What is hepatitis C?
The hepatitis C virus (Hepatitis C) can cause liver damage. Hepatitis C is transmitted mainly by direct contact with the blood of a person with HCV. Most people acquire Hepatitis C through the use of injectable drugs with equipment sharing. Up to 90% of people who have ever injected drugs, even just once, have been infected with HCV. Some people contracted Hepatitis C through unprotected sex. This is particularly true for people HIV positive, among men who have sex with men, people with other sexually transmitted diseases, people with multiple sexual partners, and those who engage in bleeding-causing sexual activities, such as fisting. Tattooing with ink and shared equipment can cause infection. Some people infected in the medical functions, definitions through health care equipment. Health professionals can get HCV from accidental bites with sharp objects. The risk of blood transfusions and blood products in the US is virtually zero.
Hepatitis C Spreads Easier
O Hepatite C se espalha mais facilmente do que o HIV através do contato com o sangue infectado. Nos EUA, pelo menos 4 vezes mais pessoas estão co-infectadas por Hepatite C e HIV. Você poderia estar infectado com HCV e não o saber, pois a maioria das pessoas não têm sintomas. Cerca de 15% a 30% das pessoas eliminam o vírus da Hepatite C, o Hepatite C, sem tratamento. O resto desenvolve infecção crônica, e o vírus permanece no seu corpo a menos que seja tratado com sucesso. O HCV pode não causar quaisquer problemas por cerca de quinze a vinte anos ou até por lapsos maiores de tempo; entretanto, ele pode causar graves danos hepáticos conhecidos como cirrose hepática. Pessoas com cirrose estão sob risco de desenvolver câncer de fígado, insuficiência hepática e morte. Um grande estudo em 2011 verificou que o simples fato (…) de ter hepatite C crônica dobra o risco de morte por qualquer outra causa.
How is Hepatitis C diagnosed?
Some people with Hepatitis C have abnormally high levels of enzymes. Can your doctor, based on the levels of these enzymes, order an HCV test?
Hepatitis C. See Fact Sheet 122 for more information on these tests. If you were at risk of having been exposed to HVC, you should be tested even if your liver enzyme levels are normal. The HCV test is recommended for all people with HIV, since co-infection between both viruses is common. Usually, the first blood test for Hepatitis C is an antibody test. A positive result means that you have been infected with HCV. However, some people have recovered from Hepatitis C infection without treatment; so you need a viral load HCV test to see if you have a chronic infection. The viral load test is recommended if you have been at risk for Hepatitis C or if you have any signs or symptoms of hepatitis.
Hep * C tests are similar for the HIV antibody test (see Fact Sheet 102) and viral load tests (see Fact Sheet 125.) Unlike HIV viral loads, viral loads of Hep C are generally much higher; often in millions. Unlike HIV, HCV viral load does not aid in the prognosis of disease progression.
Viral load of Hepatitis C or liver enzyme levels cannot tell how much your liver is damaged. A liver biopsy is the best way to check the condition of the liver. Read more Fact Sheet 672 for more information. If there is very little liver damage, some experts recommend monitoring; if there is damage (scars) HCV treatment may be necessary.
As the HEP C treated?
Almost all cases of Hepatitis C could be cured if treatment with interferon was started very soon, shortly after infection. Unfortunately most people do not have any signs of hepatitis, or they can be confused with those of the flu. Most cases are not diagnosed until years later. In 2014 the World Health Organization issued its first HCV Guide to treatment guidelines.
They are available in http://www.who.int/hiv/pub/hepatitis/hepatitis-c-guidelines/en/
The first step in treating Hepatitis C is to find out which Hepatitis C genotype you have (see Sheet of fact 674.) Most people with HCV in the US have the 1 genotype. Genotypes 1 and 4 are more difficult to treat than 2 or 3 genotypes.
The usual treatment for Hepatitis C was a combination of two drugs, pegylated interferon and pegIFN () ribavirin () (RBV). Fact Sheet 680 You have more information about these two drugs. pegIFN is injected once a week. RBV is a pill taken twice a day. These drugs have some serious side effects, including flu symptoms, irritability, depression, and low red blood cell count (anemia) or low white blood cell count (neutropenia.). Talk to your health care provider about how to deal with these side effects.
New treatments for HCV are being developed. Currently, these drugs are added to pegIFN / RBV. See Sheet of fact 682 For more information on telaprevir (Incivek) and Sheet of fact 683 No boceprevir (Victrelis).
Hepatitis C treatment does not work for everyone and some people cannot tolerate side effects. Patients get better treatment results when:
- Type 2 or 3 HCV
- Start treatment with a lower Hepatitis C viral load
- Do not have severe liver damage
- They are women
- It has less than forty years old
- Do not suffer from co-infection with HIV or hepatitis B
- They are white, not African American
The HEP C be prevented?
Although there are vaccines to protect you from infection with a Hep B or Hep B. There is still no vaccine for Hep C. The best way to prevent HEP C infection is to avoid being exposed to blood that is infected with Hep C. If you do not share equipment for drug use and avoiding other contacts with the blood of people infected with HEP C, your risk of hepatitis C infection will be lower.
HEP C and HIV TOGETHER
Because HIV and HCV can spread through contact with infected blood, many people are "infected" with two viruses. HIV increases liver damage caused by Hepatitis C. Co-infected people are more likely to have liver problems related to the use of ART anti-HIV, but your health care provider can choose the drug that is most easily metabolized by the liver.
- Infection is linked to the faster progression of Hepatitis C, and an increased risk of liver failure. On the other hand, Hepatitis C does not seem to accelerate HIV to disease progression.
- Co-infected people are more likely to have liver problems related to ART drugs against HIV, but the doctor may choose drugs that are easier to metabolize by the liver.
- People with both infections are more likely to have severe side effects. Depression is a symptom of HCV. This can cause loss of doses of medications (poor adherence, see Fact Sheet 405) and problems related to cognitive difficulty (see Fact Sheet 505.)
- HIV-positive people with less than 200 cells CD4 are at increased risk for severe liver damage from Hepatitis C.
- Co-infected people generally have higher viral loads of HCV, which means that the treatment may be less susceptible to poor results.
- Hep C treatment is less effective for co-infected persons. Cure rates are about 20% with type 1 and 50-70% with types 2 or 3.
- If someone meets the guidelines for the treatment of HIV by HIV they should be treated first. Leaving untreated HIV for a window of six to twelve months can have serious consequences.
- However, sometimes HCV should be treated first. If HIV does not need to be treated yet (if the CD4 cell count is high enough and HIV viral load is low enough), it is a good idea to treat Hepatitis C first. So the liver may be in a better position to deal with antiretrovirals.
- Some HIV drugs should be avoided when treating Hepatitis C. Do not use didanosine (ddI) with RBV. Avoid retrovir (AZT) during treatment Hepatitis C because it increases the risk of anemia. If you are infected, make sure that your health care provider knows how to treat both diseases.