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FAQs
What is hepatitis C?
The hepatitis C virus is a type of virus that primarily attacks the liver. As the virus reproduces, it kills surrounding cells and triggers the body's immune system to fight back. This defence can lead to reactions, such as inflammation and/or fibrosis (scarring) of the liver. If left untreated, hepatitis C can result in liver damage.
How do people become infected with hepatitis C?
In order to become infected with hepatitis C, a person's blood must come into contact with the blood of an infected person. Common methods of transmission are:
- The sharing of needles and intravenous drug equipment for injecting, as well non-injectable forms of drug use such as the snorting of illicit drugs.
- Tattooing, acupuncture and body piercing from contaminated equipment that is not properly cleaned after use.
- Blood transfusions/haemodialysis/transplant procedures : compulsory screening of blood is undertaken in NZ and this makes infection with hepatitis C from these procedures rare.
- Sexual contact. The risk of sexual transmission is extremely low. However, it is advisable to use condoms during menstruation, when having anal sex, if you have many partners, or if your partner has sores around the mouth or genitals or is infected with an STD.
- Mother to baby at time of delivery. Transmission is uncommon and occurs in 5-7% of mothers whom are infected with hepatitis C. The risk of the baby getting hepatitis C increases when the mother is HIV positive. Hepatitis C can sometimes be found at very low levels in breast milk, however the virus is killed as soon as it enters the baby’s stomach. Breast feeding is therefore safe.
- Other potential routes of transmission may be the sharing of toothbrushes and shaving equipment.
Please note that cooking, eating or bathing with a person that is infected with hepatitis C will not spread the virus.
How can I reduce the likelihood of spreading the hepatitis C virus?
See your doctor for a diagnosis and to discuss treatment options. Once you're undergoing treatment, be sure you take your medication as directed and stay on it for the entire prescribed course of treatment. Also, be sure to ask your doctor about how to avoid transmitting hepatitis C, and mention any particular concerns you may have.
Some important points to remember:
- Advise anyone who could come into contact with your blood—such as your sexual partner, doctor, or dentist—that you are, or might be, infected with HCV.
- Do not share toothbrushes, razors, or other personal care items that might have your blood on them.
- Carefully dispose of any bloodstained items (eg, tissues, cotton swabs, tampons, sanitary napkins) and wipe up all blood spills with bleach.
- Use disinfectants and bandages to dress cuts and wounds.
- Cover your cuts and open sores.
- Do not donate blood or organs.
What does the liver do?
The liver is the largest organ in the body. It is a key organ in regulating balance within the body. Functions of the liver include:
- Manufacturing proteins
- Storage and metabolism of fats and carbohydrates
- Detoxification of drugs and other toxins
- Excretion of bilirubin
- Metabolism of hormones
The liver has considerable reserve capacity, and can often maintain function in spite of significant disease and is one of the few human organs capable of regeneration.
When the liver becomes damaged due to chronic infection with hepatitis C, all of these functions can be affected.
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Do You Have Hepatitis C?
How do I know if I have hepatitis C?
The only way to know if you are infected is to see your doctor and get a blood test.
What type of doctor treats hepatitis C?
Doctors who treat hepatitis C include hepatologists, who specialise in diseases of the liver, gastroenterologists, who specialise in diseases of the gastrointestinal tract, primary care physicians, and infectious disease specialists. Nurses can also play a major role in hepatitis care, and may be responsible for providing support and answering questions throughout the management of the disease.
Why is my genotype important?
There are several different genotypes or strains of hepatitis C. You will want to know which specific type of virus you have to work with your doctor to determine your treatment options and how long you should be on treatment.
What is a liver biopsy?
A liver biopsy is a procedure in which a small sample of the liver is removed through a hollow needle and examined in a laboratory. This test is the best way to determine the health of your liver.
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Living With Hepatitis C
Who can help me cope with hepatitis C?
Your doctors and nurses will be your guides as you make your way through the process of treatment. In addition, there are other health professionals who can help. Of course, you'll also want to add family and friends to your support team. In addition, support groups, both online and in your community, can provide information and resources and also offer emotional comfort when you most need it. If you are receiving treatment with PEGASYS, the Pegassist™ support program will offer education and resources to both patients and their caregivers.
What should I do if I feel depressed?
Many people with hepatitis C and other illnesses experience times of depression. If you feel depressed or have any concerns about depression, it's very important to talk with your doctor.
Many factors can cause or add to feelings of depression. In people who have hepatitis C, depression can be caused by a difficulty coping with their diagnosis or their symptoms. Again, if you have concerns about depression, speak with your doctor, who can provide more information.
If I get pregnant, will I transfer the HCV virus to my unborn child?
There is a slight incidence (about 5-7% ) of transmission from mother to child. A greater concern, however, is family planning among patients being treated with interferon. When either partner is on treatment, it is important to avoid pregnancy. Medications used to treat hepatitis C may cause miscarriage or birth defects. Therefore, you should practice safe sex, regardless of which partner is in treatment. Talk to your doctor about your options.
Is it OK for me (or my partner) to get pregnant while I'm taking PEGASYS and COPEGUS therapy?
No.
