Incomplete Or Failed Response To Treatment
Some people with autoimmune hepatitis have an incomplete response to treatment, meaning that treatment helps but does not lead to remission. If you have an incomplete response to treatment, you may need to take different medicines to help prevent liver damage.
Some people may fail to respond to treatment, meaning that the inflammation and liver damage of autoimmune hepatitis keep getting worse. Your doctor may recommend additional blood tests and higher doses of medicines. If liver damage leads to complications, you may need treatment for complications.
Medication Regimens According To Hcv Genotype
The good news is that there are now more medications available to treat Hepatitis C than ever before. Based on your medical history, physical exam, laboratory and other test results, your healthcare provider will suggest which medications are right for you, as well as determine the length of time you need to be treated. This decision will depend upon a number of factors including:
- Your Hepatitis C virus genotype
- Whether or not you have cirrhosis, and if its mild or severe
- If youve received treatment before and which medications were used
- If youre waiting for or youve already had a liver transplant
- Other health conditions you may have
Treatment regimens are usually 8 to 24 weeks, but sometimes longer, depending on your particular circumstances.
What follows is a basic outline of recommended treatment protocols organized by HCV genotype. HCV genotypes are 1 , 2, 3, 4, 5, and 6. About 75% of the people with HCV in the U.S. have either genotype 1a or 1b. Between 10% 20% of people with HCV in the U.S. have either genotype 2 or 3.
Use this information as a starting point to talk with your healthcare provider about which treatment protocol is best for you. Keep in mind that these are general guidelines and they do not cover alternative treatment protocols or special situations. Its important to follow your healthcare providers instructions regarding what, when, how and for how long to take your medication, as this will depend upon your specific circumstances.
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
Next:
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Should I Be Screened For Hepatitis C
Doctors usually recommend one-time screening of all adults ages 18 to 79 for hepatitis C. Screening is testing for a disease in people who have no symptoms. Doctors use blood tests to screen for hepatitis C. Many people who have hepatitis C dont have symptoms and dont know they have hepatitis C. Screening tests can help doctors diagnose and treat hepatitis C before it causes serious health problems.
When Should You See A Doctor Or Other Healthcare Professional
Since so many people dont experience any symptoms, healthcare professionals recommend getting screened for hepatitis C at least once in your adult life. They may recommend more frequent screenings if you have a higher risk of contracting the virus.
Hepatitis C doesnt always become severe, but the chronic form can increase your risk for liver damage, liver cancer, and liver failure.
If you have any symptoms that suggest hepatitis C, especially if theres a chance youve been exposed, connect with a doctor or another healthcare professional as soon as possible to discuss your options for testing and treatment.
With a prompt diagnosis, you can get treatment earlier, which may help prevent damage to your liver.
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Hepatitis B During Pregnancy
If a woman with HBV becomes pregnant, they may transmit the virus to their baby. Women should inform the doctor who delivers their baby that they have HBV.
The infant should receive an HBV vaccine and HBIG with 1224 hours of birth. This significantly reduces the risk that they will develop HBV.
The HBV vaccine is safe to receive while pregnant.
People with a high risk of HBV include:
- the infants of mothers with HBV
- the sexual partners of people with HBV
- people who engage in sexual intercourse without contraception and those who have multiple sexual partners
- men who have sex with men
- people who inject illicit drugs
- those who share a household with a person who has a chronic HBV infection
- healthcare and public safety workers who are at risk of occupational exposure to blood or contaminated bodily fluids
- people receiving hemodialysis, which is a type of kidney treatment
- people taking medications that suppress the immune system, such as chemotherapy for cancer
- those who come from a region with a high incidence of HBV
- all women during pregnancy
People can prevent HBV infection by:
- wearing appropriate protective equipment when working in healthcare settings or dealing with medical emergencies
- not sharing needles
- following safe sexual practices
- cleaning any blood spills or dried blood with gloved hands using a 1:10 dilution of one part household bleach to 10 parts water
A vaccine against HBV has been available since 1982.
People who should receive this vaccine include:
Natural Remedies For Treating Hepatitis C
One of the most disturbing aspects of the disease hepatitis C is that many people carrying the infection dont know they have it . . . until it attacks their liver. That can result in a debilitating condition for the patient because the liver is key to regulating your bodys digestive system and flushing toxins from the body. If left untreated, hepatitis C can eventually lead to death.
