Testing For Hepatitis C
To diagnose a hepatitis C infection, doctors use a hepatitis C antibody test, which is a blood test. The test must have the approval of the Food and Drug Administration .
The hepatitis C antibody can show if a persons body has made any antibodies to HCV. If they have, this indicates that they have had the infection at some point in their lives.
Some people have the infection at some time, but their immune system eliminates the virus after a few months. In others, the body is unable to fight off the virus, leading to chronic hepatitis C infection. Many people will not experience any symptoms until the disease has progressed significantly.
A non-reactive or negative test result will generally indicate that a person does not have HCV. However, if the person has the test during the window period, they could receive inaccurate results.
If the person knows when exposure occurred, a doctor may recommend waiting a few weeks before repeating the test.
A reactive or positive result tells a doctor that the person has had an HCV infection at some point in their lives. The result indicates that their body has created antibodies to fight the virus.
However, this does not mean that a person still has active HCV. Even if their immune system has eliminated the virus, they will still have the antibodies.
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How Can I Tell If I Am Contagious And Can Spread The Infection To Others
If you have detectable HCV RNA in your blood, you have the potential to spread the disease to other people. Hepatitis C is spread by exposure to contaminated blood. The most common mechanism of exposure is the sharing of needles or other ‘works’ used in consuming drugs such as cocaine or heroin. Other routes of transmission include use of contaminated equipment for body piercing and tattooing, occupational exposure of healthcare workers to used needles or other sharp objects, and, less commonly, through sexual activity that results in tissue tears or from mother to baby during childbirth.
How It Is Done
The health professional taking a sample of your blood will:
- Wrap an elastic band around your upper arm to stop the flow of blood. This makes the veins below the band larger so it is easier to put a needle into the vein.
- Clean the needle site with alcohol.
- Put the needle into the vein. More than one needle stick may be needed.
- Attach a tube to the needle to fill it with blood.
- Remove the band from your arm when enough blood is collected.
- Put a gauze pad or cotton ball over the needle site as the needle is removed.
- Put pressure on the site, and then put on a bandage.
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Why Is Hepatitis C Treatment So Expensive
Hep C drugs are in high demand, with an estimated 2.4 million people in the United States living with the virus. This contributes to the high cost of medications.
The cost of research and development of the drugs is expensive, too. And since these medications have a high cure rate and there isnt a lot of competition theres little incentive for drug companies to lower the cost.
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Nat: Detection Of Hcv Rna
Molecular virological techniques play a key role in diagnosis and monitoring of treatment for HCV. Because it is difficult to cultivate the virus in cell culture, molecular techniques were instrumental in first identifying HCV, making it one of the first pathogens to be identified by purely molecular methods. NAT is considered the gold standard for detecting active HCV replication. HCV NAT is extremely useful in establishing the diagnosis of acute HCV infection, since RNA is detectable as early as 1 week after exposure via needle-stick or blood transfusion, and at least 4-6 weeks prior to seroconversion as demonstrated in a number of transmission settings. The diagnosis of HCV infection is established with antibody screening followed by NAT for HCV RNA for confirmation as well as for follow-up of patients on treatment. Viral load assessment at baseline is also critical for determining response kinetics during therapy. enumerates the role of NAT in HCV diagnosis.
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If You Are A Baby Boomer Heres Another Item For Your To Do List: Get Tested For Hepatitis C
As the youngest of its generation turns 50 this year, AARP has declared 2014 the Year of the Boomer.
There are many ways in which boomers contributions to society can be recognized and celebrated. But if you are one of the 77 million Americans born after the Second World War, your special year would take on greater meaning if you were to pause and think about your liver health.
Specifically, the American Liver Foundation is appealing to you to take the advice of the Centers for Disease Control and Prevention and get tested for hepatitis C.
Why, you may be thinking, are you being asked to do this? The facts speak for themselves: Anyone can get hepatitis C, but baby boomers are five times more likely to be infected.
