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I Have Hepatitis C – Now What?

US News & World Report - Health logo US News & World Report - Health 3/14/2019 Ruben Castaneda
a man and a woman looking at the camera: Male doctor counseling mature patient in waiting room. Medical professional is listening to ill man while holding digital tablet in hospital. They are sitting on seat. © (Getty Images) Male doctor counseling mature patient in waiting room. Medical professional is listening to ill man while holding digital tablet in hospital. They are sitting on seat.

While most of the estimated 3.5 million people in the U.S. infected with hepatitis C are baby boomers, the virus is spreading at a greater rate among young people, according for the Centers for Disease Control and Prevention. Overall, the highest rate of new hepatitis C infections is among people ages 20 to 29, according to a 2017 CDC press statement. Increasing IV drug use propelled by the opioid epidemic is the primary factor fueling this increase among young people, according to the CDC; sharing infected needles is a key mode of transmission. Research suggests the rate of hepatitis C infections is also rising among women of child-bearing age. Hepatitis C is associated with cirrhosis, which is potentially fatal, so it's important to get screened and treated.

If you should be diagnosed with hepatitis C, whatever your age, here are steps you should take:

Baby Boomers at Highest Risk of Hepatitis C

For an array of reasons, baby boomers – defined by the U.S. Census Bureau as people born between 1946 and 1964 – are five times more likely to have hepatitis C than other adults, according to the CDC. Overall, baby boomers account for more than 75 percent of the people in the U.S. infected with the virus, according to the American Liver Foundation. A primary reason baby boomers are at higher risk of hepatitis C infection is timing, says infectious diseases expert Dr. Aaron E. Glatt, chairman of the Department of Medicine and hospital epidemiologist at South Nassau Communities Hospital in Oceanside, New York. He's also a spokesperson for the Infectious Disease Society of America. Here's how the timing worked against baby boomers: Researchers discovered hepatitis C in 1989. Before the discovery, doctors referred to the virus as non-A and non-B hepatitis, and associated it with blood transfusions.

A few years later, in the early 1990s, researchers developed reliable specific blood tests for hepatitis C, Glatt says. Blood products weren't specifically screened for the virus until 1992, according to the American Liver Foundation. Before the test was developed, people who received a blood transfusion could have been exposed to the virus. The advent of the screening test was a major breakthrough in preventing hepatitis C spread through transfusions, Glatt says. "However, in recent decades, our better understanding of how the virus was transmitted – via non-sterilized needles and contaminated injection paraphernalia in non-transfusion settings allowed us to lower the risk of hepatitis C infections for post-baby-boomer generations by recommending single-dose vials and disposable needles."

How Is Hepatitis C Spread?

The hepatitis C virus is typically spread by blood, according to the CDC. It's spread when the virus (in blood) enters the body of someone who is not infected. The virus can be spread by IV drug users sharing needles, by a mother infected with hepatitis C passing it on to her baby and by inadvertent needle pricks in health care settings, according to the CDC. Less commonly, it can also be spread by sharing razors or toothbrushes, having sex with someone who's infected or by getting a tattoo or a body piercing with an infected needle. Before the specific screening test was developed, some baby boomers became infected with the virus while undergoing life-saving operations in the 1980s, he says. Today, most risk factors for hepatitis C are avoidable.

Hepatitis C Symptoms

Most patients infected with hepatitis C have no symptoms, and those who do have nonspecific ones like fatigue that are not typically linked to the virus, says Dr. Anurag Maheshwari, who specializes in liver disease at Mercy Medical Center in Baltimore. That's why the virus is often referred to as "the silent killer," he says. Between 70 percent and 85 percent of people infected with hepatitis C will develop a chronic infection and the risk of cirrhosis increases by 10 percent with each decade of infection, he says. Overall, between 20 percent and 30 percent of those who develop a chronic infection will develop cirrhosis, says Dr. Hardeep M. Singh, a gastroenterologist at St. Joseph Hospital in Orange, California. "Hepatitis C is diagnosed with a simple blood test that specifically looks for the virus. Medications can cure the infection in over 98 percent of cases," Singh says. The medication regimen typically involves taking a daily pill for eight to 12 weeks. The lack of symptoms in the early stages of hepatitis C infection is why people who are at risk, like baby boomers, are encouraged to get tested for the virus, Menon says.

