Hepatitis ( sources ‘- different articles of internate available
by sources )
·
Types
·
Causes
·
Symptoms
What is hepatitis?
Hepatitis refers to an inflammatory condition of the liver. It’s
commonly caused by a viral infection, but there are other possible causes of
hepatitis. These include autoimmune hepatitis and hepatitis that occurs as a
secondary result of medications, drugs, toxins, and alcohol. Autoimmune
hepatitis is a disease that occurs when your body makes antibodies against your
liver tissue.
Your liver is
located in the right upper area of your abdomen. It performs many critical
functions that affect metabolism throughout your body, including:
· bile
production, which is essential to digestion
· filtering
of toxins from your body
· excretion
of bilirubin (a product of broken-down red blood cells), cholesterol, hormones,
and drugs
· breakdown
of carbohydrates, fats, and proteins
· activation
of enzymes, which are specialized proteins essential to body functions
· storage
of glycogen (a form of sugar), minerals, and vitamins (A, D, E, and K)
· synthesis
of blood proteins, such as albumin
· synthesis
of clotting factors
According to the Centers for Disease Control
and Prevention (CDC), approximately 4.4 million Americans are
currently living with chronic hepatitis B and C. Many more people don’t even
know that they have hepatitis.
Treatment options vary depending on which type of hepatitis you
have. You can prevent some forms of hepatitis through immunizations and
lifestyle precautions.
TYPES
The 5 types of viral hepatitis
Viral infections of the liver that are classified as hepatitis
include hepatitis A, B, C, D, and E. A different virus is responsible for each
type of virally transmitted hepatitis.
Hepatitis A is always an acute, short-term disease, while
hepatitis B, C, and D are most likely to become ongoing and chronic. Hepatitis
E is usually acute but can be particularly dangerous in pregnant women.
Hepatitis A
Hepatitis A is caused by an infection with the
hepatitis A virus (HAV). This type of hepatitis is most commonly transmitted by
consuming food or water contaminated by feces from a person infected with
hepatitis A.
Hepatitis B
Hepatitis B is transmitted through contact with
infectious body fluids, such as blood, vaginal secretions, or semen, containing
the hepatitis B virus (HBV). Injection drug use, having sex with an infected
partner, or sharing razors with an infected person increase your risk of
getting hepatitis B.
It’s estimated by the CDC that 1.2 million people in the United States
and 350 million people worldwide live with this chronic disease.
Hepatitis C
Hepatitis C comes from the hepatitis C virus
(HCV). Hepatitis C is transmitted through direct contact with infected body
fluids, typically through injection drug use and sexual contact. HCV is among
the most common bloodborne viral infections in the United States. Approximately 2.7 to 3.9 million Americans are
currently living with a chronic form of this infection.
Hepatitis D
Also called delta hepatitis, hepatitis D is a serious liver disease caused by
the hepatitis D virus (HDV). HDV is contracted through direct contact with
infected blood. Hepatitis D is a rare form of hepatitis that only occurs in
conjunction with hepatitis B infection. The hepatitis D virus can’t multiply
without the presence of hepatitis B. It’s very uncommon in the United States.
Hepatitis E
Hepatitis E is a waterborne disease caused by
the hepatitis E virus (HEV). Hepatitis E is mainly found in areas with poor
sanitation and typically results from ingesting fecal matter that contaminates
the water supply. This disease is uncommon in the United States. However, cases
of hepatitis E have been reported in the Middle East, Asia, Central America,
and Africa, according to the CDC.
CAUSES
Causes of noninfectious hepatitis
Alcohol and other toxins
Excessive alcohol consumption can cause liver damage and
inflammation. This is sometimes referred to as alcoholic hepatitis. The alcohol
directly injures the cells of your liver. Over time, it can cause permanent
damage and lead to liver failure and cirrhosis,
a thickening and scarring of the liver.
Other toxic causes of hepatitis include overuse or overdose of
medications and exposure to poisons.
