Managing your Hepatitis C

The Hepatitis Foundation no longer operates a National Hepatitis C Follow-up Programme. Hepatitis C patient services are now managed by regional DHBs (District Health Boards).

If you think you have hepatitis C or would like to access treatment please contact your local GP. However if you have any questions about hepatitis C or need someone to talk to you can call our helpline on 0800 30 20 10.

If you live in the Midlands region (BoP, Waikato, Taranaki, Lakes, Tairawhiti) your monitoring and follow-up is now managed by Waikato DHB. If you have any questions about your Fibroscan appointment please call Kathryn on 07 839 8899 ext: 96289.

If you live in the Central region (Capital & Coast, Hutt, Wairarapa, Manawatu, Hawkes Bay) your monitoring and follow-up is now managed by Compass Health. If you have any questions about your Fibroscan appointment please call Megan on 04 260 6689.

If you live is any other region please see your doctor (GP) for a referral to a Hepatitis C Programme near you.

FibroScan

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Having a FibroScan is one of the most important things you can do to assess the health of your liver.

A FibroScan is a simple, painless test that determines if there is any scarring present in the liver. Scarring is described as fibrosis or cirrhosis. The Fibroscan assessment usually takes between 10 and 15 minutes and the results of the scan are available straight away. In a small number of people the Fibroscan test may not work or the result may be unreliable. The most common cause of a failed test is being overweight (obese).

You can have a FibroScan if:

  • You have hepatitis B or C.
  • A FibroScan clinic is available in your area. Please ask your GP to refer you to the local hepatitis C service for a FibroScan.

What do the results mean?

The Fibroscan result will be a number between 1 and 75 kPa. Numbers less than 12.5 suggest some scar tissue may be present in the liver. This is described as fibrosis. There may be no fibrosis, it could be mild, moderate or severe. If the result is greater than 12.5 it is likely that the liver has cirrhosis.

Cirrhosis is a word used to describe a liver where much of the normal liver tissue has been replaced by scar tissue. The structure of the liver has been permanently damaged. Once a person has cirrhosis of the liver they are at risk of going into liver failure or developing liver cancer. Cirrhosis can be caused by anything that causes damage or inflammation to the liver over many many years. Some causes of cirrhosis include: alcohol, viral hepatitis A, B, or C, fatty liver, iron overload (hereditary haemochromatosis) and there are many more.

Fibrosis means that there is some scaring present in the liver. But the damage is not permanent and there is not enough of it to cause liver failure or liver cancer. After the virus is cured the liver improves.

Why is it important to have a Fibroscan test before having treatment for hepatitis C?

Most specialists recommend everyone to have their liver assessed before having hepatitis C treatment. It is important to find out how much damage the virus has caused. It guides doctors and nurses to provide the best care for the individual.

If there is cirrhosis present then it is best for that person’s care to be provided by a hospital based specialist (usually a Gastroenterologist or an Infectious Diseases Physician). A person with cirrhosis should stay linked with a hospital service after they are cured as there is a small risk of developng liver problems even after the virus is gone.

If there is only mild or moderate fibrosis present in the liver then a person can usually be safely treated in the community (such as by a GP or a drug and alcohol service). Once cured of the virus a person without cirrhosis does not need any further follow-up.

If you require a FibroScan for immigration purposes click here. 

Read the article ‘An in-depth look at the FibroScan‘ from issue 11 of Talking Hep C for more information.

Look after your liver – Maintain a healthy lifestyle

f49296ee48900a1e8cd0bd70fdd73298_f900Drinking less alcohol is the most important lifestyle change you can make. Anyone with hepatitis C is recommended to keep alcohol intake to a minimum to reduce the risk of developing hepatitis-related complications. Regular and heavy alcohol intake will increase liver damage and increase your risk of cirrhosis.

For more information, read the article ‘The cost of alcohol on your liver‘ from issue 10 of Talking Hep C.

