What Is A Biopsy
A biopsy is a medical procedure. A tiny piece of liver is removed and examined to find out the extent of damage. It involves a large needle and local anesthetic, as well as some risk of bleeding. A pathologist looks at the piece of liver under microscopes to determine how much damage has occurred in the liver. This is a very useful test and used to be done very commonly. However, the procedure is done much less frequently than in the past. For most patients with hepatitis B and C, liver biopsy is not required. Today, other tests can be used to try to estimate the fibrosis in the liver.
How Do You Treat Hepatitis
Oral medications are taken to help treat the hepatitis C virus. They work in people with early and late stages of the disease. These medications also have few side effects.
“Prior to 2014, treatment for hepatitis C was intense and worked only half the time. Now, you can take one pill a day for eight to 12 weeks to get rid of the virus from your blood and eliminate the disease,” says Wolf. “Its literally a cure.”
If you are a baby boomer, ask your doctor about getting the one-time hepatitis C screening test. And, if you’re concerned about people in your life who are baby boomers, be sure to share this information with them, too. Spread the word on Facebook!
Who Should Get Tested For Hepatitis C
The CDC recommends that you get tested at least once no matter what. Definitely get screened if any of these things apply to you:
- You were born between 1945 and 1965.
- You use or inject drugs.
- You have ever injected drugs — even if it was just once or a long time ago.
- Youâre on kidney dialysis.
- You have abnormal alanine aminotransferase levels .
- You had a blood transfusion, blood components, or an organ transplant before July 1992.
- Youâve ever gotten clotting factor concentrates made before 1987.
- You received blood from a donor who later tested positive for hepatitis C virus.
- Youâre a health care worker, first responder, or have another job that exposes you to HCV-infected needles.
- You were born to a mother with HCV.
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Why Baby Boomers Should Get Tested For Hepatitis C
Syndicated columnist, NBC Today contributor and creator of SavvySenior.org
Dear Savvy Senior:
In the news last month there was a public health alert urging all baby boomers to get tested for hepatitis C. Is this really necessary, and if so, what are the testing and treatment procedures?
If you’re a baby boomer, getting tested for hepatitis C would be a wise decision because boomers are five times more likely to have this virus than other generations, and most people that have it don’t realize it. Those that are infected are at a very high risk of eventually developing liver cancer, cirrhosis or other fatal liver diseases. Here’s what else you should know.
CDC Recommendations The U.S. Centers for Disease Control and Prevention recently announced that all Americans born from 1945 through 1965 get a hepatitis C test. The reason is because baby boomers account for 75 percent of the 3 million or so hepatitis C cases in the U.S., even though they make up only 27 percent of the total population.
Most hepatitis C infections occurred in the 1970s and 1980s, before there were tests to detect them and before the nation’s blood supply was routinely screened for the virus.
If the test is negative, no further tests are needed. But, if the test is positive, you’ll need another test called HCV RNA which will show whether the virus is still active. This test runs between $100 and $250 if you’re not covered by insurance.
How Can I Cover Medication Costs
New therapies called direct-acting antivirals are effective and can achieve cures of over 90%. 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.
Talk with your healthcare provider about financial support that may be available.
Below are useful resources when looking for financial assistance:Private health insurance or drug plansIf you have private health insurance or a drug plan at work, you may be able to have the medication paid through your plan. Please consult your private health insurance or drug plan provider to see if your drug is covered.
Publicly funded plansEach provincial and territorial government offers a drug benefit plan for eligible groups. Some are income-based universal programs. Most have specific programs for population groups that may require more enhanced coverage for high drug costs. These groups include seniors, recipients of social assistance, and individuals with diseases or conditions that are associated with high drug costs. For more details, please contact your provincial or territorial health care ministry, or click on the appropriate link below.
Available Patient Assistance Programs for Hepatitis C treatment Holkira Pak Maviret
MerckCare Hepatitis C Program 1 872-5773 Zepatier
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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
- Loss of appetite
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.”