Autoimmune system response
In some cases, the immune system mistakes the liver as a harmful
object and begins to attack it. It causes ongoing inflammation that can range
from mild to severe, often hindering liver function. It’s three times more
common in women than in men.
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SYMPTOMS
Common symptoms of hepatitis
If you have infectious forms of hepatitis that are chronic, like
hepatitis B and C, you may not have symptoms in the beginning. Symptoms may not
occur until the damage affects liver function.
Signs and symptoms of acute hepatitis appear quickly. They
include:
· fatigue
· flu-like
symptoms
· dark
urine
· pale
stool
· abdominal
pain
· loss
of appetite
· unexplained
weight loss
· yellow
skin and eyes, which may be signs of jaundice
Chronic hepatitis develops slowly, so these signs and symptoms
may be too subtle to notice.
DIAGNOSIS
How hepatitis is diagnosed
History and physical exam
To diagnose hepatitis, first your doctor will take your history
to determine any risk factors you may have for infectious or noninfectious
hepatitis.
During a physical examination, your doctor may press down gently
on your abdomen to see if there’s pain or tenderness. Your doctor may also feel
to see if your liver is enlarged. If your skin or eyes are yellow, your doctor
will note this during the exam.
Liver function tests
Liver function tests use blood samples to
determine how efficiently your liver works. Abnormal results of these tests may
be the first indication that there is a problem, especially if you don’t show
any signs on a physical exam of liver disease. High liver enzyme levels may
indicate that your liver is stressed, damaged, or not functioning properly.
Other blood tests
If your liver function tests are abnormal, your doctor will
likely order other blood tests
to detect the source of the problem. These tests can check for the viruses that
cause hepatitis. They can also be used to check for antibodies that are common
in conditions like autoimmune hepatitis.
Ultrasound
An abdominal ultrasound uses ultrasound waves to
create an image of the organs within your abdomen. This test allows your doctor
to take a close at your liver and nearby organs. It can reveal:
· fluid
in your abdomen
· liver
damage or enlargement
· liver
tumors
· abnormalities
of your gallbladder
Sometimes the pancreas shows up on ultrasound images as well.
This can be a useful test in determining the cause of your abnormal liver
function.
Liver biopsy
A liver biopsy is an invasive procedure that
involves your doctor taking a sample of tissue from your liver. It can be done
through your skin with a needle and doesn’t require surgery. Typically, an
ultrasound is used to guide your doctor when taking the biopsy sample.
This test allows your doctor to determine how infection or
inflammation has affected your liver. It can also be used to sample any areas
in your liver that appear abnormal.
TREATMENT
How hepatitis is treated
Treatment options are determined by which type of hepatitis you
have and whether the infection is acute or chronic.
Hepatitis A
Hepatitis A usually doesn’t require treatment because it’s a
short-term illness. Bed rest may be recommended if symptoms cause a great deal
of discomfort. If you experience vomiting or diarrhea, follow your doctor’s
orders for hydration and nutrition.
The hepatitis A vaccine is available to prevent this infection.
Most children begin vaccination between ages 12 and 18 months. It’s a series of
two vaccines. Vaccination for hepatitis A is also available for adults and can
be combined with the hepatitis B vaccine.
Hepatitis B
Acute hepatitis B doesn’t require specific treatment.
Chronic hepatitis B is treated with antiviral medications. This
form of treatment can be costly because it must be continued for several months
or years. Treatment for chronic hepatitis B also requires regular medical
evaluations and monitoring to determine if the virus is responding to
treatment.
Hepatitis B can be prevented with vaccination. The CDC recommends hepatitis B vaccinations for all
newborns. The series of three vaccines is typically completed over the first
six months of childhood. The vaccine is also recommended for all healthcare and
medical personnel.
Hepatitis C
Antiviral medications are used to treat both acute and chronic
forms of hepatitis C. People who develop chronic hepatitis C are typically
treated with a combination of antiviral drug therapies. They may also need
further testing to determine the best form of treatment.
