How Do Doctors Treat Hepatitis C
Doctors treat hepatitis C with antiviral medicines that attack the virus and can cure the disease in most cases.
Several newer medicines, called direct-acting antiviral medicines, have been approved to treat hepatitis C since 2013. Studies show that these medicines can cure chronic hepatitis C in most people with this disease. These medicines can also cure acute hepatitis C. In some cases, doctors recommend waiting to see if an acute infection becomes chronic before starting treatment.
Your doctor may prescribe one or more of these newer, direct-acting antiviral medicines to treat hepatitis C:
You may need to take medicines for 8 to 24 weeks to cure hepatitis C. Your doctor will prescribe medicines and recommend a length of treatment based on
- which hepatitis C genotype you have
- how much liver damage you have
- whether you have been treated for hepatitis C in the past
Your doctor may order blood tests during and after your treatment. Blood tests can show whether the treatment is working. Hepatitis C medicines cure the infection in most people who complete treatment.
Hepatitis C medicines may cause side effects. Talk with your doctor about the side effects of treatment. Check with your doctor before taking any other prescription or over-the-counter medicines.
Hiv And Hepatitis C Coinfection
HCV infection is common among people with HIV who also inject drugs. Nearly 75% of people living with HIV who report a history of injection drug use are co-infected with HCV. All people who are diagnosed with HIV are recommended to be tested for HCV at least once. People living with HIV are at greater risk for complications and death from HCV infection. Fortunately, direct acting antivirals that are used to treat HCV work equally well in people with and without HIV infection. For more information about HIV and HCV coinfection, visit the HIV.govs pages about hepatitis C and HIV coinfection.
How Many People Have Hepatitis C
During 2013-2016 it was estimated that about two and half million people were chronically infected with HCV in the United States. The actual number may be as low as 2.0 million or as high as 2.8 million.Globally, hepatitis C is a common blood-borne infection with an estimated 71 million people chronically infected according to the World Health Organization .
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How Common Is Hepatitis C
The exact number of people infected is not known. There are around 200,000 people chronically infected with hepatitis C in the UK. Worldwide, over 180 million people are infected. Rates of infection have been relatively stable in recent years, but deaths from hepatitis C have reduced, thought to be because treatment options have become better.
Most cases are in people who inject illegal drugs. It is estimated that up to half of injecting drug users become infected with hepatitis C.
What Are The Different Types Of Hepatitis C
Hepatitis C can be acute or chronic. How long you experience symptoms will depend on the type you have.
Acute hepatitis C involves more short-term symptoms that typically last 6 months or less but acute hepatitis often leads to chronic hepatitis. When hepatitis C lasts longer than 6 months, its considered chronic.
Without treatment, you may have chronic hepatitis your whole life, since your body often cant get rid of the virus easily. Some people do get better without treatment, although treatment can go a long way toward improving the outlook.
Hepatitis C wont necessarily become chronic.
As a matter of fact, for anywhere from 15 to 45 percent of people with acute hepatitis C, the virus will clear up without treatment. In other words, if you dont have any symptoms, hepatitis C could improve on its own before you ever know you have it.
However, if your body cant get rid of the hepatitis C virus, the infection wont go away. Instead, it will become chronic, or long-term.
Experts arent sure why some people develop the chronic form of the disease and others dont. But more than half of all people with the hepatitis C virus will eventually develop the chronic form, according to the
Since hepatitis C symptoms can resemble those of other health conditions, your symptoms alone if you have any may not make it clear that you have hepatitis C.
A doctor or other healthcare professional may recommend getting tested if you:
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How Is Hepatitis C Transmitted
Because HCV is primarily spread through contact with infected blood, people who inject drugs are at increased risk for HCV infection. HCV can also be transmitted from an infected mother to child at the time of birth, from unregulated tattoos or body piercings, and from sharing personal items that may be contaminated with infected blood, even in amounts too small to see. Much less often, HCV transmission occurs through sexual contact with an HCV-infected partner, especially among people with multiple sex partners and men who have sex with men. Currently in the United States, health care related transmission of HCV is rare, but people can become infected from accidental needle sticks and from breaches in infection control practices in health care facilities.
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
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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.”
How Do You Prevent Hepatitis C
Researchers have yet to develop a vaccine that prevents hepatitis C .
Just as you might not know you have hepatitis C, other people with the condition may not know they have it, either. But you can take a few key precautions to avoid contracting it:
- Avoid sharing needles.
