Diagnosis
If a screening test shows hepatitis C, other blood tests can:
- Measure the quantity of the hepatitis C virus in the blood, called the viral load.
- Show the genotype of the virus.
Tests for liver damage
One or more of the following tests looks for liver damage in chronic hepatitis C.
- Magnetic resonance elastography (MRE). This noninvasive imaging can be done instead of a liver biopsy. It mixes magnetic resonance imaging technology with patterns formed by sound waves bouncing off the liver. This makes a map that shows places where the liver is stiff. Stiff liver tissue means scarring of the liver, called fibrosis.
- Transient elastography. Another test of liver stiffness is a type of ultrasound that sends vibrations into the liver. The test measures how fast the vibrations go through liver tissue.
- Liver biopsy. This is often done using ultrasound as a guide. It involves putting a thin needle into the liver to remove a small sample of liver tissue to be tested in a lab.
- Blood tests. A series of blood tests can show the amount of scarring in the liver.
Transient elastography
A member of the care team does transient elastography to find liver damage. This sometimes can be done instead of a liver biopsy.
Treatment
Antiviral medicines
Antiviral medicines treat hepatitis C. They're used to clear the virus from the body. The goal of treatment is to have no hepatitis C virus found in the body for at least 12 weeks after treatment ends.
Some newer antiviral medicines, called direct-acting, have better outcomes, fewer side effects and shorter treatment times. Treatment can be as short as eight weeks. The choice of medicines and length of treatment depend on the hepatitis C genotype, whether the liver is damaged, other medical conditions and earlier treatments.
Throughout treatment, the care team watches the treatment for response to the medicines and side effects. Treatment with direct-acting antiviral medicines usually lasts 12 weeks.
Due to the pace of research, treatments are changing quickly. So it's best to discuss treatment choices with a specialist.
Liver transplantation
Having a liver transplant might be an option for serious liver damage from chronic hepatitis C infection. During a liver transplant, a surgeon removes the damaged liver and replaces it with a healthy liver. Most transplanted livers come from dead donors. A small number come from living donors who donate a part of their livers.
In most cases, a liver transplant alone doesn't cure hepatitis C. The infection is likely to return. This means more treatment with antiviral medicines to prevent damage to the new liver. Several studies have shown that newer antiviral medicines cure hepatitis C after a transplant. Sometimes, the newer antivirals can cure hepatitis C before a liver transplant.
Vaccinations
There's no vaccine for hepatitis C. But a healthcare professional will likely recommend vaccines against the hepatitis A and B viruses. These are viruses that also can cause liver damage and make hepatitis C worse.
Self-care
Certain lifestyle changes can help manage hepatitis C. These measures can help keep you healthy longer and protect the health of others:
- Stop drinking alcohol. Alcohol speeds liver disease.
- Don't use medicines that might cause liver damage. Review all medicines you take with your healthcare team. You might need to not take certain medicines.
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Keep others from coming in contact with your blood. Cover wounds you have. Don't share razors or toothbrushes. Don't donate blood, body organs or semen. Tell healthcare workers that you have the virus.
Tell your partner about your infection before you have sex. Always use condoms during intercourse.
Preparing for your appointment
If you think you might be at risk of hepatitis C, see a healthcare professional. If you're diagnosed with a hepatitis C infection, a health professional might refer you to a specialist in liver diseases, called a hepatologist, or a specialist in infectious diseases.
What you can do
Consider taking a family member or friend with you to the appointment to help you remember the information you get.
Make a list of:
- Your test results. If you're seeing a liver specialist for the first time after being diagnosed with hepatitis C, write down the results of tests you've had. This includes a liver biopsy to check for damage from chronic infection and a blood test to find which hepatitis C genotype you have.
- Your symptoms, including any that may seem unrelated to the reason for which you scheduled the appointment, and when they began.
- All medicines, vitamins and supplements you take, including doses.
- Questions to ask your healthcare team.
Some basic questions to ask about hepatitis C include:
- Should I be tested for other causes of liver disease, such as hepatitis B?
- Has the hepatitis C virus damaged my liver?
- Do I need treatment for a hepatitis C infection?
- What are my treatment choices?
- What are the pros of each treatment option?
- What are the potential risks of each treatment option?
- Is there one treatment you think is best for me?
- I have other medical conditions. How will these affect my hepatitis C treatment?
- Should my family be tested for hepatitis C?
- Is it possible for me to spread the hepatitis C virus to others?
- How can I protect the people around me from hepatitis C?
- Are there brochures or other material that I can have? What websites do you recommend?
- What will decide whether I should plan for a follow-up visit?
- Is it safe for me to drink alcohol?
- What medicines should I avoid?
Be sure to ask all the questions you have about your condition.
What to expect from your doctor
You'll likely be asked a few questions, such as:
- Have you ever gotten donated blood or an organ transplant? If so, when?
- Have you ever given yourself shots of illegal drugs?
- Have you been diagnosed with hepatitis or jaundice?
- Does anyone in your family have hepatitis C?
- Is there a history of liver disease in your family?