10 Questions to Ask Your Doctor About Hepatitis C
1. How did I get hepatitis C?
The virus is spread through contact with an infected person’s blood. People who are part of the baby boomer generation may have been exposed during a blood transfusion they received before 1992, when widespread screening virtually eliminated the virus from the United States’ blood supply. Three out of every four people infected with hepatitis C were born between 1945 and 1965, which is why national health organizations, including the U.S. Preventive Services Task Force, advise baby boomers to be screened for hepatitis C at least once.
It’s also possible to contract hepatitis C during a needlestick injury in a healthcare setting or by sharing needles with other people during, for example, intravenous drug use, or by getting an unregulated tattoo. If you learn that you have hepatitis C, keep in mind that the virus can be treated and cured with medication.
2. How does hepatitis C affect my liver?
Over time, hepatitis C can damage the liver and cause inflammation as well as cirrhosis (permanent scarring of the liver) or liver cancer, according to the CDC. The catch is that you may not notice the virus’s effects until years or decades after you contracted it.
“The liver is an uncomplaining organ,” explains Thelma King Thiel, RN, the founder and chair of the Liver Health Initiative in Silver Spring, Maryland.
3. What do my test results mean?
There are two blood tests that are used to detect hepatitis C. The first tests for hepatitis C antibodies, or signs that your body fought or is fighting an infection. The results of the test will tell your doctor whether you've ever had the virus.
A positive antibody test will be followed up with a second test, which can detect the amount of virus, or so-called “viral load,” in your blood. Your doctor may then conduct another blood test to determine which type (genotype) of hepatitis C you have, which can allow your treatment to be more targeted.
RELATED: What to Expect During a Hepatitis C Test
4. How do I know if my infection is acute or chronic?
An acute infection occurs within six months of exposure to the virus. Unless you happen to get tested during that period, you may not know that you have it. Symptoms include a fever, fatigue, and nausea, but about 70 to 80 percent of people with hepatitis C don’t experience them, according to the CDC.
Some people have the ability to fight off the virus on their own, although most do not. About 75 to 85 percent of people will eventually develop chronic hepatitis C, which might not cause symptoms for decades. If your test results show that you have chronic hepatitis C, your doctor may recommend treatment.
5. Is my hepatitis C curable?
With the help of certain medications, most people can rid their bodies of hepatitis C. “Many new treatment options are becoming available that should allow almost every patient to be treated successfully," says David Nelson, MD, a professor of medicine and the associate dean for clinical research in the College of Medicine at the University of Florida in Gainesville. Nelson is also a principal investigator for the national HCV-TARGET research program tracking hepatitis C treatments and outcomes. "This will lead to healing of the liver,” he says, “and marked improvement of quality of life."
Keep in mind, however, that people don’t develop immunity to the virus. If you don’t take the right precautions, it’s possible to contract hepatitis C again.
6. Which tests can help determine if my liver is healthy?
If you have hepatitis C, you may need a liver enzyme test or an ultrasound. Determining whether you have cirrhosis is the most important initial assessment, and it helps frame all other discussions, says Dr. Nelson. "Those with more advanced liver disease often need an endoscopy and liver cancer screening."
7. What lifestyle changes should I make to help keep my liver healthy?
Besides treating your hepatitis C with prescribed medications, you should exercise, lose weight if necessary, reduce your consumption of alcohol, and refrain from using marijuana, says Nelson. Research published in 2013 in the Nutrition Journal showed that a low-fat, low-calorie diet followed for one year can improve liver health in obese people with chronic hepatitis C.
And there's good news for coffee lovers too: Coffee consumption seems to help limit the damaging effects of hepatitis C on the liver, according to a 2014 review published in the journal Liver International. More recently, a 2019 study published in the Journal of Hepatology found that drinking coffee or herbal tea may help protect the liver from scarring. You should also be immunized against hepatitis A and B; there are vaccines available for both viruses.
8. How can I make sure that I don’t pass the infection to someone else?
Hepatitis C is passed from one person to another through direct blood contact. “Avoid high-risk behaviors such as IV drug use, unprotected sex outside of a monogamous relationship, and sharing razor blades or toothbrushes,” Nelson says. But you don’t need to isolate yourself. “You can’t spread this virus by hugging or kissing kids, family, and friends," he adds. "It’s okay to carry on a normal life.”
9. Should I have other specialists on my treatment team?
If you have an addiction — for example, to alcohol, cigarettes, or illicit drugs — you may benefit from working with an addiction specialist who can help you kick the habit. A hepatologist can treat the virus itself, a mental health professional can help you cope with anxiety or depression, and a registered dietitian can help you create a customized, healthy diet.
10. Where can I find more support?
Ask your doctor whether a local clinic or other nearby organization operates a support group.
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