People who develop cirrhosis (scarring of the liver) or liver
disease as a result of chronic hepatitis C may be candidates for a liver
transplant.
Currently, there is no vaccination for hepatitis C.
Hepatitis D
No antiviral medications exist for the treatment of hepatitis D
at this time. According to a 2013 study, a drug called alpha interferon can be
used to treat hepatitis D, but it only shows improvement in about 25 to 30
percent of people.
Hepatitis D can be prevented by getting the vaccination for
hepatitis B, as infection with hepatitis B is necessary for hepatitis D to
develop.
Hepatitis E
Currently, no specific medical therapies are available to treat
hepatitis E. Because the infection is often acute, it typically resolves on its
own. People with this type of infection are often advised to get adequate rest,
drink plenty of fluids, get enough nutrients, and avoid alcohol. However,
pregnant women who develop this infection require close monitoring and care.
Autoimmune hepatitis
Corticosteroids, like prednisone or budesonide, are extremely
important in the early treatment of autoimmune hepatitis. They’re effective in
about 80 percent of
people with this condition.
Azothioprine (Imuran), a drug that suppresses the immune system, is
often included in treatment. It can be used with or without steroids.
Other immune suppressing drugs like mycophenolate (CellCept),
tacrolimus (Prograf) and cyclosporine (Neoral) can also be used as alternatives
to azathioprine for treatment.
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PREVENTION
Tips to prevent hepatitis
Hygiene
Practicing good hygiene is one key way to avoid contracting
hepatitis A and E. If you’re traveling to a developing country, you should
avoid:
· local
water
· ice
· raw
or undercooked shellfish and oysters
· raw
fruit and vegetables
Hepatitis B, C, and D contracted through contaminated blood can
be prevented by:
· not
sharing drug needles
· not
sharing razors
· not
using someone else’s toothbrush
· not
touching spilled blood
Hepatitis B and C can also be contracted through sexual
intercourse and intimate sexual contact. Practicing safe sex by using condoms
and dental dams can help decrease the risk of infection.
Vaccines
The use of vaccines is an important key to preventing hepatitis.
Vaccinations are available to prevent the development of hepatitis A and B.
Experts are currently developing vaccines against hepatitis C. A vaccination
for hepatitis E exists in China, but it isn’t available in the United States.
COMPLICATIONS
Complications of hepatitis
Chronic hepatitis B or C can often lead to more serious health
problems. Because the virus affects the liver, people with chronic hepatitis B
or C are at risk for:
· chronic
liver disease
· cirrhosis
When your liver stops functioning normally, liver failure can
occur. Complications of liver failure include:
· bleeding
disorders
· a
buildup of fluid in your abdomen, known as ascites
· increased
blood pressure in portal veins that enter your liver, known as portal
hypertension
· kidney
failure
· hepatic encephalopathy, which can involve
fatigue, memory loss, and diminished mental abilities due to the buildup of
toxins, like ammonia, that affect brain function
· hepatocellular
carcinoma, which is a form of liver cancer
· death
People with chronic hepatitis B and C are encouraged to avoid
alcohol because it can accelerate liver disease and failure. Certain
supplements and medications can also affect liver function. If you have chronic
hepatitis B or C, check with your doctor before taking any new medications.
Article r
Treating hepatitis B
·
·
Overview
Treatment
for hepatitis B depends on how long you've been infected for:
- short-term (acute) hepatitis B doesn't
usually need specific treatment, but may require treatment to relieve the
symptoms
- long-term (chronic) hepatitis B is often
treated with medication to keep the virus under control
Emergency treatment can also be given soon after
possible exposure to the hepatitis B virus to stop an infection developing.
Emergency hepatitis B treatment
See your
GP as soon as possible if you think you may have been exposed to the hepatitis
B virus.
To help
stop you becoming infected, they can give you:
- a
dose of the hepatitis B vaccine –
you'll also need two further doses over the next few months to give you
long-term protection
- hepatitis
B immunoglobulin – a preparation of antibodies that work
against the hepatitis B virus and can offer immediate but short-term
protection until the vaccine starts to take effect
These
are most effective if given within 48 hours after possible exposure to
hepatitis B, but you can still have them up to a week after exposure.
