I Had A Liver Transplant Should I Be Worried About Covid
If you have had a liver transplant you will be on immunosuppressive medication. There is currently no evidence that being on this medication increases the risk of severe COVID-19 infection. However long-term transplant patients are at risk of the health conditions that are known to increase the risk of severe COVID-19. For this reason, take particular precautions not to get infected.
Give your specialist a call and discuss your health with them. Theyll be able to advise what steps to take and what is best for your health at this time.
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.
Poor Infection Control For Tattooing And Piercing
The notes that HCV may be transmitted by receiving tattoos or piercings from unregulated settings with poor infection control standards.
Commercially licensed tattooing and piercing businesses are generally thought to be safe.
More informal settings may not have adequate safeguards to help avoid the spread of infections. Receiving a tattoo or piercing in settings such as in a prison or in a home with friends carries a of HCV transmission
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Getting Tested Is The Only Way To Know If You Have Hepatitis C
A blood test called a hepatitis C antibody test can tell if you have been infected with the hepatitis C viruseither recently or in the past. If you have a positive antibody test, another blood test is needed to tell if you are still infected or if you were infected in the past and cleared the virus on your own.
- Are 18 years of age and older
- Are pregnant
- Currently inject drugs
- Have ever injected drugs, even if it was just once or many years ago
- Have HIV
- Have abnormal liver tests or liver disease
- Are on hemodialysis
How Is Hepatitis C Infection Prevented
Unfortunately, there is no vaccine to prevent hepatitis C. To reduce your risk of getting hepatitis C:
- Injection drug use is the most common way people get hepatitis C. Avoid injecting drugs to reduce your risk. If you do inject drugs, use sterile injection equipment. Avoid reusing or sharing.
- Avoid sharing personal care items that might have blood on them
- If you are a health care or public safety worker, follow universal blood/body fluid precautions and safely handle needles and other sharps
- Consider the risks if you are thinking about tattooing, body piercing, or acupuncture are the instruments properly sterilized?
- If youre having sex with more than one partner, use latex condoms correctly and every time to prevent the spread of sexually transmitted diseases, including hepatitis C.
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How Do You Know You Have Kidney Disease
You might not! Beyond the symptoms of hepatitis C, kidney-specific symptoms may or may not be present and it’s not unusual to have the silent disease, unbeknownst to the patient. As described above, patients could see blood in the urine, but that might not always be the case. Similarly, protein in the urine might not be apparent or be attributed to other ailments that you might have .
Needless to say, none of these findings are enough to confirm or refute hepatitis C-related kidney damage. However, a good healthcare provider will order tests of kidney function in a patient with hepatitis C, while a nephrologist managing a patient with any of the above telltale features should start looking for hepatitis C as a potential cause. Specifically, there are a few other tests which could be helpful:
- Testing for cryoglobulins
- Rheumatoid factor testing
- Testing the Complement levels
Since the disease happens at a microscopic level and can come in different variations, a kidney biopsy is often the only way to confirm what is going on.
I Am Running Out Of Hep C Treatment Pills But Im Worried About Going To The Pharmacy Can I Take It Less Frequently Or Wait Until This Is Over
NO.Definitely keep taking your hep C treatment as normal, unless told not to by your doctor or specialist.
Its really important to keep taking your hep C treatment pills as normal to have the highest chance of being cured.
Pharmacies are an essential service and will stay open. Call your pharmacy to see if they deliver or can help make your visit quick and safe. You may also be able to get a friend or family member to pick your medication up for you.
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Risks And Side Effects
Other rare side effects include:
Tell your doctor if you have hepatitis B because it can flare up or reactivate if you take Harvoni. They’ll likely test you for this before you start on the drug. Tell your doctor about any medications you take because they could affect how well Harvoni works for you and even if it’s safe for you to take. For example, the heart medication amiodarone may not work well with it.
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.
