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FREQUENTLY
ASKED QUESTIONS WHAT IS HEPATITIS C? Hepatitis C is a blood borne virus that affects the liver. It is caused by the hepatitis C virus (HCV). Before 1990 it was known as “non-A – non-B hepatitis”. HOW DO I GET HEPATITIS C? HCV is spread by contact with the blood of an infected person. For example, you may have gotten infected with HCV if:
Hugging, casual contact, coughing, food or water, sharing eating utensils or drinking glasses does not spread hepatitis C. WHAT IS THE DIFFERENCE BETWEEN ACUTE AND CHRONIC? The acute phase of the viral disease is the phase at which flu-like symptoms are most likely to appear. It is also the phase in which a patient may best respond to treatment or clear the virus on their own. Once the infection has seroconverted, it is a chronic illness. If a patient has chronic HCV the virus will probably be with them throughout their life. Seroconversion usually occurs between 12 weeks and six months. WHAT ARE THE SYMPTOMS OF HEPATITIS C? Most people who have HCV do not know that they have the illness. Most are free of any symptoms or wrongly identify symptoms. Symptoms are very vague and very hard to attribute to HCV. Even though a person is not experiencing symptoms, the disease could still be causing damage to the liver. The most common symptoms are extreme fatigue, vague flu-like symptoms, muscle and joint aches. At present, testing is done primarily based on risk factors, rather than symptoms. Because of this, many cases of HCV are not being detected. Everyone should request that testing be done during routine physicals. HOW DO I KNOW IF I HAVE HEPATITIS C? The only way to know is to test positive for hepatitis C through a blood test ordered by your doctor. IS HCV BLOOD TESTING A ROUTINE PART OF MY PHYSICAL EXAM? NO. At this time a blood test for HCV is not routinely done. You must request that your doctor order the test. If you have any of the risk factors listed above, insist on a test. WHAT ARE LIVER ENZYMES? Liver enzymes are proteins produced by the liver. Everyone has a low level in their blood but when the liver is injured in any way more enzymes are released into the blood stream. Elevated liver enzymes are a red flag to doctors to investigate the cause of this increase. The two most common liver enzymes that doctors check are the ALT (SGPT) and AST (SGOT). But again, if you have any risk factors, insist on a test. Enzyme levels can be normal and you could still have liver disease. WHY SHOULD I GET TESTED IF I HAVE NO SYMPTOMS?Liver damage may be prevented, or possibly reversed if treated early enough. A person can make needed lifestyle changes to prevent or slow liver damage. If a person knows they have the disease, he/she can prevent infecting others. WHAT HAPPENS IF I TEST POSITIVE?If you test positive for antibodies to HCV, then your doctor should do a follow-up blood test to see whether actual virus material can be found in your blood, along with tests to check the state of your liver. A small number of people with HCV infection have a mild, brief disease and get rid of the virus completely. In this case, the antibodies to HCV usually remain detectable in the blood but the actual viral material does not. It is currently believed, however, that most people who get hepatitis C will have HCV infection for the rest of their lives. Your family doctor may refer you to a specialist to better advise you of treatment options. If you test positive you must not drink any alcohol or smoke (anything). Be careful with your blood to prevent transmission to others. Use condoms. Get plenty of rest. Exercise moderately. Be vaccinated against Hepatitis A and Hepatitis B. AM I GOING TO DIE IF I HAVE HEPATITIS C?Most people who have HCV will live a normal life span. However, there is still much information to be learned about HCV. As far as we know, approximately 50-80 people in 100 with chronic HCV will have their disease gradually progress over 10 to 30 years to develop scarring, or cirrhosis of the liver. A smaller number of these people will advance to cancer of the liver, liver failure and/or death. Again, this information could change as more is learned about HCV. SHOULD MY FAMILY BE TESTED FOR HCV?Ask your doctor. The likelihood is small that HCV was spread to a family member. Testing may ease a person’s concern. CAN I GIVE MY SEXUAL PARTNER HEPATITIS C?HCV can be spread by sex. There is less risk of transmission if you have one steady partner. If you have multiple partners, it is recommended to use latex condoms correctly and every time. Those with STD's have a greater chance of contracting the virus through sex. Men are more likely to infect women. A woman is more vulnerable to infection during her period. CAN A WOMAN GIVE HEPATITIS C TO HER CHILD WHILE PREGNANT OR BREAST FEEDING? It is possible that pregnant women with HCV can transmit the virus to their baby either in the womb or at childbirth. At the present time it is not known whether HCV can be spread from a mother to her baby through breast milk. However, the likelihood is thought to be very small and some liver specialists recommend that mothers if they want, breast feed their babies. Others recommend against it. HCV-positive mothers should consider refraining from breast-feeding if their nipples are cracked or bleeding. Mothers who also have the Hepatitis B virus (HBV) or HIV are at greater risk of passing HCV to their babies. Fetal monitors should not be used in deliveries of HCV positive women. A caesarian section is not recommended on the basis of HCV alone. CAN I GET A VACCINE FOR HEPATITIS C? There is no vaccine for HCV. Recent studies show that people with HCV become much sicker and their liver becomes much more damaged if they develop another form of viral hepatitis. Doctors are recommending that people with HCV receive the Hepatitis A and /or Hepatitis B vaccine's if they have not been exposed to one, the other or both. That means if a person with HCV is immune to Hepatitis B but not to Hepatitis A then he/she should get the Hepatitis A vaccine. Checking