Understanding Hepatitis -- Diagnosis and Treatment
What If I Have Symptoms of Viral Hepatitis?
If you have symptoms or signs of viral hepatitis, your health care provider can perform a blood test to check for the presence of an antibody. If you have hepatitis, more blood samples may be necessary later -- even if the symptoms have vanished -- to check for complications and determine if you have progressed from acute (infected within the past six months) to chronic (having the virus for greater than six months) disease. Most people have vague or no symptoms at all; hence, viral hepatitis is often referred to as a silent disease.
Your health care provider may also require a liver biopsy, or tissue sample, in order to determine the extent of the damage. A biopsy is commonly performed by inserting a needle into the liver and drawing out a fragment of tissue, which is then sent to a lab to be analyzed.
What Are the Treatments for Viral Hepatitis?
The treatment for viral hepatitis depends on the type and stage of the infection. Over the last several years, excellent treatments for both hepatitis B and C have become available. More and improved treatments are being evaluated all the time.
Your primary care doctor should be able to provide adequate care of your hepatitis. However, if you have severe hepatitis, you may require treatment by a hepatologist or gastroenterologist -- specialists in diseases of the liver. Hospitalization is normally unnecessary unless you cannot eat or drink or are vomiting.
Doctors sometimes recommend drug therapy for people with certain types of hepatitis. Antiviral medication for hepatitis B includes interferon, peginterferon, lamivudine (Epivir), adefovir (Hepsera), entecavir (Baraclude), tenofovir (Viread), and telbivudine (Tyzeka). Until recently, the standard treatment for chronic hepatitis C was a course of peginterferon plus ribavirin for people with genotype 2 and 3, and peginterferon plus ribavirin plus a protease inhibitor – either Incivek or Victrelis for people with genotype 1. These treatments had been shown to be effective in from 50% to 80% of those infected with hepatitis C.
In late 2013, two new direct acting antiviral drugs, sofosbuvir (Sovaldi) and simeprevir (Olysio) were approved by the FDA to treat chronic HCV infection. They are effective in 80%-95% of patients. Sofosbuvir (Sovaldi) blocks a protein needed by the hepatitis C virus to multiply. It is approved for use with pegylated interferon and ribavirin for HCV genotype 1 and 4 infections, and with ribavirin for adults with HCV genotype 2 and 3 infection. This is the first time an interferon-free regimen has been approved to treat chronic hepatitis C. Imeprevir (Olysio) also blocks a protein needed by the hepatitis C virus to multiply. It is approved for use with peginterferon-alfa and ribavirin for genotype 1 infections only.