Per natural-homeremedies.com, citing statistics from the World Health Organization, between 130 and 150 million people worldwide have been diagnosed as having the disease, with about 350,000 a year dying from it. Its a contagious disease caused by a virus most commonly transmitted through the contact of one infected persons blood with another person, and, less commonly, through transfer of semen or saliva, per healthline.com.
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Talking To Your Healthcare Professional About Treatment
Before visiting your healthcare professional to discuss treatment options, its a good idea to prepare a list of questions so that you make the best use of your time during the appointment. Some questions to ask include:
- How much Hepatitis C virus do I have in my body?
- What is my genotype?
- Has the virus damaged my liver?
- With treatment, can I be cured of the Hepatitis C virus?
- What treatment options are available?
- What are the benefits and risks of each option?
- Do I have any conditions that affect my options?
- Which option do you think is best for me and why?
- How long will treatment last?
- What side effects will I have? Are the side effects different between the treatment options?
- Will my past medical history have any impact on how I will react to the different treatments ?
- How will treatment affect my daily life?
- Will treatment affect my ability to work?
- What will the treatment cost and will my insurance cover it?
- What else can I do to keep healthy and minimize damage to my liver?
- What is the next step?
What Are The Symptoms
Most people have no symptoms when they are first infected with the hepatitis C virus. If you do develop symptoms, they may include:
- Feeling very tired.
- Sore muscles.
- Dark urine.
- Yellowish eyes and skin . Jaundice usually appears only after other symptoms have started to go away.
Most people go on to develop chronic hepatitis C but still dont have symptoms. This makes it common for people to have hepatitis C for 15 years or longer before it is diagnosed.
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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.
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.
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Eat Regular Nutritious Meals
Sometimes people with hepatitis C have a hard time eating. You may have no appetite, feel nauseated, or have different tastes than you are used to. Even if you dont feel like eating, its very important to eat small meals throughout the day. Some people have nausea in the afternoon. If this happens to you, try to eat a big, nutritious meal in the morning.
If you have cirrhosis, it may not be a good idea to eat salty foods or foods that are high in protein. If you want to know more about which foods to avoid and which foods are good to eat, ask your doctor about meeting with a registered dietitian to discuss a healthy eating plan.
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Causes Of Hepatitis C
You can become infected with hepatitis C if you come into contact with the blood of an infected person.
Other bodily fluids can also contain the virus, but blood contains the highest level of it. Just a small trace of blood can cause an infection. At room temperature, it’s thought the virus may be able survive outside the body in patches of dried blood on surfaces for up to several weeks.
The main ways you can become infected with the hepatitis C virus are described below.
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Medical Treatment For Hepatitis A B & C
Treatment for hepatitis A, B, or C is based on which type of hepatitis is present in the bloodstream and the severity of the resulting liver damage. Depending on the results of diagnostic tests, our specialists at NYU Langone may recommend antiviral medication to stop the virus from replicating and protect your liver from further damage.
How Can I Protect Myself From Hepatitis C Infection
If you dont have hepatitis C, you can help protect yourself from hepatitis C infection by
- not sharing drug needles or other drug materials
- wearing gloves if you have to touch another persons blood or open sores
- making sure your tattoo artist or body piercer uses sterile tools and unopened ink
- not sharing personal items such toothbrushes, razors, or nail clippers
Hepatitis C can spread from person to person during sex, but the chances are low. People who have multiple sex partners, have HIV or other sexually transmitted diseases, or who engage in rough or anal sex have a higher chance of getting hepatitis C. Talk with your doctor about your risk of getting hepatitis C through sex and about safe sex practices, such as using a latex or polyurethane condom to help prevent the spread of hepatitis C.
If you had hepatitis C in the past and your body fought off the infection or medicines cured the infection, you can get hepatitis C again. Follow the steps above, and talk with your doctor about how to protect yourself from another hepatitis C infection.
If you think you may have been exposed to the hepatitis C virus, see your doctor as soon as possible. Early diagnosis and treatment can help prevent liver damage.
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What About Complementary Therapies
Some people seek out complementary or alternative ways to treat their Hepatitis C. Complementary and alternative medicine, known as CAM, includes a variety of interventions. Some common complementary therapies include the following:
Relaxation techniques, such as meditation and visualization
- These focus on how a persons mind and imagination can promote overall health and well-being.
Physical techniques, such as massage, yoga, and tai chi
- These focus on using a persons body and senses to promote healing and well-being.
Herbal medicine
- These are substances that come from plants. They can be taken from all parts of a plant, including the leaves, roots, flowers and berries.