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Whos At Risk For Hepatitis C
You might be more likely to get it if you:
- Inject or have injected street drugs
- Were born between 1945 and 1965
- Got clotting factor concentrates made before 1987
- Received a blood transfusion or solid organ transplants before July 1992
- Got blood or organs from a donor who tested positive for hepatitis C
- Are on dialysis
- Get a body piercing or tattoo with nonsterile instruments
Can You Be A Blood Or Organ Donor
People with hepatitis C cant currently donate blood. The American Red Cross eligibility guidelines prohibit people who have ever tested positive for hepatitis C from donating blood, even if the infection never caused symptoms.
According to the Department of Health and Human Services , information on organ donation, those with underlying medical conditions shouldnt rule themselves out as organ donors. This reflects new guidelines for organ donation announced by the HHS.
People with HCV are now able to be organ donors. This is because advances in testing and medical technology can help the transplant team determine which organs or tissues can be safely used for transplantation.
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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.
Interaction With The Host Immune System
Several mechanisms for HCV resistance to IFN have been proposed. The NS5A protein displays a double-stranded RNA-activated protein kinase R binding site that overlaps with the IFN sensitivity determinant region but includes 26 additional amino acids essential for PKR binding . Two positively selected sites were detected within this 26 amino acid region . Mutations at the second selected site arise when HCV is passaged in the presence of IFN-alpha . The C298I change is positively selected on the genotypes 1/4 branch and both genotypes are relatively resistant to IFN therapy .
The binding of NS5A to OAS1 also contributes to inhibition of IFN antiviral activities . Based on previous biochemical data , we performed proteinprotein docking of NS5A domain I and human OAS1. Results showed that three of the positively selected sites in NS5A domain I, positions 54, 78, and 93 are at the direct binding interface with OAS1 . Notably, besides being described as RAVs for DAAs, substitutions at the Y93 site in the subtype 1b background occur at different frequency depending on the hosts genotype at the IFNL3/IFNL4 locus . A similar trend was observed for variants at NS5A positions 31 , 37 , 52 , and 54 . Interestingly, sites 93 and 54 are positively selected on the genotype 6 and 3 branches, respectively . Both these genotypes are endemic in Asia, where the frequency of the protective human IFNL3/IFNL4 variant is highest .
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I I Have Liver Disease Or Cirrhosis Of The Liver Will This Make Me More At Risk With Covid
If you have cirrhosis of the liver there is no evidence that you are at greater risk of catching COVID-19.
Having cirrhosis of the liver may increase the risk of severe illness if you have COVID-19, but the evidence is limited at the moment.
If you have elevated liver enzymes or abnormal liver function test as a result of liver disease, you may also be at risk of severe illness if you have COVID-19.
For these reasons, its best to take all necessary precautions to keep yourself safe from COVID-19 by following government and medical recommendations.
Everyone with cirrhosis should see their liver specialist regularly. Call and speak to your specialist about what is best for your health.
Causes And Risk Factors
HCV causes hepatitis C. People contract the virus through blood-to-blood contact with contaminated blood. For transmission to occur, blood containing HCV must enter the body of a person without HCV.
A speck of blood, invisible to the naked eye, can carry hundreds of hepatitis C virus particles, and the virus is not easy to kill.
The report the following risk factors for developing hepatitis C:
- using or having used injectable drugs, which is currently the most common route in the U.S.
- receiving transfusions or organ transplants before 1992, which is before blood screening became available
- having exposure to a needle stick, which is most common in people who work in healthcare
- being born to a mother who has hepatitis C
The CDC offer advice on cleaning syringes if it is not possible to use clean and sterile ones. Although bleach can kill the HCV in syringes, it may not have the same effect on other equipment. Boiling, burning and using alcohol, peroxide, or other common cleaning fluids to wash equipment can reduce the amount of HCV but might not stop a person from contracting the infection.
It is extremely dangerous to inject bleach, disinfectant, or other cleaning products, so people should make sure they rinse the syringe thoroughly. A person should only ever use bleach to clean equipment if new, sterile syringes and equipment are not available.
People who are at risk due to these factors can have screening to rule out HCV.
- peginterferon alfa-2a
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Can You Prevent Hepatitis C Infection
Thereâs no vaccine to prevent hepatitis C. To avoid getting the virus:
- Use a latex condom every time you have sex.
