Quiz: How Much Do You Know About Hepatitis C
The virus that causes hepatitis C wasn’t even discovered until 1989, but it has quickly earned a place among the most dangerous germs on earth. According to the National Institutes of Health , about 4 million Americans have been infected with the virus, which can cause a life-threatening illness. How much do you know about hepatitis C? Take this short quiz to find out.
1. A hepatitis C infection usually causes severe symptoms that are impossible to ignore.
True
2. Unlike other forms of hepatitis, hepatitis C is usually chronic .
True
3. Hepatitis C can take very different courses in different people.
True
4. Which of the following people is LEAST likely to develop hepatitis C?
a. Someone who has regular, unprotected sex with one partner
b. Anyone who has used dirty needles to inject drugs
c. Anyone who received a blood transfusion before 1992
d. Babies born to infected mothers
5. Many cases of hepatitis C occur for no apparent reason.
True
False
6. There is no vaccine for hepatitis C, and there probably won’t be for years to come.
True
1. A hepatitis C infection usually causes severe symptoms that are impossible to ignore.
The correct answer is: False
2. Unlike other forms of hepatitis, hepatitis C is usually chronic .
The correct answer is: True
3. Hepatitis C can take very different courses in different people.
The correct answer is: True
4. Which of the following people is LEAST likely to develop hepatitis C?
The correct answer is: True
References
What Is Hepatitis C
Hepatitis C is a liver infection caused by the hepatitis C virus . Hepatitis C is a blood-borne virus. Today, most people become infected with HCV by sharing needles or other equipment to inject drugs. For some people, HCV infection is a short-term or acute illness but for more than half of people who become infected with HCV, it becomes a long-term, chronic infection. Chronic HCV infection is a serious disease that can result in long-term health problems, even death. The majority of infected people might not be aware of their infection because they do not have any symptoms. There is no vaccine for hepatitis C. The best way to prevent HCV infection is by avoiding behaviors that can spread the disease, especially injecting drugs.
Fast Five Quiz: Are You Prepared To Confront Hepatitis C
Vinod K. Dhawan, MD
The onset of chronic HCV infection early in life frequently leads to less serious consequences and more favorable outcomes. Studies have shown a significantly higher estimated probability of fibrosis progression in patients who were infected with HCV at an older age .
Male gender is among the established clinical risk factors for rapid progression of hepatic fibrosis. Other risk factors include older age, excessive alcohol use, high body mass index, and hepatitis B virus or HIV co-infection.
Patients who acquire HCV infection via blood transfusion have double the risk for cirrhosis and HCC. In the past several decades, effective anti-HCV and HCV-RNA screening have sharply decreased the risk for transfusion-associated HCV infection in many countries, but older individuals may still have acquired HCV through blood transfusion.
Viral genotyping can be informative. The presence of hepatitis C genotype 3 as opposed to genotype 1 or 2 is associated with greater risk of developing steatosis, a faster rate of progression to cirrhosis, and increased risk of developing HCC. Studies have shown higher rates of hepatic steatosis, faster progression to cirrhosis, and higher rates of HCC among patients with genotype 3. Thus, close monitoring of disease progression in such patients is critical, and earlier consideration of HCV therapy for these genotypes may be warranted.
Learn more about the etiology and prognosis of HCV infection.
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Hepatitis C Signs And Symptoms
Much like with HIV and Hepatitis B, signs and symptoms for Hepatitis C are unreliable and may or may not be present. And why proper testing for all the above is the only sure-fire way to know if an infection is present.
Hepatitis C symptoms include, but are not limited to:
- Yellow skin, known as jaundice
- Yellowing eyes
- Fever
Treatment For Hcv Infection
Treatment for HCV infection is available. The role of treatment in acute infection is being evaluated and currently the existing data shows that response to 6 months of standard therapy with interferon in terms of absence of HCV RNA from serum is excellent and progression to chronicity is reduced. The recommended treatment for chronic HCV infection is a combination of a pegylated IFN alpha and ribavirin. The treatment duration depends on the genotype of the virus and it has two goals. The first is to achieve sustained eradication of HCV, that is, sustained virologic response , which is defined as the persistent absence of HCV RNA in serum for 6 months or more after completing antiviral treatment. The second goal is to prevent progression to cirrhosis, HCC, and decompensated liver disease requiring liver transplantation.
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Considerations For Hepatitis C Cases Who Were Transplant Recipients
With the availability of curative treatment for HCV infection, an increasing number of transplant recipients are receiving organs from anti-HCV and HCV-RNA positive donors . This can result in transmission of hepatitis C to the recipient, which is then treated with DAA agents . In some jurisdictions, these expected donor-derived HCV transmissions might represent a significant proportion of new acute HCV infections therefore, jurisdictions are encouraged to reach out to transplant facilities and discuss public health reporting of expected donor-derived HCV infections.
