Additional Tests You Might Need
Once youve been diagnosed with Hepatitis C, your doctor will likely order a number of tests to find out about the health of your liver and decide on a treatment plan thats most appropriate for you.
Hepatitis C genotype
The Hepatitis C genotype refers to a specific strain or type of the Hepatitis C virus. There are six major types of Hepatitis C around the world: genotypes 1, 2, 3, 4, 5 and 6. In the United States, genotypes 1, 2, and 3 are common:
- Genotype 1: Most Americans with Hepatitis C have this type
- Genotype 2: About 10% of Americans with Hepatitis C have this type
- Genotype 3: About 6% of Americans with Hepatitis C have this type
The genotype of Hepatitis C does not change over time, so you only need to get tested once.
Genotype tests are done before a person starts treatment. Hepatitis C treatment works differently for different genotypes, so knowing your genotype helps your doctor choose the best treatment for you.
Testing for Hepatitis A and Hepatitis B
Your doctor may test to see if your body is immune to Hepatitis A and Hepatitis B. If these tests show no prior exposure or protection, he or she will recommend that you be vaccinated against these two viruses to eliminate the chance of becoming infected.
Liver function tests or liver enzymes
- ALT
- AST
Liver function tests also include ALP and total bilirubin, among other things.
Tests to measure liver scarring or fibrosis
- Liver Biopsy
- Elastography
- Serum markers
Imaging tests
How Is Hepatitis B Spread
You can become infected with hepatitis B through exposure to blood, semen and other bodily fluids of an infected person. You can get the infection by:
- Having unprotected sex.
- Sharing or using dirty needles for drug use, tattoos or piercing.
- Sharing everyday items that may contain body fluids, including razors, toothbrushes, jewelry for piercings and nail clippers.
- Being treated medically by someone who does not use sterile instruments.
- Being bitten by someone with the infection.
- Being born to a pregnant woman with the infection.
Hepatitis B is not spread by:
- Kissing on the cheek or lips.
- Coughing or sneezing.
- Hugging, shaking hands or holding hands.
- Eating food that someone with the infection has prepared.
- Breastfeeding.
Living With Hepatitis B
If you have hepatitis, you should:
- avoid having unprotected sex, including anal and oral sex, unless you’re sure your partner has been vaccinated against hepatitis B
- avoid sharing needles used to inject drugs with other people
- take precautions to avoid the spread of infection, such as not sharing toothbrushes or razors with other people
- eat a generally healthy, balanced diet there’s no special diet for people with hepatitis B
- avoid drinking alcohol this can increase your risk of developing serious liver problems
- speak to your doctor if you’re thinking of having a baby
People with hepatitis B can usually have a healthy pregnancy, but it’s a good idea to discuss your plans with a doctor first as you may need extra care and your medications may need to be changed.
There’s a risk of pregnant women with hepatitis B passing the infection on to their child around the time of the birth, but this risk can be reduced by ensuring the baby is vaccinated shortly after they’re born.
Page last reviewed: 30 January 2019 Next review due: 30 January 2022
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What Is Hepatitis C
Hepatitis C is a liver infection severity can range from a mild illness to a serious, chronic illness. Of those who contract hepatitis C, more than three in four will develop a chronic hepatitis C infection. Some individuals will clear hepatitis C from their body without any treatment researchers do not fully understand why this happens.
Who Should Be Vaccinated For Hepatitis B
All newborns should be vaccinated. Also, people who are under 18 who were not vaccinated at birth should also get the vaccine. Other groups who should be sure to be vaccinated are those in certain high-risk categories, such as:
- People who have more than one sexual partner.
- Men who have sex with men.
- Adults with diabetes.
- Sexual partners of infected people and people who share households with infected individuals.
- People who are exposed to blood and other bodily fluids, including healthcare and public safety professionals, and people who work in jails and other places taking care of people who cant take care of themselves.
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Who Is Most At Risk Of Contracting Hepatitis C
You have a high risk of contracting hepatitis C if you:
- use or have used injection drugs even if it was just once or many years ago
- have received blood or blood products or an organ transplant before July 1990 in Canada
- have been in jail or
- have been injected or scratched during vaccination, surgery, blood transfusion or a religious/ceremonial ritual in regions where hepatitis C is common.