You can also keep healthy by:

  • Staying within a healthy weight range
  • Avoiding food and beverages containing a lot of fat
  • Exercising daily
  • Maintaining a healthy, well-balanced diet
  • Getting checked for diabetes and if you have it follow your doctor’s advice
  • Cannabis and other drug use should also be reduced as this can scar your liver.
For more detail please read our information sheet about hepatitis and lifestyle.
You can also read the feature article ‘Living with your liver , in good health or bad‘ from issue 1 of Talking Hep C.

People with hepatitis also need to mindful about taking pain relief medication. Please read the article ‘Pain relief and your liver‘ from issue 12 of Talking Hep C.

Having a healthy lifestyle will help you cope better with hepatitis C. It will also help avoid other liver problems such as fatty liver disease. Fatty liver is a condition where excess fat builds up inside the cells within the liver. Fatty liver may speed up the progression of scarring in people with chronic hepatitis C.

 

Managing your symptoms

If you experience symptoms such as no energy, low concentration or not wanting to exercise or eat, you can do simple things to help such as:60e45f41d01430b8eceb45b2bdb87f8d_f934

 

  • Doing some gentle exercises every day
  • Planning ahead and doing more when you have more energy
  • Eating smaller meals
  • Resting when you feel tired instead of trying to sleep
  • Having a pre-sleep routine
  • Not exercising or drinking coffee or tea before bed
  • Not napping during the day.
For more information about coping with various symptoms, read the following articles from the Talking Hep C magazine:

Common blood tests for ongoing management

To monitor your hepatitis C you will need regular liver function tests. The tests measure chemicals in the blood made by the liver and give information about the condition of a person’s liver. They help monitor the activity and severity of hepatitis C. Some of the tests include:

  • ALT- Alanine transaminase
  • AST- Aspartate aminotransferase
  • ALP- Alkaline phosphatase
  • Albumin
  • Total protein
  • Bilirubin
  • GGT- Gamma-glutamyltransferase.
Please read our information sheet for more detail about liver function tests.

Telling others

While you do not have to tell anyone about your diagnosis, reasonable precautions must be taken to avoid passing it on to others (see above for ‘preventing the spread’). It is often best to tell people you trust or people directly affected, such as household members or sexual partners.

People living with hepatitis C do not have to tell employers, unless you work in an environment that may put others at risk, such as healthcare. Discrimination against people with hepatitis in the workplace is illegal.

Telling health care workers such as a doctor or nurse may be beneficial for good health care (e.g. prescribing the most suitable medications). Health care workers, including dentists, must use standard infection control precautions for all situations and procedures that may involve contact with blood or other bodily fluids, regardless of whether you have hepatitis C or not.

Read about ‘Stigma and discrimination‘ in an article in issue 12 of Talking Hep C.

Preventing the spread

be2e0dce3c2c402f4ede0f25c1f45f4c_f906Hepatitis C is spread through blood-to-blood contact. To avoid infecting others you should take the following steps:

  • Cover any open cuts or sores
  • Clean any blood spillage with household bleach (do not put bleach on your skin)
  • Avoid sexual practices which may risk blood contact
  • Do not share piercing, tattooing, drug injecting or snorting equipment
  • Do not donate blood
  • Do not share razors, towels, toothbrushes, or any object that may come into contact with blood or body fluid.

Hepatitis C is not spread through everyday contact, e.g. touching, sneezing, coughing, or sharing cutlery.

Complementary medicines

Any patient with chronic hepatitis C should always discuss the use of any complementary or alternative medicine with their doctor or pharmacist.

While many complementary medicines are safe and provide specific benefits to people with chronic hepatitis, they can also have harmful effects and can interfere with other medicines, such as St John’s Wort, which reduces the effectiveness of telaprevir or victrelis treatment. The risk of liver toxicity from any medicine, both prescribed and complementary, is much higher in someone with underlying chronic viral hepatitis.

For more information, read the article ‘The long and short of it: Complementary medicines and hepatitis C‘ from issue 2 of Talking Hep C.

© The Hepatitis Foundation of New Zealand 2016