A listing of transplant facilities in the United States, including facility location and phone number, can be found on the OPTN websiteexternal icon . As these patients are already linked to testing and treatment, the infections should be notified to CDC as new acute cases. However, the jurisdiction need not investigate beyond indicating that the infection was donor-derived.
Typically, there are two outstanding questions that only the public health jurisdiction can answer: 1) Did the recipient have any behavioral or other risks for hepatitis C and 2) Does the jurisdiction have any ongoing investigations of health care-associated hepatitis C that might be related to this investigation?
Table 4-3. Considerations for hepatitis C cases who were organ transplant recipients*
| Organ Recipient Pre-transplant |
|---|
Ways To Catch Hepatitis C
Hepatitis C is passed on through infected blood. Most people in Europe who get hepatitis C are injecting drug users who have caught the infection by sharing contaminated needles. Hepatitis C can also be passed on by tattooing, body piercing and acupuncture, if these are done in unsterile conditions.
Pregnant women with hepatitis C may pass the infection on to their babies.
In the past, blood transfusions could be a way of catching hepatitis C. Now, all blood donors should be screened and all blood products tested to stop this from happening. People on renal dialysis may be at higher risk.
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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.
How To Prevent Hepatitis C
There is currently no vaccine for hepatitis C. Avoiding contact with infected blood is the only way to prevent the condition.
The most common way for people to contract hepatitis C is by injecting street drugs. Because of this, the best way to prevent hepatitis C is to avoid injecting.
Treatments can help many people quit. People in the U.S. can call the National Helpline for help with finding treatments.
If a person finds it difficult to stop, they can reduce the risk of contracting hepatitis C by never sharing drug equipment, ensuring a clean, hygienic environment, and always using new equipment, including syringes, ties, alcohol swabs, cottons, and cookers.
People who may come into contact with infected blood, such as healthcare workers and caretakers, should always wash the hands thoroughly with soap and water after any contact, or suspected contact, with blood. They should also wear gloves when touching another persons blood or open wounds.
People can also reduce their risk by making sure that any tattoo artist or body piercer they visit uses fresh, sterile needles and unopened ink.
The risk of contracting hepatitis C through sexual contact is low. Using barrier protection, such as condoms, reduces the risk of most sexually transmitted infections.
People who have hepatitis C can reduce the risk of transmitting it to others by:
There are many misconceptions about how hepatitis C spreads. People cannot transmit or contract the virus through:
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What Does A Negative Hcv Antibody Test Result Mean
A negative antibody test result usually means that the person has not been infected with hepatitis C .
The body needs at least two months to make antibodies. People with weakened immune systems are not always able to produce antibodies. This might happen in people with autoimmune disorders , HIV-positive people with a CD4 cell count below < 200 cells/mm3, and people taking immunosuppressants.
Sof As Line Of Treatment Of Chronic Hcv
SOF is pan-genotypic antiviral HCV-specific nucleotide inhibitor of viral NS5B polymerase that acts as chain terminator when incorporated as a substrate by RNA polymerase in the nascent HCV-RNA genome, leading to inhibition of viral replication which has a high barrier to resistance. SOF is taken at dose of 400 mg once daily oral, without relation to food intake. SOF is taken as prodrug which became active molecule by phosphorylation inside the hepatocytes. SOF is metabolized by dephosphorylation to convert the active molecule to inactive metabolite GS-331007. GS-331007 is excreted through the kidney but the dose modification of SOF is not required if creatinine clearance is 30 mL/min. In severe renal impairment and end stage renal disease SOF is not recommended. Dose adjustment is not recommended in patients with mild-to-severe hepatic impairment.
SOF treatment regimens without PegIFN should not be used for patients with genotype 1, 4, 5 or 6 HCV infection unless the HCV patients had contraindication for PegIFN. Patients with advanced liver fibrosis or cirrhosis, high baseline viral load, previous unresponsiveness to PegIFN and RBV combination therapy may need extended course for 24 wk.
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Facts About Hepatitis C
Hepatitis C is a liver disease caused by infection with the hepatitis C virus . HCV can cause both acute and chronic hepatitis infection, ranging in severity from a mild illness that lasts only a few weeks to a serious, lifelong illness resulting in cirrhosis and liver cancer.
The virus is mainly acquired by contact through broken skin with infectious blood. In Europe, the main route of HCV transmission is via injecting drug use as a result of sharing contaminated needles. More rarely, the virus can be transmitted sexually, in healthcare settings due to inadequate infection control practices or perinatally from an infected mother to the baby.
