What can I do about hepatitis C?
Being diagnosed with a disease like hepatitis C can be a little scary. The first thing is don’t panic. Take a deep breath. Although you might have been diagnosed with hepatitis C, you are not alone. Luckily, there are effective treatments available.
If you have hepatitis C, your family doctor should refer you to an expert in liver diseases (hepatologist/gastroenterologist/infectious disease specialist). A hepatologist is a specialist doctor who is an expert in treating liver diseases. An infectious disease specialist is an expert in treating chronic infections. These types of doctors are in the best position to help you diagnose and manage your condition.
Here are some recommendations on what you should do:
- Learn as much as you can about this disease. Education is very powerful and we’ve aimed to develop this LiverInfo website to be accessible and easy to understand for everyday people living with hepatitis C.
- Attend your medical appointments regularly
- Get your blood tests done as suggested by your doctor or nurse
- Learn about the medications used to treat hepatitis C.
- This LiverInfo website has many interactive and valuable tools to help you understand these medications and their impact on your disease
Treatment of hepatitis C
People with hepatitis C can lead active and productive lives with the right kind of treatment. But not everyone with hepatitis C needs treatment with medications. If hepatitis C only causes slight changes in your liver enzymes then treatment may not be necessary. However, for others, treatment is aimed at clearing the virus from the body. The decision to treat hepatitis C is based on many factors including the natural history of the disease, current state of your liver, how well the therapy may work, and potential side effects of treatment. Treatment is generally considered for the following individuals:
- Age 18 or older
- Have hepatitis C virus detectable in the blood
- Have a liver biopsy showing chronic hepatitis
- Have a liver that is working well and no other blood problems
- Are willing to accept treatment
- Have no other reasons why they cannot be treated
There are different types of hepatitis C. These types are called genotypes. In fact, there are 11 different types or genotypes of hepatitis C. The commonest genotypes throughout the world are genotypes 1, 2 & 3. These three genotypes make up over 60% of hepatitis C worldwide. In North America and Northern Europe genotype 1 is most common.
It is important to know what genotype of hepatitis C you have. Are you genotype 1 or 2 for example? Why? The genotype predicts how well you’ll respond to treatment. Unfortunately, genotype 1 doesn’t respond as well to therapy as genotypes 2 and 3. That said, there are newer effective therapies for genotype 1.
Other than the genotype of hepatitis C, there are other things that predict a better response to treatment:
- A lower amount of hepatitis C virus in your blood (lower viral load)
- The use of combinations of medications (such as peginterferon & ribavirin)
- How well you stick to the treatment (adherence)
How do you know that treatment has worked? Change in the viral load (amount of hepatitis C virus in the blood) is used to determine the response to treatment. In general, the earlier hepatitis C virus becomes undetectable in the blood the more likely you are to get rid of the virus. The other important point is you want the hepatitis C virus to be gone from your blood permanently. Usually the viral load is measured right after you’ve finished treatment and again 6 months later.
Medications for hepatitis C
Medications for hepatitis C are aimed at clearing the virus from the body. The type of medication and duration of therapy depends on a number of factors. Your liver specialist will discuss these with you.
Pegylated interferon & ribavirin
For most patients a combination of peginterferon and ribavirin is the recommended treatment.
Your body normally makes a substance called interferon. Interferon helps the immune system fight infections. Peginterferon is a specially designed long-acting form of interferon. This improves the body’s ability to fight hepatitis C virus. Peginterferon is long lasting so you only have to take it once a week.
Ribavirin is a special anti-viral medication. This medication is used in combination with peginterferon. Ribavirin works by preventing hepatitis C virus from multiplying.
Telaprevir is an anti-viral medication. It is used in combination with peginterferon and ribavirin to treat genotype 1 hepatitis C. Telaprevir targets hepatitis C virus as it grows and multiplies inside your body. Peginterferon and ribavirin work to clear the remaining virus. The combination of these three medications is known as “triple therapy.” The goal of this therapy is to cure hepatitis C. This means that the virus is no longer detectable in your blood 6 months after therapy is completed.