- When getting piercings or tattoos, check to make sure the piercer or tattoo artist uses only sterile, unopened needles and ink.
- Avoid sharing nail clippers, razors, and toothbrushes.
- Use sterile gloves when caring for someone elses wound.
Since hepatitis C is transmitted through blood, you wont get it by sharing food and drinks with someone who has the condition or by hugging, touching, or holding hands.
Hepatitis C is not commonly transmitted through sexual contact. But using a condom or another barrier method when having sex can always help lower your chances of contracting a sexually transmitted infection.
Keep in mind that you can contract hepatitis C again, even if youve had it already.
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But Even If You’ve Been Cured It Can Have Lifelong Health Implications
“Hepatitis C is a lot more than just a liver disease,” Reau says. “It has been associated with many medical conditions, such as an increased risk of developing diabetes, kidney disease and cancer.”
While curing hepatitis C significantly reduces the risk of serious complications, like liver failure, liver cancer and the need for transplantation, it doesn’t completely eliminate the health risks associated with the disease.
“Hep C is linked to scarring of the liver or cirrhosis and the more scar tissue that develops, the greater the likelihood of complications,” Reau says. “If there is a lot of scarring, you will need lifelong monitoring.”
Reau also recommends leading a healthy lifestyle to help prevent re-infection and further liver damage: Limit alcohol consumption, control your weight, avoid high-risk activities and manage diabetes if you have it.
It’s Different Than Hepatitis A And B
Each form of hepatitis has its own specific virus that spreads and is treated differently. “Hepatitis simply means inflammation of the liver, or that the virus has an affinity for hurting the liver,” Reau says.
- Hepatitis A is an acute, short-term infection that often does not require treatment.
- Hepatitis B hides deep in the body and, like hepatitis C, is treated in a variety of ways, from antiviral medications to liver transplants.
“The viruses are different, but all of them should be taken very seriously since they can lead to significant liver disease and even death,” she adds.
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Baby Boomers Are Especially Vulnerable
“The hepatitis C virus didn’t have a name or a screening test until in 1989,” Reau says. “That means people born between 1945 and 1965, the group referred to as ‘baby boomers,’ are at highest risk of infection. They grew up before health care facilities started taking standard precautions, like not sharing vials of medicine among patients and requiring staff to wear gloves.”
The CDC reports that baby boomers are five times more likely to have Hepatitis C than other adults, accounting for 75% of those living with the disease.
These are some other reasons you may be at risk:
- You have engaged in high-risk behaviors like IV drug use or unprotected sex
- Your biological mother has/had hepatitis C
- You received blood transfusions, an organ transplant or dialysis before 1989
- You were or are currently incarcerated
Chronic Hepatitis C: What Are The Signs And Symptoms
Even when an acute infection becomes chronic, it can be years before a person receives a diagnosis, thus delaying treatment. In fact, the majority of people with chronic hepatitis C are asymptomatic until the liver becomes severely damaged, often decades after exposure, says Dr. Adalja.
Its common for people to unknowingly carry HCV until they go through a blood screening or other examination for reasons unrelated to hepatitis C.
However, chronic hepatitis C is a serious issue that can result in long-term health problems, including liver damage, liver cancer, liver failure, and death.
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Symptoms Of Hepatitis B Virus
Symptoms for acute hepatitis B virus typically appear about 1 to 4 months after exposure and may resemble the flu. Most people with acute hepatitis B develop no symptoms. Symptoms may include:
Symptoms from liver involvement can include:
- dark urine
- clay-colored stools
- yellow-colored skin or eye sclera
Chronic hepatitis B is a lifelong infection and occurs in about 5% of patients who contract the virus. Infants and children are more likely to develop a chronic hepatitis B infection, but symptoms may not appear as frequently.
Up to 25% of people who develop chronic infection will develop serious liver conditions, such as cirrhosis , liver failure, or liver cancer.
Those with chronic hepatitis B do not typically have symptoms or feel ill, and can remain symptom free for 30 years or more. If symptoms appear, they are similar to the symptoms of acute infection listed above, but can be at a more advanced stage of liver impairment.
Acquiring hepatitis B during international travel is a possibility in certain regions, so review the CDC guidelines and talk to your doctor for recommendations before travel. If you know you have been exposed to hepatitis B, contact your doctor immediately within 24 hours as you may be able to receive a preventive treatment
Hepatitis C And Injecting Drugs
If you inject drugs, avoid sharing needles, syringes or other equipment such as tourniquets, spoons, swabs or water.