These therapies, which are based on different traditions and disciplines, are generally considered to be outside the realm of conventional Western medicine. When used with conventional medicine, they are referred to as complementary. When used instead of conventional medicine, they are considered alternative.
Generally, physical and relaxation therapies are safe. However, some complementary medicines can be dangerous, particularly for people who have liver disease. Many people use complementary medicines because they believe that its natural and therefore healthy and harmless. But natural does not equal healthy or safe. Poison ivy is natural, but its certainly not harmless.
For more detailed information about Hepatitis C and complementary therapies, you can visit the NCCIH website.
How Will My Provider Monitor Me During The Treatment
Your provider will meet with you during treatment to review how well you are tolerating treatment and review laboratory results. Laboratory tests help keep tabs on your health, track the viral load, and determine your response to treatment. You will be given specific dates to go get your blood tested at the lab during and after the treatment.
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What Causes Hepatitis C Infection
Hepatitis C is caused by the hepatitis C virus. It is spread by contact with an infected persons blood.
You can get hepatitis C if:
- You share needles and other equipment used to inject illegal drugs.
- You had a blood transfusion or organ transplant before 1992. Since the early 1990s, all donated blood and organs are screened for hepatitis C in Canada.
- You get a shot with a needle that has infected blood on it. This happens in some developing countries where they use needles more than once when giving shots.
- You get a tattoo or a piercing with a needle that has infected blood on it. This can happen if equipment isnt cleaned properly after it is used.
In rare cases, a mother with hepatitis C may spread the virus to her baby during pregnancy or childbirth, or a health care worker may be accidentally exposed to blood that is infected with hepatitis C.
The risk of getting hepatitis C through sexual contact is very small.footnote 1 The risk is higher if you have many sex partners or you engage in unprotected sexual activity that may involve contact with blood or an exchange of blood with an infected person . The presence of HIV or other sexually transmitted infections also increases the chances of getting hepatitis C sexually.
You cannot get hepatitis C from casual contact such as hugging, kissing, sneezing, coughing, or sharing food or drink.
How Can I Prevent Spreading Hepatitis C To Others
If you have hepatitis C, follow the steps above to avoid spreading the infection. Tell your sex partner you have hepatitis C, and talk with your doctor about safe sex practices. In addition, you can protect others from infection by telling your doctor, dentist, and other health care providers that you have hepatitis C. Dont donate blood or blood products, semen, organs, or tissue.
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What Does It Mean To Have A Successful Treatment What Is A Sustained Virologic Response
In an untreated state, the hepatitis C virus infects the cells of the liver and then continuously lives there, making copies of itself that circulate in the bloodstream. Antiviral medications can destroy the ability of the virus to reproduce, so the amount of virus in the bloodstream then decreases. The amount of virus in the blood is measured by aviral load.
Treatment is successful when the viral load drops toundetectablelevels, which means the virus cannot be detected in the bloodstream at all. The viral load becomes undetectable during treatment and remains undetected after treatment has ended. If there is still no detectable virus in the blood 12 weeks after the end of the treatment, the treatment was successful. This is called a Sustained Virologic Response .
A patient who has achieved an SVR is considered to be cured of the hepatitis C virus.
Spread Of Hepatitis C
Hepatitis C is spread through blood-to-blood contact when blood from a person with hepatitis C enters another persons bloodstream.
The most common way people become infected with hepatitis C in Australia is by sharing injecting equipment such as needles, syringes, spoons and tourniquets. It is possible to be infected with hepatitis C after only one risk event.
Hepatitis C may also be spread through:
- tattooing and body piercing with equipment that has not been properly cleaned, disinfected or sterilised such as backyard tattoos’. Registered parlours with appropriate infection control procedures are not a risk
- needlestick injuries in a healthcare setting
- receiving blood transfusions in Australia prior to 1990 before hepatitis C virus testing of blood donations was introduced
- medical procedures, blood transfusions or blood products and mass immunisation programs provided in a country other than Australia
- pregnancy or childbirth there is a 5% chance of a mother with chronic hepatitis C infection passing on the virus to her baby during pregnancy or childbirth.
Breastfeeding is safe, however if nipples are cracked or bleeding cease breastfeeding until they have healed.
Less likely possible routes of transmission of hepatitis C include:
Hepatitis C cannot be transmitted by:
- kissing
- sharing food, cups or cutlery
- shaking hands or day-to-day physical contact.
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