Hepatitis C - American Liver Foundation

Hepatitis C

Why is the liver important?Your liver is a vital organ that performsmany essential functions. It’s thelargest solid organ in the body andis located under your rib cage on theupper right side. It weighs about threepounds and is shaped like a footballthat is flat on one side.Your liver processes everythingyou eat, drink, breathe, and absorbthrough your skin. It turns nutrientsinto energy your body can use andremoves harmful substances from yourblood.1Hepatitis C

What is hepatitis C?Hepatitis C is a disease caused by avirus that infects the liver. This virus,called the hepatitis C virus or HCV forshort, is just one of the hepatitis viruses.The other common hepatitis viruses areA and B, which differ somewhat fromhepatitis C in the way they are spreadand treated.How does hepatitis C affectthe liver?Reproduced with permission from Hepatitis C Online (www.hepatitisc.uw.edu)Hepatitis means inflammation, orswelling, of the liver. When the liver isinflamed, it has a harder time doing itsjob. Some people who get HCV haveit for a short time – up to six months –and then get better on their own. Thisis called acute hepatitis C. But mostpeople, about 75% – 85%, will go on todevelop long-term or chronic hepatitisC, meaning it doesn’t go away.Hepatitis C2

Anything that damages the liver overmany years can lead the liver to formscar tissue. Fibrosis is the first stage ofliver scarring. When scar tissue buildsup and takes over most of the liver,this is a more serious problem calledcirrhosis. Unless successfully treatedwith medication, chronic hepatitis Ccan eventually lead to cirrhosis, livercancer and liver failure.Who is at risk of havinghepatitis C?You have a greater risk of infection withhepatitis C if you: Shared needles to inject drugs (themost common way HCV is spreadin the U.S.) or straws to inhale them,even once many years ago Were born between 1945 and 1965(baby boomers) Received a blood transfusion ororgan transplant before July 1992 Received a blood product forclotting problems made before 1987 Had tattoos or body piercings usingnon-sterile equipment Needed to have your blood filteredby a machine (hemodialysis) for along period of time because yourkidneys weren’t working Worked in a place where youmay have come into contact withinfected blood, such as a healthcareinstitution or correctional facility Have HIV3Hepatitis C

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Less common risks include: Being born to a mother with HCV(about 4 of every 100 infants born tomothers with HCV become infected) Having sexual contact with a HCVinfected partner Sharing personal care items, such astoothbrushes or razors, that camein contact with the blood of a HCVinfected personIt’s worth noting that recent studieshave shown an increased incidenceof acute hepatitis C in young people(under 30 years old) due to an increaseof injection drug use among that agegroup.What are symptoms ofhepatitis C?Most people with acute or chronic HCVhave no symptoms. When symptoms dooccur, they may include: jaundice (a yellowing of the skin andwhites of the eyes) itchy skin (pruritus) tiredness dark urine muscle soreness nausea loss of appetite stomach pain5Hepatitis C

Someone can have HCV for years oreven decades without experiencingsymptoms.How is hepatitis C diagnosed?There are two main blood tests usedto diagnose hepatitis C. The HepatitisC Antibody Test looks for antibodies(proteins made by your body’simmune system to fight infection) tothe hepatitis C virus; it shows if you’veever been exposed to the virus. If theantibody test is positive, another bloodtest will be performed to determine ifyou’re currently infected with HCV.This test, called an RNA Test, looksfor the genetic material (RNA) of thehepatitis C virus. If the RNA test ispositive, it means you currently havehepatitis C and should talk to a doctorexperienced in diagnosing and treatingthe disease (gastroenterologist orhepatologist).What is hepatitis C genotype?If you currently have hepatitis C, yourhealthcare provider will want to knowwhat type or “strain” of the virus youhave. The different strains of HCV arereferred to as genotypes. There are sixmajor genotypes of HCV around theworld: 1 (1a and 1b), 2, 3, 4, 5 and 6. Inthe United States, genotypes 1, 2, and 3are most common.Hepatitis C6

About 75% of people with HCV in theU.S. have either genotype 1a or 1b Between 10% - 20% of people in theU.S. have either genotype 2 or 3Your HCV genotype does not changeover time, so you only need to gettested once. Hepatitis C medicationswork differently for different genotypes,so knowing your genotype helpsyour healthcare provider choose thetreatment that’s best for you.How is hepatitis C treated?Acute Hepatitis CThe majority of people with acute HCVoften don’t know they have the virusand therefore do not seek treatment.However, if a person realizes they’vebeen exposed to the virus – like ahealthcare worker who gets a needlestick – an acute hepatitis C infection canbe identified early and medication maybe prescribed.Doctors sometimes just recommendbed rest, drinking lots of fluids, eatinga healthy diet and avoiding alcohol. It’simportant to see your doctor regularlyfor follow-up tests to make sure yourbody has fully recovered from the virus.Chronic Hepatitis CMany people already have chronic HCVwhen they’re first diagnosed because7Hepatitis C