You have a high moderate risk of contracting hepatitis C if you:
- have tattoos or body piercing
- have multiple sexual partners
- have a sexually transmitted infection , including HIV or lymphogranuloma venereum
- have experienced traumatic sex or rough sex or have used sex toys or fisting that can tear body tissue
- have vaginal sex during menstruation
- have received a kidney treatment
- have received an accidental injury from a needle or syringe
- have another infectious disease
- were born to a hepatitis C infected mother or
- have a sexual partner infected with hepatitis C.
Hepatitis C is NOT passed from person to person by:
- coughing, sneezing
- breastfeeding unless your nipples are cracked and bleeding or
- oral sex, unless blood is present.
If You Notice Symptoms See A Doctor Right Away
Symptoms of hepatitis C include the following:
- Jaundice a yellowish tone to the eyes and skin
- Mild, chronic right belly pain
- Nausea
- Loss of appetite
- Fatigue
If you believe you have been exposed to hepatitis C or notice any symptoms, visit your primary care doctor as soon as possible. If you test positive for the virus, your doctor can refer you to a hepatologist to discuss your options.
“I strongly encourage all baby boomers and others who are at high risk to get tested, even if you don’t look or feel sick,” Reau says. “If you do have hepatitis C, the earlier we discover it, the more likely we can prevent it from progressing and causing more serious damage.”
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How To Protect Yourself Against Hepatitis C
Unfortunately, there is no vaccine available for hepatitis C, but you can protect yourself by avoiding behaviors such as sharing needles and syringes. In addition, the CDC recommends people born between 1945 and 1965 get tested for hepatitis C. Testing is also recommended for people who were treated for blood-clotting problems before 1987 and recipients of blood transfusions or donated organs before 1992.
The UNC Liver Center has a clinic in Chapel Hill that specializes in hepatitis B and C, incorporating the latest clinical trials and most up-to-date therapies. Treatment for hepatitis is also available at our locations in Asheville, High Point, Raleigh and Wilmington. To learn more, call 966-2516.
Michael Fried, MD, is the director of the UNC Liver Center and a professor of medicine at the UNC School of Medicine.
Who Can Access The Cures
Hep C cures are now available to everyone in Australia who has hep C.* The national and state governments want everyone with hep C to be cured, including prisoners and people who inject drugs. Now is a very good time to consider testing for hep C or speaking to your doctor about the hep C cures.
*Cures are available to people who have a Medicare Card or Health Care Concession Card and who arent hospital inpatients.
You might be able to access healthcare and the cures via your computer or phone.
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Testing For Hepatitis C
Hepatitis C is usually diagnosed using 2 blood tests: the antibody test and the PCR test. These can be as part of a routine blood test or are often combined as a dried blood spot test. The dried blood spot test is similar to a blood sugar test in pricking the finger to get a blood spot that is put on a testing card. This is then sent to a laboratory to be tested.
Another similar test is an antigen test, which if used can often get the results back in 90 minutes. This is very expensive and not many services have access to the machine needed.
How Do You Treat Hepatitis C
When Dr. Fried started treating hepatitis C in 1990, the cure rate was 7 percent. Treatments have evolved since then, leading to a 95 percent cure rate. The treatment course includes taking one to a few pills a day for 12 to 24 weeks, and the medicines have few side effects. Hepatitis C is the only chronic viral infection that you can routinely cure, thanks to these new medicines.
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How Serious Is It
- People can be sick for a few weeks to a few months
- Most recover with no lasting liver damage
- Although very rare, death can occur
- 15%25% of chronically infected people develop chronic liver disease, including cirrhosis, liver failure, or liver cancer
- More than 50% of people who get infected with the hepatitis C virus develop a chronic infection
- 5%-25% of people with chronic hepatitis C develop cirrhosis over 1020 years
How Do You Test For Hepatitis B
A simple blood test carried out by a healthcare professional will show whether you have the virus. You may also be given extra tests to see if your liver is damaged.
If youve got hepatitis B you should be tested for other STIs. Its important that you tell your recent sexual partner/s so they can also get tested and treated. Many people who have hepatitis B dont notice anything wrong, and by telling them you can help to stop the virus being passed on. This can also stop you from getting the infection again.
