Hepatitis C

Diagnosis

Diagnosing hepatitis C typically begins with a screening test, followed by several additional tests to understand the severity of the infection and the extent of liver damage.

Blood tests

Blood tests are used to confirm the presence of the hepatitis C virus and provide important information about the virus and its effects on the body. Key tests include:

• Viral load test: Measures the amount of hepatitis C virus in the blood.

• Genotype test: Identifies the strain or genotype of the virus, which helps guide treatment decisions.

• Liver damage tests: Several tests can help assess the amount of liver damage in chronic hepatitis C.

Tests for liver damage

To assess liver damage, a healthcare provider may recommend one or more of the following tests:

• Magnetic resonance elastography (MRE): This non-invasive imaging technique combines magnetic resonance imaging (MRI) with sound waves to create a map of liver stiffness. Stiff liver tissue indicates scarring, also called fibrosis.

• Transient elastography: This ultrasound-based test measures liver stiffness by sending vibrations into the liver and tracking the speed at which they travel through the tissue. It can sometimes replace a liver biopsy.

• Liver biopsy: A thin needle is inserted into the liver to remove a small tissue sample for analysis. This test helps determine the degree of liver damage or scarring.

• Blood tests for scarring: Additional blood tests can measure levels of certain proteins that indicate liver scarring.

Treatment

Treatment for hepatitis C aims to clear the virus from the body and prevent further liver damage. The choice of treatment depends on factors such as the virus genotype, liver condition, and any other medical issues.

Antiviral medicines

Direct-acting antiviral (DAA) medications are the primary treatment for hepatitis C. These newer antiviral drugs are highly effective and have fewer side effects compared to older treatments. The goal of treatment is to have no detectable hepatitis C virus in the blood for at least 12 weeks after completing treatment.

• Duration of treatment: Treatment with DAAs typically lasts 8 to 12 weeks, depending on the virus genotype and liver condition.

• Monitoring: Throughout treatment, the healthcare team monitors progress and any potential side effects.

Because hepatitis C treatment options are rapidly evolving, it’s important to consult with a specialist to determine the most appropriate treatment plan.

Liver transplantation

For individuals with severe liver damage due to chronic hepatitis C, a liver transplant may be considered. During this procedure, the damaged liver is replaced with a healthy one, usually from a deceased donor.

However, a liver transplant does not cure hepatitis C. The virus is likely to return, so additional antiviral treatment is typically required after the transplant to prevent damage to the new liver.

Some studies have shown that newer antiviral medications may help cure hepatitis C before or after a liver transplant.

Vaccinations

Although there is no vaccine for hepatitis C, it is recommended to get vaccinated against hepatitis A and B. These viruses can also damage the liver and complicate hepatitis C infections.

Hepatitis C is a serious condition, but with the right treatment, most people can manage the virus and prevent further liver damage. Always consult a healthcare provider for the most current treatment options and recommendations.