Where possible, always use sterile needles and syringes. These are available free of charge from needle and syringe programs and some pharmacists. To find out where you can obtain free needles, syringes and other injecting equipment, contact DirectLine
Try to wash your hands before and after injecting. If you cant do this, use hand sanitiser or alcohol swabs from a needle and syringe program service.
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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
Chronic Hepatitis C Symptoms
If you donât get diagnosed and treated, you could have the disease for years and not know it. Doctors call this the chronic form, because it lasts a long time. Some people who’ve had it for a while get scarring of the liver, which is called cirrhosis. or liver cancer.
In addition to the above symptoms, signs that your liver isnât working the way it should include:
- Ascites — fluid buildup in your belly
- Easy bleeding
- Hepatic encephalopathy — confusion, drowsiness, and slurred speech
- Jaundice of the skin
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Symptoms Of Hepatitis C Virus
Symptoms for HCV may not appear for 20 to 30 years, and that is why it is so important to get tested. The U.S. Centers for Disease Control now recommends that all adults 18 years and older are tested at least once for HCV. Some high risk groups may need more frequent testing, and all pregnant women should be tested during every pregnancy.
HCV can actually clear itself from the body in about 15% of people, but most people become infected with the virus chronically.
Early symptoms of acute HCV occur within 1 to 3 months and may last several weeks. These may include:
- yellow-colored skin or eye sclera
- nausea and stomach pain
- joint or muscle pain
Chronic, long-term symptoms of HCV can include weight loss, fluid build-up and swelling, poor appetite, fatigue, easy bruising and bleeding, itchy skin, jaundice, dark-colored urine, confusion, drowsiness and slurred speech , and spider-like blood vessels on the skin .
What Drugs Treat And Cure Hepatitis C
The treatment of chronic hepatitis C has gone through several generations of medications. Not long ago, treatment was limited to interferon alpha-2b or pegylated interferon alpha-2b , and ribavirin . Interferon and pegylated interferon need to be injected under the skin , while ribavirin is taken by mouth. This combination therapy is infrequently used today, being recommended for only the least common genotypes of hepatitis C virus .
Since 2010, direct-acting antiviral drugs have been in use. The second generation of antivirals for HCV was the protease inhibitors telaprevir and boceprevir , both taken by mouth. These were used in combination with the earlier drugs to increase effectiveness . These drugs are also no longer in common use, and have been replaced by better options.
As more has been learned about how hepatitis C virus multiplies within the liver cells, new drugs continue to be developed to interfere with this multiplication at different stages. As such, we no longer think in terms of generations of drugs, but rather categories of action. Research and development of these direct-acting antivirals continue, with new agents coming to market every few months. Each category is improved and expanded by the addition of new drugs, which are safer and more effective.
Currently available and commonly used direct-acting antiviral drugs include:
- Muscle aches
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Symptoms Of An Acute Infection
Few people show symptoms during acute infection . These symptoms can include: fatigue tenderness or an aching feeling on the right side of the abdomen decreased appetite perhaps with weight loss flu-like symptoms nausea tendency to bruise or bleed easily jaundice rash dark-coloured urine and light or clay-coloured stools. These symptoms often go away after a short time.
How Is Hepatitis C Diagnosed
Symptoms alone generally dont offer enough information for a doctor to diagnose hepatitis C. Whats more, you might not have symptoms or notice any signs of the condition.
Thats why its so important to connect with a doctor or other healthcare professional and ask about getting tested if youve been exposed to the hepatitis C virus.
The also recommend hepatitis C testing for people who have abnormal liver tests, along with those who are:
- on hemodialysis
A healthcare professional can order a few different tests to help diagnose hepatitis C. These include:
- Blood tests. They may order a series of blood tests to check for the virus, starting with a hepatitis C antibody test. A PCR test can tell your healthcare professional whether the virus is currently active, and viral load testing can measure the amount of virus in your blood.
- Genotype test. This test can reveal which hepatitis C genotype you have. This information will help your healthcare professional find an effective treatment approach.
- Liver function test. If blood test results suggest chronic hepatitis C or your healthcare professional believes you could have liver damage, theyll order a liver function test. This test checks your blood for signs of heightened enzymes from your liver.
- Liver biopsy.This procedure can also help check for liver damage. A biopsy involves taking a small piece of tissue from your liver and testing it for cell abnormalities.
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