Understanding Hepatitis C

 

 

Know the facts:

  • Hepatitis C is an infection that is caused by the hepatitis C virus (HCV).
  • About 70 million people worldwide and 2.4 million people in the United States are infected with HCV.
  • HCV can spread from 1 person to another by having direct contact with an infected person’s blood and bodily fluids such as urine, poop and vomit.
  • The number of hepatitis C cases is getting higher in the United States because of the opioid epidemic. This is important to know to help stop the spread of HVC.
  • More than half of the people who are infected do not know that they have hepatitis C.
  • HCV can cause liver disease (cirrhosis, liver cancer) and may make other health problems get worse.
  • About 400,000 people die every year from problems connected with having hepatitis C.
  • The CDC says that that everyone over the age of 18 should get tested at least once for HCV. Testing every year is a very good idea for people who are at high risk, for example IV drug users or people who have more than 1 sexual partner.
  • Medicines are over 95% effective (successful) at curing hepatitis C.
  • If you had hepatitis C, there is no way to keep from getting it again (called immunity). You must protect yourself from getting infected again.

Symptoms of hepatitis C: Most people have no symptoms. Later in life, they might find out that they have liver disease. Hepatitis C may cause or make worse other health problems.

 

Symptoms of liver disease:

  • Flu-like symptoms such as fatigue, nausea, vomiting, diarrhea, sore muscles or joints.
  • Sore feeling in the upper right part of your belly.
  • Yellow color in skin and eyes (jaundice).
  • Swelling in the belly.
  • Itching.
  • Confusion.
  • Abnormal bleeding.
  • Dark yellow to brown urine.
  • Light-colored poop (gray or clay color).

 

Other health problems that may be linked to HCV:

  • Long-lasting (chronic) fatigue.
  • Depression.
  • Trouble with memory or thinking.
  • Kidney disease.
  • Cardiovascular disease.
  • Inflammatory, autoimmune disorders.
  • Skin rash.
  • Type 2 diabetes.
  • Insulin resistance.
  • Certain kinds of cancer.

 

How HCV spreads from 1 person to another.

HCV spreads by coming into direct contact with an infected person’s blood. For example, if you have ever:

  • Use an infected needle. This can happen with IV drug use, tattoos, acupuncture or body piercing.
  • Were stuck with a needle by accident in the hospital.
  • Share personal care items (such as razors) with a person who has HCV.
  • Have sex without using a condom with an infected person (a less common cause).
  • Had a blood transfusion several years ago (blood is now screened for HCV).
  • Shared drug tools with an infected person (like snorting straws).
  • Have ever been in jail. Infection can be common in prison.

 

How to stop the spread of HCV.

There is no vaccine that you can take to protect yourself from getting hepatitis C. It is up to you to keep others safe. Some important tips to stay safe:

  • Cover any breaks you have in your skin and any sores. If someone helps you, they should wear latex gloves.
  • Use condoms during sex.
  • Do not donate blood, plasma or sperm if you have or are at high risk of getting HCV.
  • Do not share personal items such as needles, razors, toothbrushes or manicure tools.
  • Hepatitis C can stay alive on surfaces outside the human body for up to 4 days at room temperature.
  • Clean any blood spills using a solution made of 1-part household bleach mixed with 10 parts water. Be sure to wear gloves when cleaning.

Most of the time, HCV is found during routine blood tests to check your liver, or after you donate blood. If you find out that you have hepatitis C, you will need to be checked for liver disease. Talk with your doctor to decide if you need to have any treatment.

Hepatitis C can be a short-term (acute) or long-term (chronic) illness. Acute hepatitis C often goes away without treatment. With new treatments, chronic hepatitis C can be cured in most people.

 

Treating Hepatitis C

Follow up with your doctor regularly.

Hepatitis C can get worse and hurt your liver without you knowing it. Talk to or visit your provider and health care team often so they can watch your condition. You may need to have some lab tests while you are on the medicine treatment and after you are done with the treatment. If you have more advanced liver disease, you will still need to follow up with your doctor to watch how the disease progresses and check for any complications.

 

Take the medicines your doctor gives you.

 

Many times, you must take medicine to cure (or get rid of) hepatitis C. The medicine is taken by mouth for 8 to 24 weeks. It must be taken at the same time every day. You cannot miss a day. Hepatitis C medicines do not usually have side effects, but you may have a mild headache and fatigue (feel very tired) in the first few weeks of treatment. This is when your body is working hard to remove the virus from your body.

 

 

 

The CDC says that everyone with chronic liver disease should get the hepatitis A and B vaccine. This will lower your chance of getting a second form of viral hepatitis, which could make your liver disease get worse. Remember, unlike hepatitis C, hepatitis B cannot be cured.

 

Frequently Asked Questions (FAQs)

 

Can I still have sex?

