http://www.ebiocare.com/communities/hepatitis/faqc.html Frequently Asked Questions on Hepatitis C Q: What is hepatitis C? A:Hepatitis C is a liver disease caused by the hepatitis C virus (HCV), which is found in the blood of persons who have this disease. HCV is spread by contact with the blood of an infected person. Most persons who get hepatitis C carry the virus for the rest of their lives. Most of these persons have some liver damage but many do not feel sick from the disease. Some persons with liver damage due to hepatitis C may develop cirrhosis (scarring) of the liver and liver failure which may take many years to develop. Q: Significance of hepatitis C? A: The nation's most common blood-borne infection, hepatitis C is estimated to affect some 4 million Americans in its chronic form. Eventually, as many as 70 percent of them will develop liver disease, according to the national Centers for Disease Control and Prevention. Q: How could a person have gotten hepatitis C? A: HCV is spread primarily by direct contact with human blood. For example, you may have gotten infected with HCV if: you ever injected street drugs, as the needles and/or other drug works used to prepare or inject the drug(s) may have had someone else's blood that contained HCV on them. you received blood, blood products, or solid organs from a donor whose blood contained HCV. you were ever on long-term kidney dialysis as you may have unknowingly shared supplies/equipment that had someone else's blood on them. you were ever a healthcare worker and had frequent contact with blood on the job, especially accidental needle sticks. your mother had hepatitis C at the time she gave birth to you. During the birth her blood may have gotten into your body. you ever had sex with a person infected with HCV. you lived with someone who was infected with HCV and shared items such as razors or toothbrushes that might have had his/her blood on them. Q: Can HCV be spread by sexual activity? A: Yes, but this does not occur very often. See section on counseling for more information on hepatitis C and sexual activity. Q: Can HCV be spread by oral sex? A: There is no evidence that HCV has been spread by oral sex. Q: Can HCV be spread within a household? A: Yes, but this does not occur very often. If HCV is spread within a household, it is most likely due to direct exposure to the blood of an infected household member. Q: Since more advanced tests have been developed for use in blood banks, what is the chance now that a person can get HCV infection from transfused blood or blood products? A: 1 chance out of 100,000, per each transfused unit. Q: What is the risk for HCV infection from a needle-stick exposure to HCV contaminated blood? A: After needle stick or sharps exposure to HCV positive blood , about 2 (1.8%) healthcare workers out of 100 will get infected with HCV (range 0%- 10%). Q: Who should get tested for hepatitis C? A: persons who ever injected illegal drugs, including those who injected once or a few times many years ago persons who were treated for clotting problems with a blood product made before 1987 when more advanced methods for manufacturing the products were developed persons who were notified that they received blood from a donor who later tested positive for hepatitis C persons who received a blood transfusion or solid organ transplant before July 1992 when better testing of blood donors became available long-term hemodialysis patients persons who have signs or symptoms of liver disease (e.g., abnormal liver enzyme tests) healthcare workers after exposures (e.g., needle sticks or splashes to the eye ) to HCV-positive blood on the job children born to HCV-positive women Q: Should pregnant women be routinely tested for anti-HCV? A: No. Pregnant women have no greater risk of being infected with HCV then non-pregnant women. If pregnant women have risk factors for hepatitis C, they should be tested for anti-HCV. Q: How long after exposure to HCV does it take to test positive with PCR? A: It is possible to find HCV within 1 to 2 weeks after being infected with the virus. Q: Can you have a false positive anti-HCV test result? A: Yes. A false positive test means the test looks as if it is positive, but it is really negative. This happens more often in persons who have a low risk for the disease for which they are being tested. For example, false positive anti-HCV tests happen more often in persons such as blood donors who are at low risk for hepatitis C. Therefore, it is important to confirm a positive anti-HCV test with a supplemental test as most false positive anti-HCV tests are reported as negative on supplemental testing. Q: Can you have a false negative anti-HCV test result? A: Yes. Persons with early infection may not as yet have developed antibody levels high enough that the test can measure. In addition, some persons may lack the (immune) response necessary for the test to work well. In these persons, research-_base_d tests such as PCR (generic polymerase chain reaction) may be considered. Q: What is the next step if you have a confirmed positive anti-HCV test? A: Measure the level of ALT ( alanine aminotransferase, a liver enzyme) in the blood. An elevated ALT indicates inflammation of the liver and you should be checked further for chronic (long-term) liver disease and possible treatment. The evaluation should be done by a healthcare professional familiar with chronic hepatitis C. Q: Should a woman with hepatitis C be advised against breast- feeding? A: No. There is no evidence that breast-feeding spreads HCV. HCV-positive mothers should consider abstaining from breast-feeding if their nipples are cracked or bleeding. Q: Should persons with chronic hepatitis C be vaccinated against hepatitis B? A: If persons are in risk groups for whom hepatitis B vaccine is recommended, they should be vaccinated. Q: Why do most persons remain infected? A: Persons infected with HCV mount an antibody response to parts of the virus, but changes in the virus during infection result in changes that are not recognized by preexisting antibodies. This appears to be how the virus establishes and maintains long-lasting infection. Q: What is the treatment for chronic hepatitis C? A: Antiviral drugs such as interferon used alone or in combination with ribavirin, are approved for the treatment of persons with chronic hepatitis C. Interferon works in 10 to 20 persons out of 100 treated. Interferon combined with ribavirin works (on the viral strain that is mostly found in the U.S.) in about 30-40 persons out of 100. Ribavirin, when used alone, does not work. Q: What are the chances of persons with HCV infection developing long term infection, chronic liver disease, cirrhosis, liver cancer, or dying as a result of hepatitis C? A: Of every 100 persons infected with HCV about: 85 persons may develop long-term infection, 70 persons may develop chronic liver disease, 15 persons may develop cirrhosis over a period of 20 to 30 years, and 5 persons may die from the consequences of long term infection (liver cancer or cirrhosis).