4 – Diagnosing and Testing For Hepatitis C
my family be tested for the virus? Should my children be tested?
It is recommended
that the people who live in your household be tested, because they might
have been exposed to the virus through exposure to your blood. Most HCV-infected
children contract the virus via perinatal transmission from their mothers.
Children should be screened for HCV if they are born to HCV-infected women,
received transfusion before 1992, or have high-risk behavior. Testing
of infants for anti-HCV should be done no sooner than 12 months of age.
Earlier testing by HCV RNA PCR at 1 or 2 months of age may be desired
to relieve family anxiety about possible infection.
It is probably best
to avoid sharing toothbrushes, fine-toothed combs, or other things that
they might have used that could have carried your blood. Having said this,
household transmission of hepatitis C is very uncommon, and we do not
recommend any other changes other than those mentioned above. In particular,
hugging, kissing, eating with the same set of dishes and silverware, and
using the same bathroom is not a problem. In a monogamous relationship,
transmission of the virus is very low.
have had hepatitis C for 25 years since my transfusion. My liver biopsy
last year showed mild scarring of the liver. My doctors told me I cannot
drink any alcohol. Is this true?
If you have scarring
of the liver, you should not drink alcohol as it can cause more damage
to your liver, cause you to develop symptoms or complications, and according
to new information cause the virus to replicate faster.
have hepatitis C with genotype 2. My last liver biopsy showed no fibrosis.
Should I be treated?
With genotype 2 and
no fibrosis, your chance of clearing virus is quite good, roughly 80%.
However, the decision is ultimately up to you. Some patients decide that
because of the subgroup of virus they have and that their liver has no
fibrosis, they will undergo therapy because they have a better chance
of getting rid of the virus altogether. Some patients in the same situation
decide that because they are feeling fine, they don't want to take medications
that could make them feel ill. This decision should be made with the help
of your doctor and your family. Once again though, you will make the final
doctor has advised me to have a liver biopsy because I have HCV. Is this
A liver biopsy is
frequently advised in cases of hepatitis C in order to determine the amount
of damage the liver has sustained from long-term infection. Like most
other areas of medicine, there are no rules that apply in every case.
There are several different types of hepatitis C (referred to as genotypes).
Some have suggested that a decision about treatment is much easier in
those with genotypes 2 or 3 hepatitis C, so a biopsy is correspondingly
less important. In other individuals with advanced scarring in the liver,
blood tests or other markers may make a biopsy unnecessary for staging.
is a liver biopsy, and why do I need one? I feel fine. Will a biopsy hurt?
Will I be under anesthesia for the procedure?
A liver biopsy is
a means by which a small sample of liver tissue is obtained for examination
under the microscope. Most of the time, anxiety about the biopsy is worse
than the biopsy itself. Nevertheless, in about 25% to 30% of patients,
there is enough discomfort after the biopsy that pain medicine must be
used. Some centers perform liver biopsies aided by an ultrasound device,
but this is not necessary. Other centers provide some light sedation prior
to the biopsy in order to reduce anxiety and keep pain to a minimum.
do I need to have a liver biopsy? Can't you tell from my blood work how
much damage my liver has sustained?
The amount of scar tissue in the liver is best assessed by means of a
liver biopsy. Blood tests may make it obvious that severe scarring (cirrhosis)
is present. In one scientific report, up to 28% of hepatitis C patients
who had liver biopsies had advanced scarring in the liver, and in only
a small fraction of these had the blood tests shown telltale signs.
HCV be misdiagnosed?
Hepatitis C can be
misdiagnosed in the early stages of the disease; that is, during the first
6 to 8 weeks after exposure if the antibody test is utilized. Rarely,
patients who are immunosuppressed or on dialysis can also have a negative
hepatitis C test. Some patients with lupus, rheumatoid arthritis, and
other autoimmune diseases may be falsely diagnosed with hepatitis C.
am so tired. Does that mean my hepatitis C is really bad? Is there anything
I can do to help with fatigue?
Fatigue is a very
common symptom in those with chronic diseases, including hepatitis C.
Needless to say, fatigue may be caused by many other things, even in the
individual who has hepatitis C. Overwork, lack of sleep, or emotional
difficulties may all contribute to fatigue. Medical conditions such as
anemia, an underactive thyroid, and poorly controlled diabetes are just
some of the conditions that can cause fatigue. Depression may also be
associated with fatigue. When I see a patient with hepatitis C who has
undue fatigue, I look for correctable causes. When no correctable causes
are found (which is most of the time) we are in a difficult situation
and modest changes in lifestyle need to be considered. Medications to
combat fatigue are not generally recommended because of the potential
for abuse and additional side effects.