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Sometimes The Infection Goes Away On Its Own
Acute hepatitis is C is a short-term illness that occurs within the first six months after being exposed to the virus. Like the human papillomavirus , early acute hepatitis C can clear on its own without treatment this happens about 25% of the time.
However, it’s more likely that the virus will remain in your body longer than six months, at which point it’s considered to be chronic hepatitis C infection.
“Being younger or a woman tends to be a factor in whether the virus clears on its own, and genetics may play a role,” Reau says. “But we can’t determine with certainty which people are certain to clear the infection and which aren’t.”
Treatment For Chronic Hbv Infection
For chronic HBV infection, antiviral medications are available.
This is not a cure for chronic HBV. However, it can stop the virus from replicating and prevent its progression into advanced liver disease.
A person with a chronic HBV infection can develop cirrhosis or liver cancer rapidly and without warning. If a person does not have access to adequate treatment or facilities, liver cancer can be fatal within months of diagnosis.
People with a chronic HBV infection require ongoing medical evaluation and an ultrasound of the liver
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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
Hepatitis B Vs Hepatitis C
Hepatitis has many different types. HBV and the hepatitis C virus have both acute and chronic forms.
The main difference between HBV and HCV is how they spread from person to person. Although HCV is transmissible via sexual activity, this is rare. HCV usually spreads when blood that carries the virus comes into contact with blood that does not.
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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 resistance that may be present .
Examples of combination DAAs with cure rates between 91%-100% include:
- Harvoni
- Zepatier
- Mavyret
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.
What Treatments Are Available For Chronic Hepatitis B If Medications Dont Work
If you have advanced hepatitis B, you might also become a candidate for a liver transplant. This path does not always result in a cure because the virus continues in your bloodstream after a transplant. To prevent being infected again after your transplant, you may be prescribed hepatitis B immunoglobulin with an antiviral agent.
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How Do My Healthcare Professional And I Decide On Treatment
Your healthcare professional will look at your health history and decide if treatment is right for you. The treatment you receive and the length of treatment may depend on:
- how much virus is in your body
- your genotype of hep C
- whether you have liver damage
- whether or not youve been treated previously
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The Sex Superbug: Gonorrhoea
Gonorrhoea may be on the verge of becoming an untreatable disease. Gonorrhoea is caused by a bacteria, and it is treated with two drugs but resistance is already developing to one of the drugs. Soon we may have no treatment options remaining for multi-drug resistant gonorrhoea infections.
Those diagnosed with gonorrhoea are at risk of serious complications and untreated, the disease can cause inflammation of the womb and infertility. The infection can also be passed from a pregnant woman to her baby.
Infection in pregnant women can lead to early labour and delivery or permanent blindness in a newborn baby.
There were 87 million new cases gonorrhoea amount men and women aged 15-49 years in 2016.
WHO/Yoshi Shimizu. Testing for sexually transmitted infections in Mongolia.
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Can Hepatitis B Be Prevented
The hepatitis B vaccine is one of the best ways to control the disease. It is safe, effective and widely available. More than one billion doses of the vaccine have been administered globally since 1982. The World Health Organization says the vaccine is 98-100% effective in guarding against the virus. Newborns should be vaccinated.
The disease has also been more widely prevented thanks to:
- Widespread global adoption of safe blood-handling practices. WHO says 97% of the blood donated around the world is now screened for HBV and other diseases.
- Safer blood injection practices, using clean needles.
- Safe-sex practices.
You can help prevent hepatitis B infections by:
- Practicing safe sex .
- Never sharing personal care items like toothbrushes or razors.
- Getting tattoos or piercings only at shops that employ safe hygiene practices.
- Not sharing needles to use drugs.
- Asking your healthcare provider for blood tests to determine if you have HBV or if you are immune.
Researching An Hiv Cure: The Main Approaches
Although the stem cell approach has had some success in the past, its very dangerous for the patient. It would only be considered a viable option, if the person needed a stem cell transplant to treat another more deadly condition, such as very advanced leukaemia which, unlike HIV, doesnt have as many other safe and effective treatment options available.
While there is promising research being carried out in these areas, there is no viable cure on the horizon.
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