Treatment for acute hepatitis B
If
you're diagnosed with hepatitis B, your GP will usually refer you to a
specialist, such as a hepatologist (liver specialist).
Many
people don't have any troublesome symptoms, but if you do feel unwell, it can
help to:
- get plenty of
rest
- take
over-the-counter painkillers, such as paracetamol or ibuprofen, for tummy (abdominal) pain
- maintain a cool,
well-ventilated environment, wear loose clothing, and avoid hot baths or
showers if itching is a problem
- take
medication such as metoclopramide to stop you feeling sick and
chlorphenamine to reduce itching – your doctor can give you a
prescription for these if necessary
Most
people recover completely in a couple of months, but you'll be advised to have
regular blood tests to check that you're free of
the virus and haven't developed chronic hepatitis B.
Treatment for chronic hepatitis B
If blood
tests show that you still have hepatitis B after six months, your doctor may
recommend medication to reduce the risk of complications of hepatitis B and regular
tests to assess the health of your liver.
Treatment
is usually offered if:
- your immune
system is unable to control the hepatitis B by itself
- there's evidence
of ongoing liver damage
Hepatitis
B medications can help keep the virus under control and stop it
damaging your liver, although they won't necessarily cure the
infection and some people need lifelong treatment.
The main
medicines for chronic hepatitis B are outlined below.
Peginterferon
alfa-2a
If your
liver is working fairly well, the first treatment offered is usually a medicine
called peginterferon alfa 2-a.
This
stimulates the immune system to attack the hepatitis B virus and regain control
over it. It's usually given by injection once a week for 48 weeks.
Common
side effects include flu-like symptoms, such as a fever and muscle
and joint pain, after you start to take the medicine, although these
should improve with time.
Tests
will be carried out during treatment to see how well it's working.
Alternative medicines may be recommended if it's not helping.
Antiviral
medicines
If your
liver isn't working well, or peginterferon alpha-2a is not suitable or not
working for you, your doctor may recommend trying antiviral medication instead.
This will usually be
either tenofovir or entecavir, both of which are taken as tablets.
Common
side effects of these medicines include feeling sick, vomiting and dizziness.
Living with hepatitis B
If you
have hepatitis, you should:
- avoid
having unprotected sex – including anal and oral sex,
unless you're sure your partner has been vaccinated against hepatitis
B
- avoid
sharing needles used to inject drugs with other people
- take
precautions to avoid the spread of infection – such
as not sharing toothbrushes or razors with other people; close
contacts such as family members may need to be vaccinated
- eat
a generally healthy, balanced diet – there's
no special diet for people with hepatitis B
- avoid
drinking alcohol – this can increase your risk of developing
serious liver problems
- speak
to your doctor if you're thinking of having a baby
People
with hepatitis B can usually have a healthy pregnancy, but it's a good idea to
discuss your plans with a doctor first as you may need extra care and your
medications may need to be changed.
There's
a risk of pregnant women with hepatitis B passing the infection on to their
child around the time of the birth, but this risk can be reduced by ensuring
the baby is vaccinated shortly after they're born.
Page
last reviewed: 21/03/2016
Next
review due: 31/12/2018
Hepatitis: Symptoms, Diagnosis, Treatment
& Prevention
Symptoms
·
Jaundice (yellowing of
the skin and eyes)
·
Feeling tired
·
Stomach ache
·
Nausea
·
Diarrhea
·
No appetite
·
Fever
·
Headaches
Diagnosis
To check for hepatitis
viruses, your doctor will test your blood. You may also need a biopsy to see if
there is liver damage.
Treatment
·
Bed rest, abstaining
from alcohol, and taking medication to help relieve symptoms. Most people who
have hepatitis A and E get well on their own after a few weeks.
·
Hepatitis B is treated
with drugs, such as lamivudine and adefovir dipivoxil. Hepatitis C is treated
with a combination of peginterferon and ribovarin.