When To Get Tested
For screening: at least once when you are age 18 years or older when you are pregnant when you have risk factors for HCV infection, regardless of age
For diagnosis: when you may have been exposed to the hepatitis C virus, such as through injection drug use, or when you have signs and symptoms associated with liver disease
For monitoring: before, during, and after hepatitis C treatment
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Why Is It So Important To Take Hepatitis C Drugs Correctly
Taking any medicine correctly is extremely important. Taking medicines correctly means:
For hepatitis C drugs, these issues are especially important because, if a medicine is not taken correctly, it may not kill the virus completely. Then, because the virus has “seen” the drug, it learns how to mutate and change in ways that allow it to escape the drug and avoid getting killed off. This is called drug resistance.
Developing drug resistance is a serious issue. It means that the treatment may not work and that the patient may not respond to future treatments.
To prevent drug resistance, it is important to take any medication correctly, but especially DAAs such as Harvoni, Mavyret, Epclusa, and Zepatier.
Resistance can develop quickly. It is very important to take these new antiviral medications according to instructions, on schedule, and not to skip or reduce doses.
What Is The Treatment For Hcv
There are several drugs that can be used to treat HCV infection. Most commonly, a combination of drugs is used, and new drugs are under development. Before 2000, chronic HCV was curable in only 10% of cases. Now, treatments for HCV can cure over 90% of people with hepatitis C before late complications occur, but even those with advanced liver disease often respond to treatment. This increases the opportunity to intervene early and prevent HCV-associated deaths.
- According to the CDC, recent treatment guidelines recommend monitoring people with acute HCV but only considering treatment if the infection persists longer than 6 months.
- Chronic HCV is usually treated with a combination of drugs.
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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.
Should I Get Tested For Hepatitis C
Q.I have recently been hearing a lot about getting tested for hepatitis C. I don’t think I have any risk factors, but is this something I should consider?
A. Hepatitis C is a viral disease that causes inflammation of the liver. The CDC reports that 75% of all current cases of hepatitis C are in the baby boomer generation and many more are undiagnosed. The reason is that a vast majority of people have no symptoms, such as fatigue, muscle and joint pain, abdominal pain, and nausea.
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How Hepatitis C Is Diagnosed
To determine a hepatitis C diagnosis, your doctor will:
- Get your medical history .
- Perform a physical exam, especially checking for changes in skin color, swelling in your lower extremities, and tenderness in your abdomen.
- Order certain diagnostic blood tests.
The first diagnostic tool in the screening process is a blood test that screens for HCV antibodies proteins the body produces in response to the virus. An enzyme immunoassay is used to perform this test.
A negative result for the antibody test means that you’ve never had HCV in your blood, while a positive result means you were exposed to the virus at some point in your life. Up to a quarter of people spontaneously clear the virus from their blood within six months of contracting it.
Because EIA sometimes produces false-positive results, a test called recombinant immunoblot assay may be used to confirm that you have the HCV antibody. This test is not necessary for most patients, and it is more commonly performed by blood banks to check for the virus in donated blood.
A negative EIA result may just mean that your body has not yet produced the HCV antibody , and you may need to be tested again in a few months.
If you have a positive antibody test, your doctor will then use another blood sample to conduct a qualitative polymerase chain reaction test or a process called transcription-mediated amplification , which looks for the presence or absence of RNA of HCV in your blood.
Are There Supplements That Are Good For My Liver
If a person eats a balanced diet, they will normally get enough vitamins and minerals. People with liver disease should avoid taking large amounts of supplements or “mega-vitamins.” This is because the liver has to do extra work to process them. Your provider may put you on a general multivitamin without iron.
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Will The Baby Be Infected If The Mother Or Father Has Hepatitis C
The baby’s risk of becoming infected with hepatitis C in the womb varies, depending on whether the parent with hepatitis C is the father or the mother.
If the mother is infected, whether or not the father is infected, there is a 5% chance that the baby will be born with hepatitis C. The risk is the same regardless of whether the birth occurs by vaginal delivery or by cesarean section. The risk is higher if the mother is also living with HIV.