they were unknowingly infected manyyears ago. If you have chronic HCV,your healthcare provider will evaluatehow well your liver is working and mayorder additional testing including a liverbiopsy or FibroScan and imaging testssuch as a CT scan, MRI, or ultrasound.The good news is that there arenow more medications available totreat HCV than ever before, makingtreatment regimens shorter in duration,easier to tolerate, and more effectivethan in the past. The purpose of usingmedications to treat hepatitis C is to: Clear the hepatitis C virus from yourbloodstream Slow down the progression ofinflammation and scarring ofyour liver Reduce the risk of developingcirrhosis and liver cancerBased on your medical history, physicalexam, lab work and other test results,your healthcare provider will suggestwhich medication(s) are right for you,as well as determine the length of timeyou need to be treated. This decisionwill depend upon a number of factorsincluding: Your HCV genotype Whether or not you have cirrhosis,and if it’s mild (compensated) orsevere (decompensated) If you’ve received treatment beforeHepatitis C8

and which medications were used If you’re waiting for or you’ve alreadyreceived a liver transplant Other health conditions you may haveTreatment regimens are usually 12 or24 weeks, but can vary depending onyour particular circumstances. To learnmore about treatment options, visit ourwebsite www.liverfoundation.org.What are the potentialoutcomes of hepatitis Ctreatment?The potential outcomes of treatmentare the following: Sustained virologic response (SVR):You are considered cured if HCV isnot detected when measured with ablood test three months after you’vecompleted treatment. This is calleda sustained virologic response anddata suggest that you will stay virusfree indefinitely. Improved response, but no SVR:The amount of HCV detected inyour body is significantly lowerthan before treatment, but is stilldetectable. No response: The medications hadminimal or no effect. Incomplete treatment: Treatmentended earlier that the prescribedduration.9Hepatitis C

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What is the best way to stopthe spread of hepatitis C?HCV is transmitted, or spread, whenblood from a hepatitis C-infectedperson enters the bloodstream ofsomeone who is not infected. Thereis no vaccine to prevent HCV. Theonly way to stop the spread of HCV isto avoid direct contact with infectedblood: Do not share needles or other drugparaphernalia (straws, filters, etc.) Use recommended safety measuresif you are exposed to blood orneedle sticks at work Practice safe sex Use clean needles and equipmentfor tattoos or body piercings Do not share razors, toothbrushes,or other personal care itemswith others Wear gloves if you have to touchsomeone’s bloodI’ve been diagnosed with HepC. What questions should I askmy healthcare provider?Preparing a list of questions to askyour healthcare provider during anappointment can be very helpful.Some questions to ask include: What is my HCV genotype? How much hepatitis C virus do Ihave in my body?11Hepatitis C

Has the virus damaged my liver? What are the benefits and risks oftreatment? What treatment options areavailable to me? Which option do you think is bestfor me and why? How long will treatment last? What side effects will I have? Howcan I manage the side effects? How will treatment affect my dailylife? What will the treatment cost and willmy insurance cover it? How likely is it that I will developcirrhosis or liver cancer? What else can I do to keep healthyand minimize damage to my liver? What prescription and overthe-counter medications orsupplements should I avoid? Should I be vaccinated for hepatitisA and hepatitis B? Should my family be tested forhepatitis C? What is the next step?What is the best way tomanage hepatitis C? Adhere to your hepatitis C treatmentregimen, as prescribed Take only those medications andsupplements recommended by yourdoctor Talk to your doctor about hepatitis Aand hepatitis B vaccinesHepatitis C12

Avoid alcohol and drugsEat healthy mealsExerciseRest when you feel tiredKeep all medical and labappointments See your liver specialist regularlyThis is a very hopeful time for peoplewith hepatitis C as treatment is rapidlychanging for the better. With highercure rates, shorter treatment times, andall-oral treatment regimens for mostpeople with HCV, everyone shouldconsider getting treated. Discuss therisks and benefits of pursuing treatmentwith your healthcare provider.13Hepatitis C

Facts At-A-Glance Hepatitis C is a liver disease causedby the hepatitis C virus (HCV). HCV is spread by direct contact withinfected blood. There is no vaccine to prevent HCV. Most people with HCV have nosymptoms. About 75% of people with HCV donot know they are infected with thevirus. HCV is diagnosed by blood tests. Approximately 25% of people fullyrecover from HCV within six monthsafter exposure and 75% of peopledevelop long-term or chronic HCV. About 3.2 million Americans havechronic HCV. Chronic HCV can lead to cirrhosis(severe scarring) of the liver, livercancer and liver failure. Chronic HCV is the leading cause foradult liver transplantation in the U.S. People who were born between1945 and 1965 (baby boomers) arefive times more likely to be infectedwith HCV. Stop the spread of HCV byavoiding direct contact with otherpeople’s blood: Use clean needles;wear gloves if you have to touchsomeone’s blood; do not sharetoothbrushes, razors, or otherpersonal items. Medications are now available thatcan cure most people of hepatitis C.Hepatitis C14

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American Liver 465-4837)/Liverinfo/LiverUSA/AmericanLiverPrinting of this brochure has been made possible byindependent educational grants fromGilead Sciences, Abbvie, and Merck & Co. 2019 American Liver Foundation. All rights reserved.

Hepatitis C 2 What is hepatitis C? Hepatitis C is a disease caused by a virus that infects the liver. This virus, called the hepatitis C virus or HCV for short, is just one of the hepatitis viruses. The other common hepatitis viruses are A and B, which differ somewhat from hepatitis C in the way they are spread and treated.