Hepatitis C - diagnosis and treatment (2023)

Diagnose

Screening for hepatitis C

the us The Preventive Services Task Force recommends that all adults ages 18 to 79 be screened for hepatitis C, including those without symptoms or known liver disease. screening forHCVis especially important if you are at high risk of exposure, including:

• Anyone who has ever injected or inhaled illegal drugs
• Anyone who has abnormal liver function test results with no identified cause
• Babies born to mothers with hepatitis C
• Health and rescue workers who have been exposed to blood or accidental needle sticks
• People with hemophilia who were treated with coagulation factors before 1987
• People who have undergone long-term hemodialysis treatment
• People who received blood transfusions or organ transplants before 1992
• Sexual partners of people diagnosed with hepatitis C infection
• people with HIV infection
• Anyone born between 1945 and 1965
• Everyone who was in prison

Other blood tests

If an initial blood test shows you have hepatitis C, additional blood tests will:

• Measure the amount of hepatitis C virus in your blood (viral load)
• Identify the genotype of the virus

Tests for liver damage

Doctors typically use one or more of the following tests to assess liver damage in chronic hepatitis C.

• Magnetresonanz-Elastographie (MRE).A non-invasive alternative to a liver biopsy (see below),MREcombines magnetic resonance imaging technology with patterns formed by sound waves bouncing off the liver to create a visual map showing stiffness gradients throughout the liver. Stiff liver tissue indicates scarring of the liver (fibrosis) as a result of chronic hepatitis C.
• Transient Elastography.Another non-invasive test, transient elastography, is a type of ultrasound that transmits vibrations to the liver and measures the speed of their propagation through the liver tissue to assess its stiffness.
• liver biopsy.This test is usually done under ultrasound guidance and involves inserting a thin needle through the abdominal wall to take a small sample of liver tissue for laboratory testing.
• blood tests.A series of blood tests can show the extent of fibrosis in your liver.

Note: This content was created prior to the 2019 coronavirus disease (COVID-19) pandemic and does not show proper pandemic logs. Please follow all recommended guidelines for masking and social distancing from the Centers for Disease Control and Prevention.

Treatment

Antiviral drugs

Hepatitis C infection is treated with antiviral medicines designed to clear the virus from your body. The aim of treatment is that no hepatitis C virus is detected in your body for at least 12 weeks after the end of treatment.

Researchers have recently made significant advances in treating hepatitis C using new, "direct-acting" antiviral drugs, sometimes in combination with existing ones. As a result, people are experiencing better results, fewer side effects, and shorter treatment times — some as little as eight weeks. The choice of drugs and the duration of treatment depend on the hepatitis C genotype, the presence of existing liver damage, other diseases and previous treatments.

Because of the pace of research, recommendations for medications and treatment regimens are changing rapidly. It is therefore best to discuss your treatment options with a specialist.

Throughout treatment, your care team will monitor your response to medication.

Lebertransplantation

If you've had serious complications from chronic hepatitis C infection, a liver transplant may be an option. In a liver transplant, the surgeon removes your damaged liver and replaces it with a healthy liver. Most transplanted livers are from deceased donors, although a small number are from living donors who donate part of their livers.

In most cases, a liver transplant alone does not cure hepatitis C. The infection is likely to return and will require treatment with antiviral drugs to prevent damage to the transplanted liver. Several studies have shown that new, direct-acting antiviral regimens are effective in curing post-transplant hepatitis C. At the same time, treatment with direct-acting antiviral drugs can be achieved in appropriately selected patients prior to liver transplantation.

vaccinations

Although there is no vaccine against hepatitis C, your doctor will likely recommend that you receive vaccinations against hepatitis A and B viruses. These are separate viruses that can also cause liver damage and complicate the course of chronic hepatitis C.

Clinical Trials

Explore the Mayo Clinic studiesExperimenting with new treatments, interventions and tests as a means of preventing, detecting, treating or managing this condition.

lifestyle and home remedies

If you receive a diagnosis of hepatitis C, your doctor will likely recommend certain lifestyle changes. These measures will help you stay healthy longer and also protect the health of others:

• stop drinking alcoholAlcohol accelerates the progression of liver disease.
• Avoid medications that can cause liver damage.Review your medications with your doctor, including over-the-counter medications you take and herbal and dietary supplements. Your doctor may recommend that you avoid certain medications.
• Help prevent others from coming into contact with your blood.Cover any wounds you have and don't share razors or toothbrushes. Do not donate blood, body organs or semen and tell the medical staff that you have the virus. Also, tell your partner about your infection before sex and always use condoms during intercourse.

Prepare for your appointment

If you think you are at risk for hepatitis C, contact your GP. Once you've been diagnosed with hepatitis C infection, your doctor may refer you to a liver disease (hepatologist) or infectious disease specialist.

What you can do

As appointments can be short and there is often a lot to discuss, it is good to prepare well. To prepare, try the following:

• Check your medical record.This is especially important if you are visiting a liver specialist (hepatologist) for the first time after discovering that you have hepatitis C. If you've had a liver biopsy to check for damage from a chronic infection and a blood test to determine your hepatitis C genotype, make sure you know the results so you can share them with your medical team.
• Observe all restrictions before the appointment.When making an appointment, be sure to ask if there is anything you need to do in advance, such as B. Restricting your diet.
• Write down any symptoms you haveincluding any that seem unrelated to the reason you made the appointment.
• Make a list of all medicationsVitamins or supplements you are taking.
• Consider taking a family member or friend with you.Sometimes it can be difficult to remember all the information given during an appointment. Someone accompanying you may remember something you missed or forgot.

To make the most of your time with your doctor, bring a list of questions you want to ask. Put your most important questions at the top of your list in case time runs out. If you have hepatitis C infection, there are a few basic questions you should ask your doctor:

• Should I get tested for other causes of liver disease like hepatitis B?
• Has the hepatitis C virus damaged my liver?
• Do I need treatment for hepatitis C infection?
• What treatment options do I have?
• What are the benefits of each treatment option?
• What are the potential risks of each treatment option?
• Is there a treatment that you think is best for me?
• I have other illnesses. How will these affect my hepatitis C treatment?
• Should my family be tested for hepatitis C?
• Can I spread the hepatitis C virus to others?
• How can I protect people around me from hepatitis C?
• Should I see a specialist? Will my insurance cover the costs?
• Are there brochures or other materials I can take with me? Which websites do you recommend?
• What determines if I should schedule a follow-up visit?
• Is it safe for me to drink alcohol?
• What medications should I avoid?

Don't hesitate to ask any other questions you can think of during your appointment.

What to expect from your doctor

Your doctor will likely ask you some of the following questions. If you were concerned about your answers beforehand, this part of the visit may go faster than usual, giving you more time to address your concerns.

• Have you ever had a blood transfusion or an organ transplant? If so, when?
• Have you ever taken self-injected medications that were not prescribed by your doctor?
• Have you ever been diagnosed with hepatitis or jaundice?
• Does anyone in your family have hepatitis C?
• Is there a history of liver disease in your family?