Of all the people in the United States who have hepatitis C, more than 75 percent were born between 1945 and 1965.
Over all, considering that an estimated 3.2 million people have hepatitis C in the United States, the disease has been described as an unrecognized health crisis.
There are vaccines available for the hepatitis A and B viruses, but no vaccine is available yet to prevent hepatitis C. So testing for hepatitis C is critical to finding and treating the disease at its earliest stages.
Hepatitis C the silent epidemic
The longer the virus goes undetected, the greater a persons risk of developing serious liver disease, including cirrhosis and liver cancer.
Why is the baby boom generation so susceptible?
What does the test involve?
Hep C 123 Program
Enzyme Immunoassays For Detection Of Hepatitis C Antibody
The HCV Ab test is used for initial screening for hepatitis C. The test is performed by enzyme immunoassays , which detect the presence of hepatitis C antibodies in serum. The result of the test is reported as positive or negative. Third-generation EIAs have a sensitivity/specificity of approximately 99%. However, the presence of HCV Ab does not indicate whether the infection is acute, chronic, or resolved. A positive antibody test result should be followed up with an HCV RNA test to confirm that viremia is present.
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How Long Does It Take To Cure Hepatitis C
Depending on the drug combination, the specific genotype of hepatitis C that is to be treated, any prior treatment, and whether the person has cirrhosis, the duration of medical therapy may be as few as 8 weeks, or up to 24 weeks. Most regimens are for 12 consecutive weeks. This is much shorter than the interferon-based treatments years ago that lasted up to 48 weeks. Generally, a person is not considered cured until the RNA viral load is undetectable for 24 weeks after therapy is stopped. This is called sustained virologic response or SVR.
The presence of cirrhosis or liver fibrosis is determined by liver biopsy, noninvasive fibrosis scans, or formulas that estimate liver fibrosis based on blood tests, such as AST-to-platelet Ratio Index or Fibrosis-4 Index.3
A very important aspect of treatment is the elimination of all alcohol consumption. Alcohol adds fuel to the fire when it comes to chronic hepatitis. Drinking alcohol greatly worsens liver fibrosis and speeds progression to cirrhosis, and there is no safe amount to drink for someone with chronic hepatitis. Drinking alcohol also makes it harder for the medications to be effective and may interfere with proper dosing.
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What Are Signs Of Hepatitis B
When you first get hepatitis B, it is called acutehepatitis B. Most adults who have hepatitis B willrecover on their own. However, children and someadults can develop chronic hepatitis B.
Acute hepatitis B: Signs of acute hepatitis B canappear within 3 months after you get the virus.These signs may last from several weeks to 6 months.Up to 50% of adults have signs of acute hepatitis Bvirus infection. Many young children do not show anysigns. Signs include:
- Yellow skin or eyes
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How Is The Test Used
The various hepatitis C tests have different uses:
The HCV antibody test may be performed as part of an acute viral hepatitis panel to determine which of the most common hepatitis viruses is causing your symptoms.
The Pandemic And A Spike In Drug Use Has Exacerbated The Disease But Some States Are Beginning To Lift Barriers That Have Prevented People From Getting Treatment
While national efforts to eliminate hepatitis C have faced setbacks because of increased drug use, the impact of COVID-19 and insurance complications, theres a bright spot: Some states are now making it easier for patients to treat the disease.
Hepatitis C a viral inflammation of the liver spread through blood and other bodily fluids that infects more than 2 million adults and contributes to 14,000 deaths annually has grown more widespread in recent years, with the Infectious Diseases Society of America estimating that hepatitis C infections spiked 71 percent from 2014 through 2018.
Theres a cure for it. Gileads two direct-acting antiviral drugs, Sovaldi and Harvoni, have been available for nearly a decade. The Food and Drug Administration approved Sovaldi in December 2013 and Harvoni in October 2014. Since then, the FDA has approved other antivirals.