Complications of Hepatitis C

It's estimated that 75 percent to 85 percent of those infected with hepatitis C will develop a chronic infection, according to the Centers for Disease Control and Prevention. Twenty or even 30 years after infection, hepatitis C can cause advanced liver disease or cirrhosis, which involves scarring of the organ, says Dr. K.V. Narayanan Menon, medical director of liver transplantation at the Cleveland Clinic. The main complication is cirrhosis, which can lead to liver failure or liver cancer. "Hepatitis C is a liver-related virus, so its main effect is on the liver," Menon says. "The virus causes chronic inflammation of the liver that leads to scar tissue formation." Hepatitis C can contribute to joint pain, thyroid problems and may increase the risk of diabetes by increasing insulin resistance, says Dr. Sudha Kodali, a hepatologist at Houston Methodist Hospital in Houston. Cirrhosis, which is potentially fatal, can cause a raft of symptoms, according to the National Institute of Diabetes and Digestive and Kidney Diseases:

  • Jaundice (yellowing of the skin and the whites of the eyes).
  • Weight loss.
  • Confusion.
  • Nausea and vomiting.
  • Easy bruising and bleeding.
  • Darkening of the urine.
  • Swelling of the lower legs, ankles or feet.
  • Mild pain around the upper right side of the abdomen.
  • Feelings of weakness and fatigue.

How to Respond to a Hepatitis C Diagnosis

1. Don't panic.

Keep in mind, there's a cure for hepatitis C, Maheshwari says. "This is a fixable condition, we can take care of it," he says. Dr. Anthony Michaels, medical director of liver transplantation at the Ohio State University Wexner Medical Center, says hepatitis C is as treatable as a bacterial infection like pneumonia, which can be knocked out with antibiotics. Keep in mind, this medication can cure hepatitis C, but it won't quickly undo the damage the disease has inflicted on your liver. Liver damage can be reversed, but it could take time, perhaps years, Maheshwari says.

2. Don't obsess about when and how you were infected.

Searching your memory to try to figure out when and how you were infected with hepatitis C can be a waste of emotional energy, Maheshwari says. "Some patients are totally fixated on how and when they might have caught this disease," he says. "I say to them, 'I have no way to date this, I can't say when or how you got it.' This is an exercise in futility, you have to move on and let us take care of this." Studies have shown that about a third of patients don't recall any behavior that put them at risk of contracting the virus, Maheshwari says.

3. Stop drinking alcohol.

If you drink alcohol heavily, moderately or lightly, stop right away, Maheshwari says. "Drinking alcohol is like pouring fuel on the fire (of hepatitis C), even if you don't have cirrhosis," he says. Research suggests that consuming alcohol if you have hepatitis C can cause worse liver damage than either drinking without the virus or having the virus and not imbibing, Maheshwari says. Bloom also suggests avoiding medications that are known to have liver toxicity, such as some pain medications, sleep aids, nutritional supplements and anti-inflammatory drugs.

4. Talk about your diagnosis.

As with other viruses, like HIV, there can be a social stigma attached to a hepatitis C diagnosis, Maheshwari says. Some patients feel that some people judge them for their past behavior that put them at risk of being infected with hepatitis C. Maheshwari suggests talking to your doctor and joining a support group for people infected with hepatitis C. The American Liver Foundation's website lists 30 states that have support groups, and others can be found online. Talking about your feelings of stigmatization with a professional counselor can also be helpful.

Related Video: Doctors Transplant Heart With Hepatitis C (Provided by KING-TV Seattle)



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