Management of Hepatitis C I: Investigation and Treatment

Investigation of Hepatitis C

When it comes to hepatitis C, most patients (60 to 70 percent) with HCV infection are asymptomatic i.e. they don’t show any sign or symptom; when symptoms do occur, they are non-specific and include fatigue, nausea, anorexia, myalgias, arthralgias, weakness, and weight loss. This sometimes makes it difficult for most medical doctors to ascertain what could be physically wrong with an individual.

This is the reason why it is important to investigate certain symptoms by seeking counsel and visiting a hospital for diagnosis. This is the reason why medical doctors recommend that adults aged between18 to 79 years be screened for hepatitis C, even those without symptoms or known liver disease. Screening for HCV is especially important if one is at high risk of exposure, including:

• Individual who have injected or inhaled illicit / illegal drugs.
• Individual who have abnormal liver function test results with no identified cause.
• Babies born to mothers with hepatitis C.
• Health care workers who might have been exposed to blood or used and contaminated injections / syringe.
• People with hemophilia and might have undergone long – term hemodialysis treatments.
• People who received blood transfusions illegally.
• Sexual partners of anyone diagnosed with hepatitis C infection.
• People with HIV infection.
• Anyone who has been in prison and might have gotten involved with other people with the HCV.

Also, medical doctors could also recommend the test of liver so as to locate any form of abnormalities; and this happen when hepatitis C might have become chronic in the body. Doctors typically use one or more of the following tests to assess liver damage in chronic hepatitis C.

• Magnetic Resonance Elastography (MRE): A noninvasive alternative to a liver biopsy, MRE combines magnetic resonance imaging technology with patterns formed by sound waves bouncing off the liver to create a visual map showing gradients of stiffness throughout the liver. Stiff liver tissue indicates the presence of scarring of the liver (fibrosis) as a result of chronic hepatitis C.
• Transient Elastography: Another noninvasive test, transient elastography is a type of ultrasound that transmits vibrations into the liver and measures the speed of their dispersal through liver tissue to estimate its stiffness.
• Liver Biopsy: Typically done using ultrasound guidance, this test involves inserting a thin needle through the abdominal wall to remove a small sample of liver tissue for laboratory testing.
• Blood Tests: A series of blood tests can indicate the extent of fibrosis in the liver.Although hepatitis C virus has no form of vaccine at the moment, yet certain medicine can be used to curb its effect on different individuals.

Treatment of Hepatitis C

• Antiviral medications

Hepatitis C infection is treated with antiviral medications intended to clear the virus from the body. The goal of treatment is to have no hepatitis C virus detected in the body at least 12 weeks after a complete treatment.

Medical researchers have recently made significant advances in treatment for hepatitis C using new, direct-acting antiviral (DAA) medications.

These DAA has been known to be the safest and most effective medicines for treating hepatitis C. The choice of medications and length of treatment depend on the hepatitis C genotype, presence of existing liver damage, other medical conditions and prior treatments. Some types of hepatitis C can be treated using more than 1 type of DAA.

Some of the approved hepatitis C medicines include:

1. Simeprevir
2. Sofosbuvir
3. A combination of ledipasvir and sofosbuvir
4. A combination of ombitasvir, paritaprevir and ritonavir, taken with or without dasabuvir
5. A combination of sofosbuvir and velpatasvir
6. A combination of sofosbuvir, velpatasvir and voxilaprevir
7. A combination of glecaprevir and pibrentasvir
8. Ribavarin

• Liver Transplantation

For individuals who might have developed serious complications from chronic hepatitis C infection, liver transplant might be an option for them. This is because there might be need for their damaged livers to be replaced with healthy ones.

In most cases, a liver transplant alone doesn't cure hepatitis C. The infection is likely to return, requiring treatment with antiviral medication to prevent damage to the transplanted liver. Several studies have demonstrated that new, direct-acting antiviral medication regimens are effective at curing post-transplant hepatitis C. At the same time, treatment with direct-acting antivirals can be achieved in appropriately selected patients before liver transplantation.

• Vaccinations

Although there is no vaccine for hepatitis C, doctors are more likely to recommend that an individual receive vaccines against the hepatitis A and B viruses. These are separate viruses that also can cause liver damage and complicate the course of chronic hepatitis C.

[Next Article: Causes and Prevention of Hepatitis C]