- Don’t share personal items like razors.
- Don’t share needles, syringes, or other equipment when injecting drugs.
- Be careful if you get a tattoo, body piercing, or manicure. The equipment may have someone else’s blood on it.
Find out more on how to prevent hepatitis C.
Positively Selected Sites Impinge On Central Processes Of Hcv Life Cycle
Analysis of positively selected sites was performed by inspection of literature reports describing the effect of specific mutations, as well as by performing docking analyses. Overall, positively selected sites could be categorized on the basis of the functional effect they are likely to entail, as follows: cell entry, interaction with the host immune system, and association with membrane/lipids. The details of these sites are reported below, as well as in Figures 4, 5.
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Getting Tested For Hepatitis C
Seek medical advice if you have persistent symptoms of hepatitis C or there’s a risk you’re infected, even if you do not have any symptoms.
A blood test can be carried out to see if you have the infection.
GPs, sexual health clinics, genitourinary medicine clinics or drug treatment services all offer testing for hepatitis C.
Early diagnosis and treatment can help prevent or limit any damage to your liver, as well as help ensure the infection is not passed on to other people.
Recurrence Of Hepatitis C
Approximately 99 percent of people who achieve SVR are cured of hepatitis C for life. The risk of hepatitis C returning after SVR is extremely rare. Also, once you reach SVR, you arent at risk of passing HCV on to others.
In some cases, your hepatitis C symptoms may flare up again before you reach SVR. But this isnt considered a recurrence because the infection isnt cured to begin with. A more likely explanation for recurrence is a new infection altogether.
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How Common Is Hepatitis C In The United States
In the United States, hepatitis C is the most common chronic viral infection found in blood and spread through contact with blood.14
Researchers estimate that about 2.7 million to 3.9 million people in the United States have chronic hepatitis C.13 Many people who have hepatitis C dont have symptoms and dont know they have this infection.
New screening efforts and more effective hepatitis C treatments are helping doctors identify and cure more people with the disease. With more screening and treatment, hepatitis C may become less common in the future. Researchers estimate that hepatitis C could be a rare disease in the United States by 2036.17
Hepatitis C Testing And Diagnosis
Doctors will start by checking your blood for:
Anti-HCV antibodies: These are proteins your body makes when it finds the hep C virus in your blood. They usually show up about 12 weeks after infection.
It usually takes a few days to a week to get results, though a rapid test is available in some places.
The results can be:
- Nonreactive, or negative:
- That may mean you donât have hep C.
- If youâve been exposed in the last 6 months, youâll need to be retested.
If your antibody test is positive, youâll get this test:
HCV RNA: It measures the number of viral RNA particles in your blood. They usually show up 1-2 weeks after youâre infected.
- The results can be:
- Negative: You donât have hep C.
- Positive: You currently have hep C.
You might also get:
Liver function tests: They measure proteins and enzyme levels, which usually rise 7 to 8 weeks after youâre infected. As your liver gets damaged, enzymes leak into your bloodstream. But you can have normal enzyme levels and still have hepatitis C. Learn the reasons why you should get tested for hepatitis C.
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Kidney Disease From Hep C Treatment
In a nutshell, treat the cause. In those found to have severe kidney damage which could be causally linked to hepatitis C, the treatment should focus on treating hepatitis C. However, it’s not always that straightforward. Not every patient with hepatitis C is necessarily a candidate for treatment since response rates vary and the side effects of therapy have to be kept in mind.
Certain patients could already be past the point of no return when it comes to both salvaging liver or kidney function. Kidneys don’t especially have much of a regenerative capacity. So if severe scarring has already occurred in the kidneys, it’s unlikely that the patient would recover kidney function even with treatment of hepatitis C. Regardless, there could be perfectly valid reasons , to still treat hepatitis C.
An important point to remember is that the presence of kidney disease itself changes treatment choices for hepatitis C as well. This is because therapy is often different based on the level of kidney damage. Talk to your healthcare provider about the best treatment path for you.