A silent disease with no symptoms
Most people with acute HCV infection do not have any symptoms. Those who develop chronic infection are often asymptomatic until decades after infection when symptoms develop secondary to serious liver damage.
Around 30% of people with chronic hepatitis C suffer from liver damage and a small number of those develop cancer. Hepatitis C is considered to be one of the leading causes of liver cancer and liver transplants in Europe.
HCV: no vaccine but a cure
The infection can be cured, especially if it is detected and treated with the appropriate antiviral drug combinations. Antiviral treatment can now cure over 90% of persons with HCV infection.
Risk Of Hcv Infection In Recipients Of Blood Transfusion
Prior to 1992, blood transfusions carried a high risk of HCV infection, approximately 15-20% with each unit transfused. In 1988, 90% of cases of posttransfusion hepatitis were due to NANBH viruses which was later found out to be due to HCV. The move to all-volunteer blood donors instead of paid donors had significantly reduced the risk of posttransfusion hepatitis to 10%. Screening of blood further reduced the rate of posttransfusion hepatitis C by a factor of about 10,000 to a current rate of 1 per million transfusions. The few cases that still occur are due to newly infected people donating blood before they have developed antibodies to the virus, which can take up to 6-8 weeks.
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Effective Treatments Are Available For Hepatitis C
New medication to treat for HCV have been approved in recent years. These treatments are much better than the previously available treatment because they have few side effects and do not need to be injected. There are several direct-acting antiviral HCV treatments that cure more than 95% of people who take them in 8 to 12 weeks. HCV treatment dramatically reduces deaths among people with HCV infection, and people who are cured of HCV are much less likely to develop cirrhosis or liver cancer.
Take Action! CDCs National Prevention Information Network Service Locator helps consumers locate hepatitis B and hepatitis C prevention, care, and treatment services.
Initial Hepatitis C Symptoms Are Often Mild Or Nonexistent
The illness occurs when people are exposed to blood that contains the hepatitis C virus by using contaminated needles, for example, or by getting a transfusion of blood that hasnt been screened for contaminants, according to the World Health Organization .
The first stage of infection, called acute hepatitis C, develops within six months of exposure to the virus. Most people dont look or feel sick at this point, according to the Centers for Disease Control and Prevention , but some people may experience symptoms, which include:
- Fatigue
- Sore muscles and joints
- Yellowish color in the eyes and skin
If these problems are caused by acute hepatitis C, they usually appear about six to seven weeks after the infection took place the incubation window for the hepatitis C virus ranges from two weeks to six months. For approximately 15 to 25 percent of people infected with hepatitis C, the virus clears up on its own, without treatment, the CDC reports, while the remainder of those infected develop whats known as chronic hepatitis C.
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I’m A Health Care Worker Who Was Recently Exposed To Hcv Is There Post
No. Immune globulin is not recommended for postexposure prophylaxis against HCV, and prophylactic antiviral therapy is also not recommended. However, following exposure, a health care worker should be tested for HCV antibody right away and at 6 months so that early HCV infection can be identified. Several studies suggest that interferon treatment begun early in the course of HCV infection is associated with a higher rate of cure however, further studies are needed to confirm this. There is no hepatitis C vaccine.
Virological Tools For Diagnosis
Virological diagnosis of HCV infection is based on two categories of laboratory tests, namely serologic assays detecting specific antibody to HCV and assays that can detect, quantify, or characterize the components of HCV viral particles, such as HCV RNA and core antigen . Direct and indirect virological tests play a key role in the diagnosis of infection, therapeutic decision-making, and assessment of virological response to therapy.
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Story Of Sughran Bibi Pakistan
Sughran Bibi is a 36-year-old mother who contracted hepatitis C virus following a blood transfusion. She lives in Bangla Mor, Shuja Abad,of the Multan district in the Punjab province of Pakistan.
Two years ago, Sughran Bibis child was delivered by caesarean section. She experienced severe anaemia during her pregnancy, and had to be transfused with blood during the surgery. Soon after the delivery, Sughran Bibi was diagnosed with HCV.
The diagnosis was particularly distressing for Sughran Bibi, as she had watched her mother suffer from HCV as well. The disease had a huge impact on her wellbeing: she experienced occasional memory loss, felt lethargic, and lost interest in her home andfamily. She consoled herself by relying on a local Ayurvedic expert and spent her few resources on treatments that did not relieve her sickness.
Starting in June 2017, HCV treatments were rolled out through primary and secondary health care departments in her province. Sughran Bibi was finally able to receive proper testing and treatment at her local clinic.
After 6 months of therapy, Sughran Bibi was cured of HCV infection. I am happy and thankful to the Hepatitis Control Programme, she said. Having completed her treatment, she feels rejuvenated and energized again.