Hepatitis C

Diagnosis

Hepatitis C Screening

It is crucial to undergo HCV screening if you are at a higher risk of exposure. This includes individuals who:

• Being born between 1945 to 1965
• Anyone who has been in prison.
• HIV infection
• Medical professionals and emergency personnel who have come into contact with blood or unintentional needle sticks.
• Those who have ever injected or inhaled illegal substances.
• Anyone having abnormal liver function test outcomes without a known reason.
• Children born to hepatitis C-positive mothers.
• Hemophiliacs who received clotting factor therapy before to 1987
• Patients who have received hemodialysis for an extended period of time.
• Those who had organ transplants or underwent blood transfusions prior to 1992.
• Sexual partners of those who have been told they have hepatitis C.

Other blood examinations

After an initial blood test confirms the presence of hepatitis C, subsequent blood tests will:

• Determine the viral load, which measures the quantity of hepatitis C virus in your blood.
• Identify the genotype of the virus, indicating the specific strain or variant of hepatitis C that you have.

Tests for liver damage

Doctors employ various tests to evaluate liver damage in chronic hepatitis C, including:

• Magnetic resonance elastography (MRE): MRE is a noninvasive alternative to liver biopsy. It utilizes magnetic resonance imaging (MRI) technology combined with sound waves to generate a visual map displaying stiffness gradients in the liver. Increased stiffness indicates the presence of liver scarring (fibrosis) resulting from chronic hepatitis C.
• Transient elastography: This noninvasive test involves the use of ultrasound to transmit vibrations into the liver and measure the speed at which they disperse through liver tissue. This measurement provides an estimation of liver stiffness.
• Liver biopsy: Typically guided by ultrasound, this procedure entails inserting a thin needle through the abdominal wall to extract a small sample of liver tissue. The sample is then analyzed in the laboratory to assess the extent of liver damage.
• Blood tests: A series of blood tests can provide insights into the degree of fibrosis present in the liver. These tests help in determining the severity of liver damage caused by chronic hepatitis C.

Treatment

Antiviral medications

Hepatitis C infection is now treated with advanced antiviral medications that aim to eliminate the virus from the body. The goal of treatment is to achieve sustained virologic response, meaning no detectable hepatitis C virus in the body at least 12 weeks after completing treatment. Recent breakthroughs in direct-acting antiviral medications, sometimes combined with existing drugs, have led to improved outcomes, fewer side effects, and shorter treatment durations, some as brief as eight weeks. Treatment selection and duration depend on factors such as hepatitis C genotype, existing liver damage, other medical conditions, and prior treatments. Given the rapidly evolving research, it is important to consult a specialist to discuss the best treatment options. Throughout treatment, your healthcare team will closely monitor your response to the medications.

Liver transplantation

Liver transplantation is considered as a potential treatment for individuals experiencing severe complications from chronic hepatitis C infection. The procedure involves the removal of the damaged liver and its replacement with a healthy liver, typically obtained from deceased donors, although some may come from living donors who donate a portion of their livers. However, it is important to note that a liver transplant alone does not typically cure hepatitis C. There is a high likelihood of the infection returning, which necessitates the use of antiviral medication to prevent harm to the newly transplanted liver. Recent studies have shown the effectiveness of new direct-acting antiviral regimens in successfully treating post-transplant hepatitis C. Additionally, in appropriately selected patients, treatment with direct-acting antivirals can be administered before the liver transplantation procedure.

Vaccinations

While there is currently no vaccine available for hepatitis C, it is advisable for individuals with chronic hepatitis C to consider getting vaccinated against hepatitis A and B. These viruses are distinct from hepatitis C but can also lead to liver damage and complicate the progression of the disease. Your doctor is likely to recommend these vaccinations as a preventive measure.