Hepatitis C Survivor  

With Hepatitis C The Initial Test Result Isn't Everything...

Written By:  Teri Gottlieb

Recently, the CDC has suggested that every person born between 1945 and 1965 be screened for Hepatitis C.  The Baby Boomers are the highest risk group for Hep C and we need to get a handle on this.  In some cases this testing is being done and that's a good thing but apparently 50% of the people who have tested positive in this group have had nothing more than the initial antibody screening done.  This is not enough.  This does not paint the entire picture.  All that initial test does is prove that you have been exposed to the virus.  It does not tell you if you have an active case of Hepatitis C.  What is causing the testing to stop at this critical stage?  Is it a fear of what's to come or is it a lack of follow-through by the doctors?  Or, is it a little of both?  No matter what the underlying problem is here, it needs to be fixed before more people die.  Make no mistake, Hepatitis C is a potentially fatal disease. Not wanting to know the answer will not save your life. In this case, ignorance is not bliss. 

The first step in this process is to ask your doctor to test you for HCV. If your doctor questions why you want this test, please, feel free to tell him that you want the test run because you asked him to run it. If you are a Baby Boomer the CDC is strongly urging you to get tested. The initial test is one for antibodies. This will show if you have ever been exposed to the Hepatitis C virus. If this test comes back negative, you are fine. You have not been exposed. You don't need to worry about this any longer. If, however, this test comes back positive, the process has just begun. Additional testing is needed to find out if, in fact, you have a chronic Hepatitis C infection. 

Hepatitis C is a silent, life threatening viral infection that is currently affecting more than 3 million people. Besides the fact that this number is huge, the bigger problem is that 75 percent of these people are totally unaware that they have this virus.  They have no idea that their livers are slowly being damaged. Sometimes the damage is fatal. Hep C is called the silent killer for a reason. By the time you actually have symptoms of the disease progression, it's often too late. Most people will not have symptoms until they are in End Stage Liver Disease and are in liver failure. At this point, the ONLY hope is a transplant and it usually cannot happen quickly enough to save the patient's life. 

In 2012, Dr. Bryce Smith of the Centers for Disease Control and Prevention (CDC) stated that "The United States is in the middle of an unrecognized health crisis." He was talking about Hepatitis C. 

Of the Baby Boomer population, in almost one half of the diagnosed cases, the patient had no apparent risk factors. They had not used illicit drugs, they had not received blood products prior to 1993, they did not work in the medical field where they were exposed to contaminated blood. They did, however, do very typical things that were not considered risky, such as ear piercings at the mall, tattoos, vaccinations where the "air gun" was used and children were lined up and given vaccinations in succession. They also had gone to the dentist. Before Universal Precautions were put into place, dental equipment was not sterilized in a way that would kill this virus. Any of these incidents could have exposed them to Hep C. 

Currently, some doctors are relying on the results of standard liver testing to determine if their patient might have Hepatitis C.  They are not ordering HCV screening unless liver enzymes are elevated. The problem with this, is that the liver enzymes won't be elevated until the virus has done a significant amount of damage to the liver. Hepatitis C is easier to treat when there is not liver damage present. This practice is actually putting the patient on a narrower path to cure. If you wait until you already have cirrhosis of the liver, your chance of clearing the virus  is significantly lower. Depending on elevated liver enzymes will miss as many as half of those who are infected with HCV. You must specifically ask for the Hepatitis C Antibody test.  If the result of this test is negative, no further testing is required. BUT, if this test comes back positive, it is important to have an "RNA" test done to show if the virus is indeed active. If the RNA test shows that the virus is undetectable, you're done. You are all good. You were exposed but your body fought the infection off on its own.  If, however, that RNA test comes back with a number, you have an active case of Hepatitis C. 

This virus can cause fatigue, fever, swelling of the stomach, headaches, muscle and joint pains, poor appetite, dark urine, tenderness in the area of the liver and jaundice, or yellowing of the skin. Most people will not experience any of these symptoms for 20 to 30 years after being infected. If you are experiencing symptoms, you already have significant liver damage. At this point, there is more than likely cirrhosis (scarring) of the liver and possibly even cancer. Hepatitis C is the leading cause of liver transplants in the United States and is also responsible for more than half of the cases of liver cancer. If you have had a positive Hepatitis C antibody test and your RNA test came back positive with numbers showing (this number could be anywhere from 100 to 30 million or higher) DO NOT PANIC. Your next step is to find a Hepatologist, an Infectious Disease Specialist or a Gastroenterologist who treats Hepatitis C. The specialist will do further testing to see what your next steps should be. It is likely that you will have an ultrasound and a biopsy of your liver. After those tests are completed, your doctor can help you decide what the best course of action is for you.

Not everyone with this virus needs to treat but about 20 percent of the people with Hepatitis C will go on to have serious liver damage unless the virus is treated. You can be cured of this virus but only if you know that it's there.  PLEASE GET TESTED!

Should you be tested?
• You were born between 1945 and 1965
• You injected illegal drugs (only once is enough)
• You snorted cocaine through a shared straw or a rolled up dollar bill
• You received a blood transfusion or organ donation prior to 1992
• You received clotting factor concentrates before 1987
• As a health care or emergency worker, you experienced a needle stick or penetrating injury
• You have HIV
• You shared tattoo or piercing needles or ink
• You shared a razor, toothbrush or nail clippers with someone else
• You have had long-term kidney dialysis
• You have been told your liver tests are abnormally high
• Your mother had hepatitis C when you were born
• You worked with blood or blood products
• You have been in prison or worked in one