If the father has hepatitis C but the mother does not, the baby cannot become infected because a father cannot pass the virus directly to a baby. If the father first passes the virus to the mother through sex, then the baby possibly could be infected by the mother. However, the chance of the virus being transmitted both from father to mother and then from mother to baby is almost zero.
All children born to HCV-infected women should be tested for HCV infection. Testing is recommended using an antibody-based test at or after 18 months of age. Approximately 25-50 % infants with hepatitis C will clear the infection without any medical help by age 4. For those who become chronically infected, most have no symptoms .
If I Have Hepatitis C Infection Does This Mean I Am Going To Have Other Health Problems
Hepatitis C can cause scarring of the liver leading to cirrhosis and liver cancer. Other conditions have also been linked to hepatitis C and are known as extra-hepatic manifestations of hepatitis C. They include diabetes mellitus, arthritis, hypothyroid, and aplastic anemia among other conditions. Talk to your provider for more information.
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How Is Liver Damage Assessed
If you have hepatitis C, doctors can gauge the level of liver damage you’ve experienced. One useful diagnostic tool is called a hepatic function panel, a group of blood tests performed together that examine the levels of certain liver enzymes, bilirubin , and proteins circulating in the blood.
Higher-than-normal levels of the liver enzymes, indicate that your liver is damaged, possibly from cirrhosis or liver cancer.
Albumin may be low, and your total bilirubin levels may also be elevated.
Along with the hepatic function panel, your doctor may also order two other tests: one test to determine the levels of the liver enzyme gamma-glutamyl transpeptidase in your blood, and a prothrombin time test that measures how well your blood clots.
A liver biopsy, in which a liver tissue sample is removed with a thin needle inserted through your skin and into your liver, can provide more details about the amount of scarring and damage HCV has caused.
Your doctor may also order an imaging test, such as a computerized tomography scan, magnetic resonance imaging , or ultrasound, to see if your hepatitis C has caused liver cancer, a possible complication of hepatitis C.
Additional reporting by Deborah Shapiro.
Can I Drink Alcohol Once In A While If I Have Hepatitis C
Alcohol can clearly contribute to worsening liver disease. You must discuss with your health care provider if any amount of alcohol is safe for you.
Alcohol can cause inflammation and scarring in the liver. If you have any underlying liver condition, such as hepatitis C or hepatitis B or damage from long-term alcohol use, your liver will be more sensitive to alcohol. When you have hepatitis C virus, alcohol on top of the hepatitis C can cause the inflammation and scarring to be worse, and overall damage to the liver may happen much faster when you drink alcohol.
Here is some helpful information about alcohol and hepatitis:
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What Are The Tests For Hepatitis C
There are two blood tests needed to diagnose hepatitis C:
The antibody test–called HCV antibody, HCV Ab, or anti-HCV–is done first. If this test is positive, it means that you have been infected with hepatitis C at some point in the past. If your antibody test is negative, then you have never been infected with hepatitis C if you were infected within the past month or so, the test may not be accurate you may needed to be retested at a later date.
However, a positive antibody test does not tell you if you still have hepatitis C. For that, you need to have a HCV RNA test, which determines whether the virus itself is in the bloodstream.
If any RNA is present in the blood after 6 months from time of infection, then you have chronic hepatitis C.
If no RNA is detected in the blood after 6 months, you no longer have hepatitis C.
Awareness Prevention And Early Diagnosis Are Essential
There’s a good reason why hepatitis C is known as a “silent killer.”
According to the U.S. Centers for Disease Control and Prevention, an estimated 3.2 million Americans live with chronic hepatitis C infection, which is transmitted through infected bodily fluids like blood and semen, and causes inflammation of the liver. Yet up to 75% of people who have hepatitis C aren’t aware they have it.
Most of those living with the virus experience only mild symptoms or don’t have any symptoms at all until they develop serious liver damage or another life-threatening liver disease. Unfortunately, that means they aren’t getting diagnosed and treatment is delayed until the later stages when irreversible liver damage has occurred.
Here, hepatologistNancy Reau, MD, associate director of the Solid Organ Transplant Program at Rush University Medical Center, explains who is at risk for hepatitis C and offers advice to help you protect yourself.
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