Treatment And Management of Hepatitis C
Hepatitis C (HCV) is a viral infection caused by the hepatitis C virus and primary affects the liver causing chronic liver disease and cirrhosis. Hepatitis C is predominantly spread through body fluids mainly blood-to-blood contact through certain instances such as blood transfusions, needlestick injuries, poorly sterilized medical equipment or through intravenous drug administration. HCV infection progresses to a chronic stage in 80% of patients infected with the virus and often completely treated in 20% of the patients with acute HCV infection. Early diagnosis is, therefore, a vital practice in the treatment and management of Hepatitis C.
Hepatitis C symptoms are generally difficult to detect in acute infections as the virus only causes easily detectable symptoms in only 15% of the cases. The symptoms generally range from generally vague symptoms such as muscle or joint pains, nausea, fatigue and decreased appetite to mild symptoms such as acute liver failure. Chronic Hepatitis C develops after several years from unmanaged or untreated acute HCV infection and is associated with mild symptoms including constant fatigue and mild cognitive problems that may lead to other serious liver conditions such liver cirrhosis or liver cancer.
Routine diagnosis of HCV is highly recommended for adults at high infection risk i.e. those born between 1945 and 1965. The diagnosis is primarily conducted in a laboratory by detecting the presence of HCV antibodies via an enzyme immunoassay. However, a positive result should be confirmed with a qualitative and quantitative HCV RNA test using an HCV RNA polymerase chain reaction (RNA). Other diagnostic procedures may include liver biopsies, liver function tests, and ultrasound scans to determine the extent of liver damage due to HCV.
Hepatitis C treatments have advanced over the years with the capability of clearing the virus in 95% of acute infections. In rare instances, the body’s immunity single-handedly fights off and clear the virus. While there is an effective treatment exist, Hepatitis C lacks an effective vaccine, therefore, an early prevention is not available at the moment. Treatment of patients with chronic HCV infections should be selected based on the patient’s genotype, extent or liver cirrhosis or fibrosis, prior treatment, comorbidities along with drug toxicity
Hepatitis C infections are generally treated with antiviral medication. Currently, the recommended medication per US Food and Drug Administration (FDA) is Mavyret, a daily pill that combines glecaprevir and pibrentasvir. The drug has been proven effective in treating acute HCV infections in adults without liver cirrhosis within a period of 8 weeks. Chronic infections will require a longer period to treat. Other effective drugs in treating HCV include Zepatier, Harvoni, Vosevi, Daclastasvir, Ritonavir and Sofosbuvir-velpatsvir and are selected based on the Hepatitis C genotype. It is important to note that these drugs can have side effects like fatigue, skin rash, mild anxiety, depression, nausea, diarrhea among other effects, therefore, it is important to consult a doctor before beginning on any medication.
Managing HCV Infections
While on treatment, HCV patients should be medically managed to ensure the completely fight off the infection and to return to a healthy state along with managing the side effects of the drugs. HCV management involves:
- Coming up with effective lifestyle changes such as changing your diet, sexual behaviors or avoiding alcohol to prevent further liver damage along with reducing the risk of spread of the virus
- Ensuring medical adherence to prevent treatment failure or resistance development
- Exercising regularly
- Quit smoking completely
Medical and pharmaceutical advances have made possible to treat Hepatitis C making it one of the few treatable viral infections. While an effective cure may be available, it is important to protect yourself from contracting the disease.