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 peginterferon, Epivir, Hepsera, Baraclude, Tyzeka, and tenofovir. The standard treatment for chronic hepatitis C is 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 have been shown to cure up to 80% of those infected with hepatitis C.
Incivek and Victrelis 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 pegylated interferon and ribavirin keeps HCV in check. Be aware that Victrelis may interact with some HIV drugs. The FDA has warned that it has received reports of a serious skin rash from combination treatment with Incivek, which has led to several deaths.
Also, most drugs have at one time or another been implicated as a cause of liver damage. If you currently have hepatitis, or if you have a history of liver disease or other liver problems, tell your health care provider before taking any medication – either prescription or over-the-counter, including herbal therapies.