Questions to Ask Your Doctor About Hepatitis C

If you’ve been told you have the hepatitis C virus (HCV), you should know you’re not alone. A silent epidemic, chronic hepatitis C affects an estimated 2.4 million Americans, according to the Centers for Disease Control and Prevention (CDC).

You probably have many questions about your diagnosis, including how you caught the virus and what steps you should take next. Here are answers to some common questions about hepatitis C that can help you find the proper treatment.

1. How Did I Get Hepatitis C?

The virus is spread through contact with an infected person’s blood. Today, most people become infected with hepatitis C by sharing needles, syringes, and other equipment used to inject drugs, according to the CDC.

It’s also possible to contract hepatitis C from a needlestick injury in a healthcare setting or by getting an unregulated tattoo.

In the past, some people were exposed from receiving a blood transfusion before 1992, when widespread screening virtually eliminated the virus from the U.S. blood supply.

If you learn that you have hepatitis C, keep in mind that the virus can be treated and cured with medication.

2. How Does Hepatitis C Affect My Liver?

Over time, hepatitis C can damage the liver and cause inflammation, as well as cirrhosis (permanent scarring of the liver) or liver cancer. The catch is that you may not notice the virus’s effects until decades after you contracted it.

“The liver is an uncomplaining organ,” explains Thelma King Thiel, RN, founder and chair of the Liver Health Initiative in Silver Spring, Maryland.

3. What Do My Test Results Mean?

There are two blood tests that are used to detect hepatitis C. The first one tests for hepatitis C antibodies, or signs that your body fought or is fighting off an infection. The results will tell your doctor whether you’ve ever had the virus.

If the antibody test is positive, you’ll receive a second test, which can detect the amount of virus, or “viral load,” in your blood. Your doctor may then conduct a third blood test to determine which type (genotype) you have, to allow for more targeted hepatitis C treatment.

4. How Do I Know if My Infection Is Acute or Chronic?

An acute infection occurs within six months of exposure to the virus. Unless you happen to get tested during that period, you may not know that you have it. Signs include a fever, fatigue, and nausea, but about 70 to 80 percent of people with hepatitis C don’t experience symptoms, according to the CDC.

Some people have the ability to fight off the virus on their own, but most do not. About 75 to 85 percent of people with the infection will eventually develop chronic hepatitis C, which might not cause symptoms for decades. If you test positive for chronic hepatitis C, your doctor may recommend treatment.

5. Is My Hepatitis C Curable?

Almost always, yes. With the help of medications, most people can rid their bodies of hepatitis C. “Many new treatment options are becoming available that should allow almost every patient to be treated successfully,” says David Nelson, MD, president of University of Florida Health in Gainesville.

These treatments, known as direct-acting antivirals (DAA), are taken orally over the course of eight to 12 weeks and have a cure rate of over 95 percent, according to the CDC.

“This will lead to healing of the liver and a marked improvement in quality of life,” says Dr. Nelson, who also leads the national HCV-TARGET research program, which tracks hepatitis C treatments and outcomes.

Keep in mind that you can’t develop immunity to the virus, so if you don’t take the right precautions — such as stopping injection drug use — it’s possible to contract hepatitis C again.

6. Which Tests Can Help Determine if My Liver Is Healthy?

If you have hepatitis C, you may need a liver enzyme test or an ultrasound. Determining whether you have cirrhosis is the most important initial assessment and helps frame all other discussions, says Nelson. “Those with more advanced liver disease often need an endoscopy and liver cancer screening.”

7. What Lifestyle Changes Should I Make to Help Keep My Liver Healthy?

Besides treating your hepatitis C with prescribed medications, you should exercise, lose weight (if necessary), reduce your consumption of alcohol, and refrain from using marijuana, says Nelson. You should also get the hepatitis A and B vaccines.

The American Liver Foundation recommends that untreated people with hepatitis C who have liver damage limit salt, sugar, and fat and avoid foods that are high in iron, such as spinach and red meat. But, you don’t have to give up your coffee: A study published in the Journal of Hepatology found that drinking coffee or herbal tea may help protect the liver from scarring, so you can include a few cups of joe in your diet.

8. How Can I Make Sure That I Don’t Pass the Infection to Someone Else?

HCV is passed from one person to another through direct blood contact. “Avoid high-risk behaviors, such as intravenous drug use, unprotected sex outside of a monogamous relationship, and sharing razor blades or toothbrushes,” Nelson says. That being said, you don’t need to isolate yourself. “You can’t spread this virus by hugging or kissing kids, family, and friends,” he adds. “It’s okay to carry on a normal life.”

9. Should I Have Other Specialists on My Treatment Team?

If you have an addiction — for example, to alcohol, cigarettes, or illicit drugs — you may benefit from working with an addiction specialist who can help you kick the habit. A hepatologist can treat the virus itself, a mental health professional can help you cope with anxiety or depression, and a registered dietitian can help you create a customized, healthy diet for hepatitis C.

10. Where Can I Find More Support?

Ask your doctor whether a local clinic or other organization operates a support group. You can also look online to find a group nearby or join a virtual group. Start with the Hepatitis C Association or the Hepatitis Foundation International.

Additional reporting by Joseph Bennington-Castro.