·
Liver transplant of
hepatitis B or C, or D-caused liver failure.
Prevention
·
Hepatitis A
Immunization of children (1-18 years of age) consists of two or three doses of the vaccine. Adults need a booster dose six to 12 months following the initial dose of vaccine. The vaccine is thought to be effective for 15–20 years or more.
Immunization of children (1-18 years of age) consists of two or three doses of the vaccine. Adults need a booster dose six to 12 months following the initial dose of vaccine. The vaccine is thought to be effective for 15–20 years or more.
·
Hepatitis B
Safe and effective vaccines provide protection against hepatitis B for 15 years and possibly much longer. Currently, the Center for Disease Control and Prevention recommends that all newborns and individuals up to 18 years of age and adult participating at risk of infection be vaccinated. Three injections over a six to 12 month period are required to provide full protection.
Safe and effective vaccines provide protection against hepatitis B for 15 years and possibly much longer. Currently, the Center for Disease Control and Prevention recommends that all newborns and individuals up to 18 years of age and adult participating at risk of infection be vaccinated. Three injections over a six to 12 month period are required to provide full protection.
·
In General:
o Wash your hands after going to the bathroom and
before fixing food or eating.
o Use latex condoms, which may lower the risk of
transmission.
o Avoid tap water when traveling to certain
countries or regions. Ask your doctor about risks before you travel or call the
Centers for Disease Control and Prevention at 877-FYI-TRIP.
o Don't share drug needles.
o Don't share personal items—such as toothbrushes,
razors and nail clippers—with an infected person.
NIH Research to Results
Liver diseases afflict
Americans of all ages and stages, but most frequently those in the productive
"prime of life" years, between the ages of 40 and 60 years, notes Jay
Hoofnagle, M.D., of the National Institute of Diabetes and Digestive and Kidney
Diseases (NIDDK). Minorities and the poor are especially hard hit.
Currently, an estimated
5.5 million Americans (approximately 2 to 3 percent of adults) suffer from
chronic liver disease or cirrhosis. The combined diagnoses of chronic liver
disease, cirrhosis, viral hepatitis, and liver cancer make liver disease one of
the 10 leading causes of death in the United States. While death rates from
some forms of liver disease are decreasing, those for viral hepatitis and liver
cancer are on the rise, both in the U.S. and worldwide. An estimated one
quarter of Americans will suffer from a liver or biliary (gallbladder-related)
disease at some point during their lifetime. Hepatitis, especially hepatitis C,
is a chief cause of liver diseases.
Questions
to Ask Your Doctor
·
What kind of hepatitis
do I have?
·
Can I spread it to my
family and others?
·
Can it be treated? If
so, how?
·
Can I drink wine or
beer?
·
How long will I be sick?
·
What if I am not better
in a few weeks?
"The hepatitis C
virus was discovered just 20 years ago," says Dr. Hoofnagle, who directs
the Liver Disease Research Branch in NIDDK's Division of Digestive Diseases and
Nutrition. "Today it is clear that hepatitis C is the most common cause of
chronic liver disease in the United States, the most common cause of liver
scarring (cirrhosis), the most common reason for liver transplantation, and,
now, the most common cause of liver cancer. Hepatitis C is the most critical
area of all liver disease research."
Among many NIDDK
research projects related to hepatitis and liver disease:
·
A recent study concluded
that about half of patients with chronic hepatitis C recovered after receiving
initial treatments from two drugs, peginterferon and ribavirin.
Read More "Hepatitis" Articles
The Dangers of Hepatitis / Hepatitis Can Strike Anyone / Hepatitis: Symptoms, Diagnosis, Treatment & Prevention
The Dangers of Hepatitis / Hepatitis Can Strike Anyone / Hepatitis: Symptoms, Diagnosis, Treatment & Prevention
Spring 2009 Issue:
Volume 4 Number 2 Page 25
Hepatitis (Viral Hepatitis, A, B, C,
D, E, G)
·
·
Medical
Author: Charles Patrick Davis, MD, PhD
·
Medical
Editor: Jay W. Marks, MD
·
INDEX
Quick GuideHepatitis in Pictures: What Puts You at Risk?