for immunity involves a simple blood test. HOW CAN I PREVENT SPREADING HEPATITIS C TO OTHERS? There is no need for anyone with HCV to be socially isolated. · Tell anyone who may have contact with your blood that you have HCV (e.g. dentists, co-workers, manicurists, tattooists, nurses, blood technicians, etc.). Insist they use sterile tools and techniques. This means autoclaving equipment. · Do not donate blood, body tissue, or semen · Do not share personal items that might have your blood on them, such as toothbrushes, dental appliances, nail-grooming equipment, razors, or syringes. · Cover your cuts and skin sores to keep from spreading HCV · Insist that your healthcare providers follow routine barrier precautions and safely handle needles and other sharps. If you are a healthcare worker always do the same. · Any time your blood comes in contact with food, dispose of the food · Any time your blood gets on a hard surface, clean the surface with a solution of 1 part chlorine bleach mixed with 10 parts water. Leave the solution in contact with the surface for several minutes. · Do not share needles or other equipment if you are using intravenous drugs. Do not place dirty needles on household surfaces. WHAT SHOULD I EAT IF I HAVE HEPATITIS C? People diagnosed with HCV can eat anything they want. The only recommendation is that they make healthy food choices. Use moderation in salt and fat intake. Include fresh fruits and vegetables. Proper diet can help your body heal itself and help you keep up your energy to fight off fatigue. No drinking alcohol in any form. The HCV infection progresses more rapidly in people who drink alcohol. Alcohol puts an added burden on an already damaged liver. Do not take more than 1 extra strength Tylenol (500mg) every 6 hours for pain. Cut out red meat, it is hard on the body to metabolize. WHAT CAN PERSONS WITH HEPATITIS C DO TO PROTECT THEIR LIVES? § Stop using alcohol § Do not smoke (anything) § See your doctor regularly § Don’t start any new medicines or use over-the-counter, herbal, and other medicines without a physician’s approval. This includes pain relievers, such as, Tylenol, Advil, Aspirin, etc. § Get vaccinated against Hepatitis A and Hepatitis B IS THERE A TREATMENT FOR HEPATITIS C? Treatment for HCV varies depending upon the extent of a person’s disease. Sometimes lifestyle changes, such as, stopping alcohol drinking, is sufficient. For people with more active disease doctors may recommend a treatment with powerful drugs, the equivalent of chemotherapy. Selection of treatment should be done on the basis of medical testing and patient awareness of all options. Patients who have drug and alcohol problems must be clean and sober prior to treatment. WHAT CAUSES A PERSON WITH HEPATITIS TO HAVE YELLOW SKIN AND EYES? This is called jaundice. When red blood cells complete their life cycle and break down naturally in your body, they produce a yellow pigment that’s passed to the liver and excreted into bile. Yellowing is caused by the buildup of bile pigment the damaged liver could not process; the liver then passes it into the intestines. WHAT IS CIRRHOSIS? HCV can, and often does, cause inflammation in the liver. A condition where scar tissue develops in the liver is called fibrosis. To the extent where such scarring becomes extensive and permanent, it is called cirrhosis. Advanced cirrhosis can interfere with the normal functioning of the liver. WHAT OTHER INFORMATION SHOULD PATIENTS WITH HCV BE AWARE OF? · HCV is not spread by: sneezing, hugging, coughing, food or water, sharing eating utensils or drinking glasses, or casual contact. · Persons should not be excluded from work, school, play, childcare or other settings on the basis of their HCV infection status. · Involvement with a support group may help patients cope with HCV and learn about the disease so that they can work with their healthcare provider and understand what they must do to prevent severe liver disease. HOW DO I LIVE WITH HEPATITIS C? While testing positive is not good news, it is not all doom and gloom or a death sentence. Don’t panic. Many people live 10-30 years with the virus without becoming seriously ill or having liver failure. Here are some important things to remember: § Lead as normal a life as possible. In most people the infection does not disappear, so you need to learn to live with it and learn to accept it. Think positive; most of those infected don’t progress to liver failure. Attend a support group for emotional support. § Don’t add another liver disease. Get vaccinated against Hepatitis A and Hepatitis B. § Do not drink alcohol. This is the single most important way to prevent liver damage. § Do not smoke. Smoking has been associated with higher rates of liver cancer. § Practice safe sex. HCV can be transmitted sexually. Use latex condoms and safer sex practices even if both partners are infected, and particularly if you have multiple partners. Tell sexual partners about your illness. § Practice moderation. Avoid extremes of behavior, diet and exercise. Rest if you are tired, and get plenty of sleep. If you become upset easily, discuss this with your doctor. § Maintain a nutritious diet. Drink plenty of water. § Be wary of blood. Cover cuts; don’t share toothbrushes, razors, manicure tools or anything that may have your blood on it. A professional should do ear and body piercing. Do not get tattooed. Do not donate blood, soft body tissue, or semen. § Have regular check-ups. A physician who knows about HCV can establish a pattern of infection, look for changes, watch for disease and therapy-related problems, and offer access to new therapies as they become available. § Be informed. Learn as much as you can about your disease. Keep yourself updated on current research, information, and treatment. Be active in your care and treatment asking your doctor and pharmacist questions. Be aware of your own health status and what your various options are. Take responsibility for yourself and realize you do play a role in your illness.
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