Ribavirin has been shown to cause birth defects in unborn babies of female patients taking ribavirin and in babies of females whose male partner is undergoing treatment with ribavirin.
Pregnancy MUST be avoided by female patients and female partners of male patients during combination treatment with Pegasys and ribavirin and for six months after completing treatment.
Female patients and female partners of male patients must have a pregnancy test to confirm that they are not pregnant prior to starting treatment.
Two methods of contraception (including one barrier method) must be used simultaneously at all times during treatment and for six months after treatment.
If you or your partner becomes pregnant during therapy or within 6 months after treatment with ribavirin, immediately report the pregnancy to your doctor.
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Considering Treatment
How can I fight hepatitis C?
Your body naturally produces the protein interferon, and it makes even more interferon when it is trying to fight off an infection such as hepatitis C. People with hepatitis C may receive a treatment regimen that includes injections of supplemental interferon. This helps in two major ways:
- The interferon attaches itself to healthy cells and helps them to defend themselves against viruses.
- The interferon also increases immune system activity, such as the production of white blood cells, to help fight viruses.
How do I know if interferon therapy is working?
People with hepatitis C take interferon therapy (either alone or in combination with ribavarin) to try to clear the virus from their bodies and to try to protect the liver from further damage. To find out if interferon therapy is doing either of these things, doctors look at what's called "virologic response" and "histologic response."
- Virologic response—Virologic response is the most common way of evaluating hepatitis C treatment success. Your doctor will use a blood test to measure how much hepatitis C virus is in the blood. The best virologic response is a "sustained viral response," which means that the virus remains undetectable in your bloodstream at least 6 months after completing hepatitis C therapy. However, many people may still benefit from interferon treatment even if they don't have a strong virologic response.
- Histologic response—Histology (the study of tissue under a microscope) is used to see if liver inflammation has decreased.
Should I be treated for hepatitis C?
Many hepatitis C patients benefit from treatment, and treatment is usually the best way to prevent future liver damage. However, the decision to treat hepatitis C is a very personal one that only your doctor can help you to make.
Your doctor will first want to be sure that you have hepatitis C by taking a blood test. Once you know for certain, more tests may be needed—including tests to determine the health of your liver. Once these tests have been done, your doctor will be able to help you decide if you should take medication for your hepatitis C.
Do hepatitis C therapies cause side effects?
Click here - How is hepatitis C treated?
What is PEGASYS?
Click here - Introducing PEGASYS
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What is PEGASYS and ribavirin combination therapy?
PEGASYS is a medicine used to treat adults with chronic hepatitis C.
COPEGUS is an antiviral agent, also known as ribavirin, that fights infection.
Pegasys can be used alone or in combination with ribavirin, however the use of ribavirin alone is not effective for the treatment of hepatitis C.
With PEGASYS and ribavirin combination therapy, the hepatitis C virus can be decreased to a level so low that it cannot be measured by blood tests. After 3 to 6 months of therapy, a blood test can help your healthcare provider determine your likelihood of long-term response.
How can I be sure PEGASYS therapy is working?
Be sure to keep up with your doctor's appointments and scheduled lab tests, as these tests and check-ups are the only way for your doctor to assess the effect of treatment on your condition. Also, once you start interferon therapy, be sure to stick with it until your doctor advises you that the treatment regimen is complete.
How do I take PEGASYS and ribavirin?
Like all other alfa interferon therapies for hepatitis C, PEGASYS must be injected.
However, because PEGASYS is pegylated, it only needs to be injected once per week. In addition, PEGASYS is presented in a ready to use pre-filled syringe at a fixed dose of either 180mcg or 135mcg.
In addition to PEGASYS, your doctor may prescribe ribavirin. Ribavirin is used to help stop the virus from multiplying. Ribavirin is a tablet, so while it does not need to be injected, you will need to take several tablets every day.
The usual course of therapy with PEGASYS and ribavirin is 24 to 48 weeks, depending upon what hepatitis C genotype you have. Always be sure to take PEGASYS and ribavirin exactly as your doctor has prescribed them.
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Family and Friends
How can I help a family member or friend with hepatitis C?
There are a number of ways that you can provide support to your friend or loved one with hepatitis C.
- First, it is important to learn all you can about the disease so you can better understand what your family member or friend is experiencing.
- Encourage him or her to continue daily activities, but also be aware of times when he or she is fatigued or feeling ill and needs more help than usual.
- Most importantly, help him or her to eat nutritious foods, exercise regularly, take medications correctly, and maintain a positive attitude.
- During the first 12 weeks of treatment, when side effects may be at their peak, be sure to emphasize the potential benefits of treatment and the importance of protecting the liver. By being positive about treatment, you can offer a great deal of help and support.
Am I at risk of becoming infected with hepatitis C?
Hepatitis C is spread through contact with infected blood. As long as you take steps to avoid exposure to infected blood, you can minimize your risk of becoming infected with the hepatitis C virus. These steps include not sharing any sharp instruments, including needles, nail scissors or files, toothbrushes, and any other hygienic items that may have even trace amounts of blood on them.
Please note :
The information in this website on ribavirin relates to the COPEGUS brand of ribavirin only. If you have been prescribed another brand of ribavirin, please see your doctor or nurse for the information on that product.
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