What is the treatment for viral hepatitis?
Treatment of acute viral hepatitis and chronic
viral hepatitis are different. Treatment of acute viral hepatitis involves
resting, relieving symptoms and maintaining adequate intake of fluids.
Treatment of chronic viral hepatitis involves medications to eradicate the
virus and taking measures to prevent further liver damage.
Acute hepatitis
In patients with acute viral hepatitis, the
initial treatment consists of relieving the symptoms of nausea, vomiting,
and abdominal pain (supportive
care). Careful attention should be given to medications or compounds, which can
have adverse effects in patients with abnormal liver function (for example, acetaminophen [Tylenol and others], alcohol, etc.). Only those
medications that are considered necessary should be administered since the
impaired liver is not able to eliminate drugs normally, and drugs may
accumulate in the blood and reach toxic levels. Moreover, sedatives and
"tranquilizers" are avoided because they may accentuate the effects
of liver failure on the brain and cause lethargy and coma. The patient must
abstain from drinking alcohol, since alcohol is toxic to the liver. It occasionally
is necessary to provide intravenous fluids to prevent dehydration caused by vomiting. Patients with
severe nausea and/or vomiting may need to be hospitalized for treatment and
intravenous fluids.
Acute HBV is not treated with antiviral drugs.
Acute HCV - though rarely diagnosed - can be treated with several of the drugs
used for treating chronic HCV. Treatment of HCV is recommended primarily for
the 80% of patients who do not eradicate the virus early. Treatment results in
clearing of the virus in the majority of patients.
Chronic hepatitis
Treatment of chronic infection with hepatitis B
and hepatitis C usually involves medication or combinations of medications to
eradicate the virus. Doctors believe that in properly selected patients,
successful eradication of the viruses can stop progressive damage to the liver
and prevent the development of cirrhosis, liver failure, and liver cancer.
Alcohol aggravates liver damage in chronic hepatitis, and can cause more rapid
progression to cirrhosis. Therefore, patients with chronic hepatitis should
stop drinking alcohol. Smoking cigarettes also can aggravate liver disease and should be stopped.
Medications for chronic hepatitis C infection
include:
- injectable alpha interferons (Pegasys)
- oral ribavirin (Rebetol, Copegus)
- oral boceprevir (Victrelis)
- simeprevir (Olysio)
- oral sofosbuvir (Sovaldi)
- oral simeprevir (Olysio)
- oral daclatasvir (Daklinza)
- oral ledipasvir/sofosbuvir (Harvoni)
- oral ombitasvir/paritaprevir/ritonavir (Technivie)
- oral ombitasvir/paritaprevir/ritonavir/dasabuvir (Viekira Pak)
Medications for chronic hepatitis B infection
include:
- injectable alpha interferons
- oral lamivudine (Epivir)
- oral adefovir (Hepsera)
- oral entecavir (Baraclude)
- orak telbivudine (Tyzeka)
- oral tenofovir (Viread)
Because of constantly ongoing research and
development of new antiviral agents, the current list of medications for
chronic hepatitis B and C infections is likely to change every year. Many of those
drugs which are currently available are rarely used because of newer, safer,
and more effective alternatives.
Decisions regarding treatment of chronic
hepatitis can be complex, and should be directed by gastroenterologists,
hepatologists (doctors specially trained in treating diseases of the liver), or
infectious disease specialists for several reasons including:
- The diagnosis of chronic viral hepatitis may not be straightforward. Sometimes a liver biopsy may have to be performed for confirmation of liver damage. Doctors experienced in managing chronic liver diseases must weigh the risk of liver biopsy against the potential benefits of the biopsy.
- Not all patients with chronic viral hepatitis are candidates for treatment. Some patients need no treatment (since some patients with chronic hepatitis B and C do not develop progressive liver damage or liver cancer).
