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What If My Hep C Test Is Positive?

Hepatitis C virus infects the liver to cause inflammation and fibrosis. The resulting condition, Hepatitis C, has both an acute phase and a chronic phase. This disease can be diagnosed accurately through simple blood tests that are quick and easy to administer.


If you test positive for Hepatitis C, a follow-up test may be needed to confirm the diagnosis. A follow-up test may also be useful in determining whether the initial positive tests indicated a past infection or an ongoing disease process. Your doctor may then advise anti-viral medications for HCV treatment which lasts for about 8 to 12 weeks.


With prompt diagnosis and accurate treatment, HCV can be eliminated from the host entirely. In the past, Hepatitis C used to be a grave diagnosis. However, modern treatment protocols have made it a lot easier to not just treat, but to completely cure Hepatitis C.


WHAT TO DO IF MY HEP C TEST IS POSITIVE?

There are two different types of tests available to diagnose Hepatitis C. Both of these tests are fairly accurate and provide a clear representation of the patient's health status. To fully understand what happens if your test results come back positive, it is important to understand the mechanics of these individual tests for Hepatitis C.


The first test, the anti-HCV antibody detection test, is a blood test that looks for the presence of anti-HCV antibodies against the Hepatitis C virus in your blood. These antibodies are made when the virus first enters your bloodstream and last throughout your life even if you get completely cured of the disease.


The second test is a PCR test that looks for the presence of viral RNA in your blood. The HCV RNA test has both a quantitative aspect and a qualitative aspect. The quantitative aspect of this test allows physicians to find out exactly how much viral RNA is present in your blood. The qualitative aspect of the HCV RNA test helps identify current, ongoing Hep C infections.


Both of these tests are required in tandem to make an accurate diagnosis of Hepatitis C. The anti-HCV antibody test is done when the doctor suspects you have Hepatitis C. If the test result comes back positive, it means that either you had a past infection with Hepatitis C or you have a current ongoing Hep C infection. Another possibility is that the anti-HCV antibody test was false positive, in which case a repeat test would clear things up.


Once a positive antibody test is received, your doctor will order the HCV RNA test. This test will help to clear the cause of the presence of antibodies in your blood. This test will be negative if the antibodies are present due to a past infection that has subsided after treatment. If you have an ongoing infection in the liver, the HCV RNA test will come back positive.


Once a diagnosis of Hepatitis C is confirmed, treatment can be started. Your doctor will initiate a course of anti-viral medications, also known as DAAs or direct-acting anti-viral drugs. Modern anti-viral drugs allow for a complete cure of Hepatitis C in 8 to 12 weeks. After the treatment is complete, another HCV RNA test is done to ensure that no signs of an ongoing infection are left.


HOW IS HEPATITIS C TREATED?

The treatment regime used for Hepatitis C involves the use of direct-acting anti-viral drugs, also known as DAAs. Treatment with DAAs lasts for 8 to 12 weeks and is highly effective in eliminating the Hepatitis C virus from over 90% of people. 


Multiple anti-viral drugs are included in this treatment regime. The choice of drugs and the number of drugs used to treat a Hep C infection depend on the genotype of the virus causing the infection. Six different Hep C variants exist, and they differ from each other on their genotype basis. These genotypes can be identified using the genotyping tests. Some viral genotypes may require a combination of multiple DAAs to be eliminated. 


Some of the drugs that are included in this regime and are approved for Hep C treatment include:

  • Simeprevir
  • Sofosbuvir 
  • Ribavirin
  • Velpatasvir
  • Voxilaprevir


Hepatitis C treatment is highly effective in treating the infection. 9 out of 10 people are completely cured of their disease when treated with DAAs. However, successful treatment does not imply that you have gained immunity from the Hep C virus. You can get infected with another Hep C infection even after the successful treatment of the previous infection. Infection with multiple types of hepatitis simultaneously, such as a co-infection of Hepatitis C and B, is also possible. Co-infections are harder to treat, and patients frequently progress to end-stage liver disease. The need for liver transplants is also higher in patients who present co-infections.


