed, its important to see a liver specialist who has experience with hepatitis B.
Having a specialist with hepatitis B expertise on your team not only safeguards your health, it also lessens the stress of having a chronic liver disease. My specialist gave me all the possible scenarios, but most importantly, he gave me my life back, one hepatitis B patient recalled.
When first diagnosed, its often a primary health provider or for children a pediatrician who gets the test results and calls to break the news. Doctors may run additional blood tests and/or immediately refer you to a liver specialist. They may recommend a specialist who accepts your insurance or practices in the same healthcare system, but you may have to do some research to find the best specialist to treat your hepatitis B.
There are two types of specialists who treat liver diseases:
- A gastroenterologist is an internist who has trained in digestive disorders including the liver, but how much liver expertise a gastroenterologist has varies based on their training. Its important to find out if they specialize in liver diseases.
- A hepatologist is a physician who specializes in the liver. This doctor has the most expertise and should be up-to-date about new treatments and clinical trials. But not all hepatologists have treated hepatitis B. Many will have treated hepatitis C, but not hepatitis B, so you need to ask.
Tips for finding a specialist:
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Primary Care Physicians And Nurse Practitioners Can Achieve Cure Rates Matching Those Of Liver Disease Specialists
This Reading Room is a collaboration between MedPage Today® and:
Primary care providers can successfully manage direct-acting antiviral treatment for hepatitis C, though some complicated cases should still be referred to specialists, experts say.
Recent studies have shows that hepatitis C treatment by primary care physicians and nurse practitioners can result in cure rates similar to those achieved by hepatologists and infectious disease specialists. Increasing the number of providers is key to expanding access to effective new therapies.
“There is no reason that a primary care provider cannot successfully treat the uncomplicated patient with chronic hepatitis C,” Raymond Chung, MD, chief of hepatology at Massachusetts General Hospital in Boston, told MedPage Today. “However, it is important that prospective treaters receive proper education and training first.”
The advent of DAAs has made treatment of chronic hepatitis C shorter, easier, and much more effective compared with the old interferon-based therapy.
Today, using interferon-free DAA regimens, treatment duration has fallen from a year to 8 or 12 weeks, and sustained virological response rates exceed 95% even for hard-to-treat patients. A growing number of experts maintain that all hepatitis C patients should be treated, and that biopsies are no longer necessary.
Studies show that many, or even most, hepatitis C patients do not need to be treated by specialists in the DAA era.
Who Is At Risk For Hepatitis C
You are more likely to get hepatitis C if you
- Have injected drugs
If you have chronic hepatitis C, you probably will not have symptoms until it causes complications. This can happen decades after you were infected. For this reason, hepatitis C screening is important, even if you have no symptoms.
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