Hepatitis

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    Hepatitis C is the leading cause of liver transplantation. Chronic HCV infection can lead to cirrhosis, liver cancer and liver failure.
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    In addition to protease inhibitors, other classes of drugs that inhibit the growth or replication of the hepatitis C virus are in development, under active study, with some even undergoing review by the FDA for approval. These include nucleotides, potent drugs that have little resistance and few drug-to-drug reactions with a low profile of side effects; nonnucleotides, which are less potent and do develop resistance; a class called NS5A inhibitors, which develop resistance but can be a useful component in a multidrug regimen; and others.

    The new direct-acting antiviral drugs are not just less toxic and more potent than older drugs. Interferon and ribavirin weren't working directly against the virus, whereas the newer ones are. Moreover, some of the new drugs are “pangenotypic”: They work on all six types (genotypes 1-6) of the virus.

    Telaprevir and boceprevir have currently only boosted cure rates when added to pegylated interferon and ribavirin, but other direct-acting antivirals (DAA) combinations have been shown to cure a certain segment of people without interferon. Although initially the percentage was relatively low, about 30% in certain people, newer studies have shown rates over 90% with multi-drug, all-oral, interferon-free regimens. Though some of the data remains preliminary and the drugs are not yet FDA approved, the ability to cure people without interferon represents a very important advance that holds great promise. It is only a matter of time before effective interferon-free therapy will be available in wider groups of people.

    Trials of interferon-free regimens are currently under way even in the sickest patients like those who have undergone or are awaiting liver transplantation. In addition to their potential to yield new therapies for people with hepatitis C, they may also improve the options available for people with the virus who undergo liver transplantation for liver cancer. In the past, it has been shown that 12 weeks of interferon-based therapy followed by liver transplantation would cure up to 80% of people of hepatitis C. The problem was that most people could not tolerate the pretransplant interferon therapy. At this time, preliminary data suggest that most people can tolerate one of the new drugs, sofosbuvir (previously called GS7977), with ribavirin and that it can suppress hepatitis C to undetectable levels in most people. Studies will see whether the drug is effective in maintaining viral clearance after a transplant.
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    Here's how you can stay healthy if you are living with hepatitis C:
    • Eat a healthy diet, stay physically active, see a doctor on a regular basis, and ask if you could benefit from new and better treatments.
    • Talk to your doctor before taking over-the-counter medicines and avoid alcohol because they can cause liver damage.
    • Reduce the risk of transmission to others by not donating blood or sharing personal items that might come into contact with blood.
    (The presence of the CDC logo and CDC content on this page should not be construed to imply endorsement by the U.S. government of any commercial products or services, or to replace the advice of a medical professional. The mark “CDC” is licensed under authority of the PHS.)
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    The following people should be tested for hepatitis C:
    • Born from 1945 through 1965
    • Have received blood products with clotting factor before 1987
    • Have received blood transfusion or organ transplant before July 1992
    • Have ever injected drugs, even if only one time
    • Have HIV
    • Have been on kidney dialysis for several years
    • Are health or public safety workers who have been stuck with a needle or other sharp object with blood from a person with hepatitis C or unknown hepatitis C status
    • Born to a mother with hepatitis C
    (The presence of the CDC logo and CDC content on this page should not be construed to imply endorsement by the U.S. government of any commercial products or services, or to replace the advice of a medical professional. The mark “CDC” is licensed under authority of the PHS.)
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    About 3 million adults in the United States are infected with the hepatitis C virus, and most are baby boomers. Up to three out of four people who are infected don't know they have hepatitis C, so they aren't getting the necessary medical care. Baby boomers -- anyone born from 1945 through 1965 -- should get tested for hepatitis C.

    (The presence of the CDC logo and CDC content on this page should not be construed to imply endorsement by the U.S. government of any commercial products or services, or to replace the advice of a medical professional. The mark “CDC” is licensed under authority of the PHS.)
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    A follow up test is needed after a hepatitis C antibody test, but only if the antibody test is positive. The hepatitis C antibody test can tell if you have ever been infected, but cannot tell whether you are still infected. Only a different follow-up blood test can determine if you are still infected. So that’s why the follow-up test is important. Without the follow-up test, a person will not know if they still have hepatitis C and cannot get the medical care they need.  And new CDC data shows only half of people with a positive hepatitis C antibody test had the follow-up test reported to the health department. The other half did not have a follow-up test reported, although some of them may have beentested.