Boceprevir is an anti-viral medication. It is used in combination with peginterferon and ribavirin to treat genotype 1 hepatitis C. Boceprevir targets the hepatitis C virus as it grows and multiplies inside your body. Peginterferon and ribavirin work to clear the remaining virus. The combination of these three medications is known as “triple therapy.” The goal of this therapy is to cure hepatitis C. This means that the virus is no longer detectable in your blood 6 months after therapy is completed.
Fatigue and hepatitis C
Many people with hepatitis C feel tired. Feelings of being tired, weak, or having low energy are common. For an active energetic person this can really affect their lives. Here are some tips on battling fatigue:
- Understand that fatigue is common and normal with hepatitis C and is common and normal with some of the therapies used to treat it.
- Listen to you body. Napping and resting can help. A 30-60 minute nap during the day can help give you some energy. But don’t nap too much as too much sleep in the day can affect your night time sleep and can actually make you feel more tired.
- Go to bed early and try to get a full night’s sleep every night. Get on a schedule where you go to bed and get up at the same time every day.
- Pace yourself. If you’re feeling good don’t go crazy overdoing things.
- Prioritize your activities. Do what is most important first. Don’t forget to do things that make you feel better.
- Balance social activities that can make you feel tired. If hosting a family dinner (like Thanksgiving) is getting to be too much, ask someone else for help.
- Ask your family for help. You might need help with basic things like cooking, cleaning and shopping.
- Try to exercise regularly. Even if it is just walking for a few minutes each day. Having a partner or friend do this with you makes it a little easier. Believe it or not, exercise is one of the best things for battling fatigue.
Your family and hepatitis C
It is important to let your family or others who live with you know about your hepatitis C. It is essential that they understand the disease and its treatment. Family can also offer much needed physical and emotional support. If you have children, be honest and open and don’t try to “hide it” or “keep it a secret.” Children are smart and they’ll sense that something is going on. Often fear of the unknown is worse than the truth.
Here are some tips for your family:
- Explain that hepatitis C cannot be spread by coughing, sneezing, hugging, sharing food or water, or from toilet seats.
- It is important for all family members to know that hepatitis C can be spread by anything that could contain your blood. Items that should not be shared include razors, toothbrushes, and nail clippers.
- Help educate your family about hepatitis C and your therapy. Consider having them attend medical appointments with you.
- It is important for family to know that hepatitis C can make you feel tired. The therapy can also have side effects. There may be times you need to rely on them for help.
Natural or home remedies for hepatitis C
There are no known natural remedies or complementary therapies that have been proven to help hepatitis C in any significant way. However, it’s important to let your liver specialist or nurse know about all therapies you are taking. Some alternative therapies or herbs can cause serious problems with the liver and your general health. Some therapies can interact with other medications. Alternative and herbal medicines are not rigorously tested or monitored. So we don’t know how safe they are, we don’t know all of their side effects, and often we don’t even know the exact ingredients or strength of the therapy.
Diet for hepatitis C
Questions about diet and disease are very common. We all want to know what we can do to help ourselves. Can we change our diet to improve our immune system and help fight hepatitis C? Changing our diet gives us a sense of control over a disease which often seems to have a mind of its own.
Unfortunately, there is no diet that has been proven to significantly alter the course of hepatitis C. Following the basics of healthy eating can help improve health and well-being in everyone, including those with hepatitis C.
Alcohol and hepatitis C
Unfortunately, due to the nature of hepatitis C, some people may turn to alcohol to help them cope with fatigue, distress, and depression. Alcoholic beverages are not an effective treatment for hepatitis C and there is no doubt that heavy alcohol use worsens hepatitis C.
However, many of us like to share an occasional glass of wine, a beer, or a spirit. Is it safe to do this with hepatitis C? Once you’re infected with hepatitis C, the strongest risk factor for developing liver scarring and liver cancer is alcohol. Alcohol use, even in small amounts, has been found to worsen hepatitis C. Unless you are deliberately trying to worsen your hepatitis C, no amount of alcohol is good. While hepatitis C is in your body you should avoid alcohol altogether.
Smoking and hepatitis C
Cigarette smoking, whether you have hepatitis C or not, has no positive effects on any aspect of your health. Smoking can also increase the risk of liver cancer in men. So if you are a smoker with hepatitis C, quitting could be one of the best things you can do to improve your overall health.