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Initially, HAV, HBV and HCV are tested for with a blood test that looks for antibodies.
Remember your ABC’s and ask your doctor to test you for Hepatitis A, B and C. If you show antibodies, don’t panic. Antibodies ONLY mean that at some point, you’ve had contact with that virus. If you do show antibodies for HBV or HCV, you need to have another test run that counts the amount of virus (if any) in your blood. This is called a “viral load” test. If you have a viral load, you have a chronic infection. If you don’t have a viral load, you’re done testing, but you’re not done yet! If you have a chronic infection, you should have further tests (see below) done to determine the damage, if any, to your liver. If you test negative for antibodies for Hepatitis A & B, GET VACCINATED ! ! ! There is a combo vaccine – three shots over a period of six months. Remember, HAV does not become a chronic infection, but it can still make you really sick and even possibly kill you. If you test negative for HBV, count your blessings and get vaccinated. Please. You don’t want HBV – it can go from zero to liver cancer in as little as six months without ever going through the stages of fibrosis mentioned earlier. You can treat it, but you can’t get rid of it. (Rarely, someone does go through a seroconversion where antigens convert to antibodies, but this occurs in only about 1%/year of those who are treating).
HCV – same program. Have the antibody test – if you have antibodies, have the viral load test run. If you have a viral load, you have a chronic infection and you should have further tests done to determine your status (see below). Remember, there’s no vaccine for HCV, but there is treatment and, for many, a cure.
Further testing – includes determining your genotype (which genetic variation you have) and perhaps a liver biopsy to physically examine liver tissue and assess the level of damage to the liver. Genotyping will determine which treatment drugs you should use and how long you need to use them. All of this initial workup should be done by a gastroenterologist or hepatologist.
Treatment for HBV is anti-viral medications administered daily with the hope of pounding the virus into submission or achieving a seroconversion. This can take up to 5 years or even longer. At this point there’s no cure for HBV, but treatment can reduce the risks for developing cirrhosis or liver cancer.
Treatment for HCV is, at this time, a combination of interferon (IFN) and anti-viral medication in tablet form –ribavirin (RBV). The interferon is taken by injection once a week, the pills are taken twice a day. More recently new drugs, protease (pro’- tea- ace) inhibitors, have been added to the standard protocol of IFN/RBV (only for genotype 1). The addition of these new drugs is raising the cure rates from around 45-50% to around 65-80%. Treatment durations are determined by genotype and by whether or not you’re using the third drug. The treatment drugs can have very uncomfortable side effects. Other new drugs are in clinical trials right now that may soon eliminate interferon as a part of treatment. Your status, as determined by the tests outlined above, will determine whether you can wait for the new drugs or whether you should treat now.
Because of the magnitude of this problem, the CDC has decided to mandate testing for everyone born between 1945 and 1965. If you don’t already know someone with viral hepatitis, you will. Viral hepatitis is now killing more people in this country than HIV. There is no greater gift than good health. Please get tested.
Finally, I would be remiss if I didn’t urge you to consider organ donation. As I write this, 16,811 people are waiting for a liver. Roughly 6,000 livers become available every year. The wait time can be as long as six to twelve months.
(Sigh)…………..Are we there yet?!?
There’s much more information than I can present here. I’m sure many of you will have questions. Please feel free to email us at Local Area Support for Hepatitis – LASH – the non-profit I run with my partner, Toni Donovan. We observe strict confidentiality. We’d be happy to do a presentation for your group, large or small. We have a support group meeting once a month. Thank you so much for reading all of this!
Click here for the entire “Your Liver, Your Health” series.
Hollis Pickett, in partnership with Toni Donovan, runs a Redding area non-profit – Local Area Support For Hepatitis, also known as LASH. Hollis has been involved with hepatitis advocacy since 2002 and is a steering committee member with CalHEP Alliance. She has been the bookkeeper and office manager for the law firm of Carr, Kennedy, Peterson & Frost for the past 25 years. Toni has just completed a Masters in Public Health (MPH) and is currently employed by Planned Parenthood and Acaria Health (a specialty pharmacy). LASH provides community education and patient/caregiver support for those infected with chronic viral hepatitis. A support group meets once a month for patients and their families. LASH offers group presentations, individual counseling and clinical education for patients entering treatment. You can contact them via e-mail at firstname.lastname@example.org or call Toni (945-7853) or Hollis (524-5601).