    (The presence of the CDC logo and CDC content on this page should not be construed to imply endorsement by the U.S. government of any commercial products or services, or to replace the advice of a medical professional. The mark “CDC” is licensed under authority of the PHS.)
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    AScripps Health answered

    Infectious hepatitis A is a food- or water-borne disease (sometimes fatal) that attacks the liver. Immunization fully protects against the disease and should be taken by nearly all international travelers.

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    AScripps Health answered

    If you’re part of the “baby boom” generation, born between 1945 and 1965, the Centers for Disease Control (CDC) has a message for you: Get tested for hepatitis C.

    Hepatitis C is spread through infected blood -- and that’s why baby boomers are at such high risk. The American Gastroenterological Association (AGA) notes that baby boomers represent 82 percent of Americans with hepatitis C. Because blood wasn’t regularly tested for the virus until the 1990s, people who had blood transfusions before that may have been infected. Hepatitis C can also be transmitted through IV drug use, unprotected sex, unsterile piercings or tattoos or exposure to infected blood, and may be passed from mother to baby during birth. People can continue passing the virus for decades after they are infected.

    Because hepatitis C can have no symptoms until considerable damage has been done to the liver, up to 75 percent of those infected don’t even know they have the virus. If newly infected patients have symptoms, they can be ambiguous, such as nausea, poor appetite, fatigue or dark urine. Such symptoms are easily mistaken for flu or an upset stomach, so people tend not to seek medical care.

    The CDC’s recommendation for age-based screening may identify more than 800,000 more cases of chronic hepatitis C than conventional screening. Until now, physicians have been screening patients by asking them questions, such as whether they have had a blood transfusion or used IV drugs. However, this was not effective at identifying patients who needed to be tested.

    Screening all baby boomers through a simple blood test enables physicians to identify and treat more people in the early stages of the disease and reduces the complications and cost of treating them for cirrhosis, liver cancer and other serious liver problems.

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    AHealthwise answered

    If you see a person with hepatitis B become unconscious, call 911 or other emergency services.

    Call a doctor right away if you have been diagnosed with hepatitis B and you have severe dehydration or these signs of liver failure:

    • Extreme irritability.
    • Trouble thinking clearly.
    • Extreme sleepiness.
    • Swelling of the arms, legs, hands, feet, belly or face.
    • Heavy bleeding from the nose, mouth or rectum (including blood in the stool), or under the skin.
    • Yellowing of the skin and the whites of the eyes.

    Call to make an appointment if:

    • You have risk factors for hepatitis B, such as handling blood or body fluids as a routine part of your job or having many sex partners.
    • You have any symptoms of hepatitis B.
    • Someone in your household has been diagnosed with hepatitis B.
    • Your sex partner has been diagnosed with hepatitis B.
    • You have been bitten by or exposed to the blood or body fluids (such as semen or vaginal fluids, including menstrual blood) of someone who has hepatitis B.

    Watchful waiting: Watchful waiting is a period of time during which you and your doctor observe your symptoms or condition without using medical treatment. Because of the need to prevent the spread of hepatitis B, watchful waiting isn't advised if you have symptoms of the virus or if you think you have come in contact with the virus.

    Who to see: Hepatitis B usually can be diagnosed by:
    • Family medicine doctors.
    • Pediatricians.
    • Internists.
    • Physician assistants.
    • Nurse practitioners.
    These specialists may work with your doctor to plan treatment:
    • Gastroenterologist
    • Hepatologist
    • Infectious disease specialist

    © Healthwise, Incorporated.

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    ARealAge answered

    The most common screening test for detecting hepatitis B virus (HBV) infection is a blood test that searches for the presence of hepatitis B surface antigen (HBsAg). The presence of this antigen (a foreign molecule capable of inducing a protective response from the body) shows that a hepatitis B viral infection is present or that vaccination against HBV has been successful.

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