Yes. Hepatitis C can be spread through sex, but this is not common unless blood is exchanged. Your partner is safest if you use a latex condom correctly every time you have sex. If you have only 1 partner, you may not need to change your habits.

 

Is hepatitis C contagious?

HCV can be spread through direct contact with infected blood, urine, vomit or poop. It is safe to touch or kiss a person who is infected. It is safe for an infected person to sneeze or cough around other people. It is also safe to share food. All these things are safe if there is no blood exposure.

Sharing anything that may have blood on it  (like a toothbrush, needles, sharps or razors) is not safe. Protect yourself by staying away from other people’s blood and any item that could have blood on it.

 

Is hepatitis C treatment expensive?

Hepatitis C medicines are paid for by most commercial and government insurance plans. If you do not have or lose your insurance, talk to your pharmacist about ways to help with the cost. The cost of medicine should never keep you from getting the treatment that is right for you.

 

Will my health get better after treatment?

Scarring of the liver (fibrosis) is permanent and will not go away. But, if you are cured, your liver may not be as inflamed as it was before. This may help you have better liver function. Other conditions that were caused or made worse by hepatitis C may also get better. Some of these conditions include:

 

  • Diabetes
  • Vascular disease
  • Kidney problems
  • Skin rash
  • Eye trouble
  • Thyroid disease

 

 

What if I am pregnant?

Hepatitis C medicines are not recommended for use in pregnant people. If you are pregnant, your doctor will probably tell you to wait to start treatment until after you have your baby. Your baby should get tested for hepatitis C at 18 months old.

 

 

What if I am breastfeeding?

There is not much data about the safety of hepatitis C medicines during breastfeeding and if they could harm your baby. Talk about the risks and benefits with your doctor. Breastfeeding with hepatitis C is safe unless your nipples are cracked or bleeding.

 

Is hepatitis C curable?

Over 95% of the time, hepatitis C can be cured with medicine taken by mouth for 8 to 24 weeks.

How long the treatment will take and the chance that you will be cured depend on:

  • Your past treatment experience (if you are resistant to the antiviral medicine).
  • Virus genotype.
  • Stage of liver disease.
  • How well you are able to follow your medicine plan.

It is important to take your medicine at the same time every day. This will give you the best chance of being cured. If you miss doses, this can make the treatment fail.

 

How will I know if I am cured?

Your doctor will order a blood test (hepatitis C viral load) that will be done 12 or more weeks after the end of treatment. If the viral load cannot be detected (found in the blood), then you are considered cured. Since the treatment is not 100% effective, it is important to follow up with your doctor to have this test to be sure you are not still infected.

 

 

If I am cured, can I be reinfected?

Yes. There is no vaccine for HCV. Even if you are cured, you can get the disease again.

 

Protecting Your Liver

Taking good care of yourself is the best way to prevent the health problems that have been linked to the hepatitis C virus (HCV). It is important to give your liver the best chance to be healthy that you can. This means you should stay away from things that can make liver damage worse.

 

Medicines and supplements:

Some medicines and herbal supplements can harm your liver. To protect yourself:

  • Check with your health care provider or pharmacist before taking anything that you buy over-the-counter. This includes all herbal medicines. The FDA does not control herbal medicines, so it may be hard to know which ones could harm your liver.
  • Make sure you tell any health care provider who prescribes medicine for you that you have hepatitis C.
  • If you have cirrhosis, talk with your provider about which medicines are safe. Do not take nonsteroidal anti-inflammatory drugs (NSAIDs) such as naproxen and ibuprofen. They can hurt your kidney if you have cirrhosis.

 

Do not drink alcohol.

Your liver must work hard to process alcohol. If you have HCV infection, drinking alcohol may make you more likely to get cirrhosis. You may also develop it faster. Doctors do not know if there is a safe amount of alcohol to drink. It is best for your health that you do not drink any alcohol.

 

Get tested.

Make sure you get tested for hepatitis A and hepatitis B. There are vaccines against them. Talk with your health care provider about getting these shots.

 

Stay healthy.

Your body’s immune system fights against infections. Your body can do this much better when you are healthy. Eating healthy foods and getting plenty of sleep will help keep your body strong. Also, try to stay positive and enjoy your life. Other ways you can help protect your liver are:

  • Staying at a healthy weight.
  • Keeping your blood pressure and cholesterol levels in a healthy range.
  • Controlling diabetes, if you have the disease.

 

How to contact your hepatitis C pharmacist:

Robin Bricker-Ford, PharmD, BCIDP, BCPS, AAHIVP UCHealth University of Colorado Hospital Hepatology and Infectious Diseases Clinic

720.848.2245                                                                           

Other hepatitis C resources:

  • Centers for Disease Control and Prevention (CDC)
  • American Association for the Study of Liver Disease (AASLD)
  • American Liver Foundation Offers discussion communities and listings of support groups by state: inspire.com/groups/american-liver-foundation

 

 

©2022, University of Colorado Hospital, Aurora

March  2022

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