- Medications for chronic infection with hepatitis B and hepatitis C are not always effective. Prolonged treatment (6 months to years) often is necessary. Even with prolonged treatment, rates of successful treatment (defined as complete and lasting eradication of the virus) often are low (usually less than 80% and often around 50%).
- Most of the medications such as interferon and ribavirin can have serious side effects, and doses may have to be reduced.
- There are several different strains of hepatitis C viruses with differing susceptibilities to medications. For example, hepatitis C type 3 is more likely to respond to interferon injections and ribavirin than type 1. Certain hepatitis B strains are resistant to lamivudine but respond to adefovir or entecavir.
In addition, recent research has shown that
combination of certain antiviral medications result in a cure (viral clearance)
in many patients with chronic hepatitis C. Further studies and FDA approval is
pending.
Fulminant hepatitis
Treatment of acute fulminant hepatitis should be
done in centers that can perform liver transplantation since acute fulminant
hepatitis has a high mortality (about 80%) without liver transplantation. Continue Reading
Medically
Reviewed by a Doctor on 2/29/2016
Treatments and drugs
Appointments
& care
Multimedia
·
Treatment to prevent hepatitis B infection after exposure
If you know you've been
exposed to the hepatitis B virus, call your doctor immediately. If you haven't
been vaccinated or aren't sure whether you've been vaccinated or whether you
responded to the vaccination, receiving an injection of hepatitis B immune globulin
within 12 hours of coming in contact with the virus may help protect you from
developing hepatitis B. You should be vaccinated at the same time.
Treatment for acute hepatitis B infection
If your doctor determines
your hepatitis B infection is acute — meaning it is short-lived and will go
away on its own — you may not need treatment. Instead, your doctor might
recommend rest and adequate nutrition and fluids while your body fights the
infection.
Treatment for chronic hepatitis B infection
If you've been diagnosed
with chronic hepatitis B infection, you may have treatment to reduce the risk
of liver disease and prevent you from passing the infection to others.
Treatments include:
·
Antiviral
medications. Several antiviral medications — including lamivudine
(Epivir), adefovir (Hepsera), telbivudine (Tyzeka) and entecavir (Baraclude) —
can help fight the virus and slow its ability to damage your liver. Talk to
your doctor about which medication might be right for you.
·
Interferon
alfa-2b (Intron A). This synthetic version of a
substance produced by the body to fight infection is used mainly for young
people with hepatitis B who don't want to undergo long-term treatment or who
might want to get pregnant within a few years. It's given by injection. Side
effects may include depression, difficulty breathing and chest tightness.
·
Liver
transplant. If your liver has been severely damaged, a liver
transplant may be an option. During a liver transplant, the surgeon removes
your damaged liver and replaces it with a healthy liver. Most transplanted
livers come from deceased donors, though a small number come from living donors
who donate a portion of their livers.
Other drugs to treat
hepatitis B are being developed.
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Can Hepatitis C Be Cured?
Hepatitis C is a viral infection that can attack and damage the liver. It’s one of the most serious hepatitis viruses, and can lead to various complications including liver transplant. In some cases, it can even lead to death. However, new treatments for hepatitis C over the past few years mean that the virus today is much more manageable than it was in the past. In most cases, hepatitis C is curable, so it’s important to seek treatment early if you may have an infection.
What are the symptoms of hepatitis C?
Every hepatitis C infection begins as an acute infection. It occurs a few weeks after exposure. For many people, this stage of the virus has no symptoms. If you do experience symptoms, they can begin weeks or months after exposure to the virus. Possible symptoms include:
Most cases of acute hepatitis C will develop into a chronic infection. Chronic hepatitis C usually has no symptoms until it begins to cause liver scarring, or cirrhosis, and other liver damage. Over many years, the virus attacks the liver and causes damage. This can lead to liver failure or even death.
