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Understanding Hepatitis C -- Diagnosis and Treatment

How Do I Know If I Have Hepatitis C?

Because hepatitis C doesn't always cause symptoms, you may not know you have the virus. Routine screening for hepatitis C is not typically performed unless you think you have come in to contact with a person infected with hepatitis C or if you were born between 1945 and 1965 (baby boomer screening). If you think you may have hepatitis C, your health care provider can test for it with a blood test. 

The CDC recommends that you have a blood test for hepatitis C if any of the following are true:

  • You have been notified that you received blood from a donor who later tested positive for the disease.
  • You have ever injected drugs, even once many years ago.
  • You received a blood transfusion or an organ transplant before July 1992.
  • You received a blood product used to treat clotting problems that was made before 1987.
  • You were born between 1945 and 1965 (baby boomer screening).
  • You have had long-term kidney dialysis.
  • You have signs or symptoms of liver disease.
  • You have HIV or hepatitis B.
  • You were born to a hepatitis C-positive mother.

If you are found to have hepatitis C, your health care provider may also perform a liver biopsy, or tissue sample, to determine the extent of liver damage. A liver biopsy is commonly performed by inserting a needle into the liver and drawing out a fragment of tissue, which is then sent to a laboratory to be analyzed.

What Are the Treatments for Hepatitis C?

If treatment is necessary, hepatitis C is typically treated with a combination of drugs for many months. A typical regimen would likely include some form of interferon, such as peginterferon (an injectable drug) and ribavirin. The latest evidence shows that peginterferon and ribavirin are more effective than standard interferon and ribavirin. 

The latest drugs approved to treat hepatitis C are Olysio (simeprevir) and Sovaldi (sofosbuvir). Olysio and Sovaldi are combined with the older drugs interferon and ribavirin. This combination is quickly becoming the new standard for treating hepatitis C. Taking these combinations has increased cure rates for people with type 1 hepatitis C (the most common form in the U.S.) from less than 50% to between 68% and 75%. Also, some patients have been able to stop treatment in as little as 24 weeks. 

Incivek and Victrelis are also approved as add-on therapy that can boost the chances that hepatitis C will be cured. They both target the HCV protease enzyme, making it nearly impossible for the virus to replicate. Although the virus quickly becomes resistant to either drug used alone, combination therapy with interferon and ribavirin keeps HCV in check. Also, it should be noted that the FDA has warned that Victrelis may interact with certain HIV drugs. 

Treatment requires close monitoring with frequent blood tests and may require additional medications to combat side effects. Treatment is usually provided by someone experienced with treatment of hepatitis C, such as a hepatologist or infectious diseases specialist. However, due to the increasing number of people infected with Hepatitis C, more and more primary care doctors are being trained to manage Hepatitis C. 

If you have hepatitis C, avoid alcoholic beverages and medications that may put added strain on the already injured liver. You may also want to get vaccinated for hepatitis A and B, if you are not already immune. Discuss this with your health care provider.

 

WebMD Medical Reference

Reviewed by Kimball Johnson, MD on March 29, 2013
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