Still, a high price tag and administrative hurdles to covering and prescribing the drug have complicated uptake.
Without treatment, hepatitis C is a chronic condition that can lead to liver cancer or advanced liver disease and even be fatal. But antivirals can cure a patient in eight to 12 weeks and have been proven to be 95 percent successful at curing hepatitis C.
That same report found that the number of people receiving treatment for hepatitis C is far below the trajectory needed to hit federal goals to eliminate viral transmission by 2030.
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Early Treatment Can Help You Prevent Liver Cancer Or Liver Failure
According to the CDC, out of every 100 people with hepatitis C:
- 75-85 will develop chronic liver disease.
- Up to 20 will get cirrhosis, a dangerous scarring of the liver.
- 1-5 will die from liver cancer or liver failure.
Getting tested and treated early can stop the hepatitis C virus from triggering cirrhosis or cancer. Your doctor will be able to keep an eye out for signs of liver trouble. They can start treatment before you serious damage starts.
CDC: Hepatitis C FAQs for Health Professionals,Hepatitis C Fact Sheet,Hepatitis C: What to Expect When Getting Tested,Living with Chronic Hepatitis C.
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Evaluation Of Individuals With Positive Screening Test
Patients with a positive screening test for anti-HCV antibody should be tested for serum HCV RNA. Serum HCV RNA quantifies the amount of viral RNA in serum and indicates ongoing infection. If HCV RNA is detectable, tests should be performed to determine the extent of hepatic fibrosis. These tests typically include liver biopsy or noninvasive measures, such as biochemical markers of fibrosis or transient elastography., An ultrasound of the abdomen should also be performed to identify the possible presence of cirrhosis and focal lesions in the liver suspicious for hepatic malignancy.
Patients who have a positive anti-HCV on a screening test but have no detectable HCV RNA should have a confirmatory HCV RNA test a few months later. If HCV RNA remains undetectable, these individuals should be reassured that they do not have hepatitis C infection and that the anti-HCV may remain persistently positive. Such individuals have either cleared the virus or the true specificity of the test is lower than the reported 100%, and the test result was a false positive.
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Hepatitis C And Baby Boomers
According to the CDC, people born from 1945-1965, also referred to as baby boomers, are five times more likely than other adults to have hepatitis C. As a result, the CDC recommends that everyone born between these years be tested once for hepatitis C. Testing can help baby boomers that may have been living with the disease for decades to verify their health status and to determine the best course of action for treatment.
How Can You Prevent Hepatitis C
To prevent hepatitis C, do not share needles with other individuals. Drug users are at an increased risk for hepatitis C and may put themselves at a higher risk for contracting the disease by sharing needles. Additionally, avoid using razors or other personal items that may have come in contact with the blood of a person that is infected.
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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.
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.
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Whos Most At Risk Of Infection
The hep C virus is transmitted through blood consequently, one of the most significant risk factors in the U.S. is actively injecting drugs with shared needles or syringes. Even if you dont use drugs anymore, just one shared needle, many years ago, is enough to cause infection. The exposure might have been ancient history, says Michael Barry, M.D., a professor of medicine at Harvard Medical School in Cambridge, MA, and a member of the U.S. Preventive Services Task Force.
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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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Are Alternative Medicines Available
Some people believe certain forms of alternative medicine help cure hepatitis C.
However, the National Center for Complementary and Integrative Health reports that there are no effective, research-proven forms of alternative treatment or complementary medicine for hepatitis C.
Silymarin, also known as milk thistle, is an herb commonly suggested to help cure hepatitis C liver disease. But a rigorous did not find any beneficial effects from this supplement.
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What Are The Names Of The Medications For Treating Hepatitis C
Since 2014, multiple different antiviral treatments for hepatitis C have been developed. With the many options now available, often there is more than one good choice for a patient. Some of the treatments are recommended as first-line options, some are second-line options, and others are used less commonly in light of all the available choices.
Second line hepatitis C medications:
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