Since hepatitis C doesn’t always cause symptoms, the only way to be sure whether you have an infection is to be tested for it. A simple blood screening test can tell your doctor whether you have antibodies to hepatitis C in your blood. The presence of antibodies means you’ve been exposed to hepatitis C. A second test for virus levels will tell your doctor whether you have a hepatitis C infection.
Does everyone need treatment?
The Centers for Disease Control and Prevention (CDC) reports that up to one out of four people who contract the hepatitis C virus will eventually be cured from the condition without treatment. For these people, hepatitis C will be a short-term acute infection that goes away without treatment.
For most people, however, acute hepatitis C will develop into a chronic infection that does require treatment. Since the virus often doesn’t have symptoms until after liver damage has taken place, it’s important to get tested for it if you think you might have been exposed.
Are there medicines to cure hepatitis C?
In the past, chronic hepatitis C was treated with a combination of ribavirin and interferon. Rather than directly attacking the virus, these drugs worked by strengthening your immune system. The immune system would then kill the virus. The goal of treatment was to rid your body of the virus.
However, since 2011, the Food and Drug Administration has approved many antivirals that attack hepatitis C more directly. These drugs have much better success rates than older treatments. Some of the most recommended treatments for different genotypes of hepatitis C include:
All of these drug combinations are protease inhibitors. This means they prevent the virus from getting the proteins it needs to reproduce. Over a period of time, usually 12 to 24 weeks, this causes the virus to die out and clear from your system.
For all of the protease inhibitor drugs, the goal of hepatitis C treatment is sustained virologic response, or SVR. SVR means that the amount of hepatitis virus in your system is so low that it can’t be detected 12 weeks after you finish treatment. If you achieve SVR after treatment, you can say that your hepatitis C infection is cured.
Is there a way to prevent hepatitis C?
There is currently no vaccine to help protect people from getting hepatitis C. However, there are vaccines for other hepatitis viruses, including hepatitis A and hepatitis B. According to the CDC, researchers are working toward developing a vaccine for hepatitis C as well.
If you are diagnosed with hepatitis C, your doctor may advise you to get vaccinated against hepatitis A and hepatitis B. This is because these viruses can also lead to liver damage and complications during treatment of hepatitis C.
Since you can’t prevent hepatitis C by getting vaccinated, the best prevention is to avoid exposure. Hepatitis C is a bloodborne pathogen, so you can limit your chances of exposure by avoiding risky behavior. This means never sharing needles and practicing proper protocol if you ever need to be exposed to bodily fluids. Hepatitis C is usually not transmitted through sexual contact, but it’s possible. So you can also limit your exposure by using condoms, unless you and your partner are monogamous and have both been recently tested.
Can a transplant cure hepatitis C?
If you develop chronic hepatitis C and it leads to liver cancer or liver failure, you may need a liver transplant. Hepatitis C is one of the most common reasons for liver transplants.
A liver transplant removes a damaged liver and replaces it with a healthy organ. However, the National Digestive Diseases Information Clearinghouse notes that it’s possible for hepatitis C to return even after a transplant. The virus lives in your bloodstream, not your liver, so removing your liver won’t cure the disease. If you have an active infection of hepatitis C, continued damage to your new liver is very likely. However, if you have achieved SVR before the transplant, you are unlikely to develop a second infection.
Are alternative medicines available?
Certain forms of alternative medicine are believed by some to help cure hepatitis C. However, Mayo Clinic reports that there are no research-proven forms of alternative treatment or complementary medicine for hepatitis C.
Milk thistle is an herb commonly suggested to help cure liver disease. But a study published in JAMA found that milk thistle was no more effective than a placebo in treating patients with hepatitis C.
What is the outlook?
According to the National Institutes of Health, it’s definitely possible to have a positive response to treatment of hepatitis C. Depending on the genotype of hepatitis C, approximately 90 percent of people who are treated with protease inhibitors will achieve SVR and be cured of the infection. According to a 2015 study published by Jayne Smith-Palmer, people who achieve SVR have a 1-2 percent relapse rate and a very low likelihood of liver-related mortality.
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