If the treatment does not work, it may be extended or repeated multiple times. New drug combinations are also tried to find the perfect recipe for the Hepatitis C elimination.


DOES THE TREATMENT FOR HEP C HAVE ANY SIDE EFFECTS?

Like any other treatment regime in the world, Hepatitis C treatment comes with side effects. However, DAAs have very few side effects, and most of the existing ones are easily tolerated by many people. The most common side effect from DAAs is nausea, vomiting, and headache.


Side effects may vary from person to person. If you cannot manage your side effects, talk to your doctor about the possibility of changing a drug or two in your treatment protocol.


Although most side effects are mild and easily tolerated, some people may experience severe side effects with Hepatitis C treatment. These include:

  • Major depressive disorder
  • Skin problems (irritation, itching)
  • Anxious behavior
  • Sleep problems
  • Anorexia 
  • Hair loss


WHAT ARE THE COMPLICATIONS OF HEPATITIS C?

Hepatitis C is a progressive disorder. If left untreated or poorly managed, the disease process will progress to engulf the entire liver into a plethora of complications. 


For starters, Hepatitis C causes inflammation of the liver. There are only two courses of action once the inflammation has started. Either the acute phase is treated with the correct medication, or the acute phase inflammation subsides, resulting in fibrosis of the liver. Extensive fibrosis results in complete scarring of the liver. Extensive scarring can result in a condition known as liver cirrhosis.


Liver cirrhosis occurs when most of the liver's viable tissue is replaced with non-functional, fibrotic tissue. This fibrotic tissue is incapable of performing normal liver functions, and thus new symptoms start appearing in the body. A severe deficiency of clotting factors (synthesized in the liver) ensues, and the patient starts to bleed easily, often in their joints and other cavities. Blood protein concertation decreases, and fluid moves out of the blood vessels and pools in the pleural and abdominal cavity.


1 out of 3 people with chronic liver disease goes on to develop liver cirrhosis without proper management. Once cirrhosis has occurred, the liver is severely compromised. This stage is known as the decompensated liver disease since the liver can’t compensate for anything anymore. A cirrhotic liver is also highly likely to develop liver cancer, particularly hepatocellular carcinoma.


A cirrhotic liver can also go into complete shutdown, which is then known as liver failure. Liver failure is characterized by massive internal bleeding and encephalitis. 


HOW TO PREVENT HEPATITIS C INFECTIONS?

The risk of Hepatitis C can be significantly lowered with a few precautions. These precautions include measures like:

  • Avoiding injectable drug use and sharing needles with other people
  • Avoiding unprotected sexual contact
  • Always following protection protocols if you are a healthcare worker
  • Wearing a condom for all sexual activities
  • Getting vaccinated for Hepatitis B
  • Not getting tattoos or piercings from unauthorized places


If you already have Hepatitis C and you are not getting treatment for it, make sure to contact a healthcare worker as soon as possible. You can also take several measures in addition to the ones listed above to avoid spreading the disease to other people. These measures include:

  • Not donating blood
  • Covering up cuts or open sores so that no item gets contaminated with your blood
  • Avoid sharing your personal hygiene products with anyone


RELATED QUESTIONS

Q) Can I Get Vaccinated To Prevent Hepatitis C Infections?

There is no vaccine for Hepatitis C. However, there is an effective treatment regime that eliminates the virus and the disease.


Q) Can I Get Re-Infected With Hepatitis C After Treatment?

Yes. Re-infection with Hepatitis C after successful treatment is possible. This is because successful treatment of Hep C infection with DAAs does not provide any long-term immunity to the patient.


Q) Can I Get Infected With Both Hepatitis C And B At The Same Time?

Yes. Patients can get infected with both Hepatitis B and C at the same time. The co-infection of Hep B and C is much more problematic than both individual infections. Patients with co-infection can develop liver cirrhosis and liver carcinoma at much greater rates than those with individual infections.


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