1. Understanding Hepatitis C (Hep C)

2. What is hepatitis C? Hepatitis C (Hep C)...
Is an infection caused by a virus
Is 1 of 5 hepatitis viruses (A, B, C, D, and E)
Causes inflammation of the liver
Inflammation is swelling that occurs when the body’s tissues are injured or infected
Inflammation causes organs to not work as they should 2

3. Types of hepatitis 3 Hepatitis C
Type of Hepatitis
Facts
Hepatitis A
Spread by ingestion of fecal matter or by contaminated food or water
Lasts from a few weeks to several months; does not become long-term (chronic)
Hepatitis B
Spread by blood, semen, or other body fluids, from an infected mother to her newborn or from contaminated needles and body piercing/tattoos
Can be short-term (acute, lasting for a few weeks) or long-term (chronic) and lead to liver disease or liver cancer
Hepatitis C
Spread when the blood of an infected person gets into another person’s bloodstream
Sometimes short-term (acute), but usually long-term (chronic); may lead to liver disease or liver cancer
Hepatitis D
A serious liver disease that occurs with hepatitis B; uncommon in the United States
Hepatitis E
Uncommon in the United States; usually spread by ingestion of fecal matter via unclean water supply
A serious liver disease that usually results in short-term (acute) infection; does not lead to chronic infection
Hepatitis C
Spread when the blood of an infected person gets into another person’s bloodstream.
- Examples: The sharing of contaminated needles, body piercing/tattoos and mother-to-child during pregnancy. 3

4. What does the liver do? The liver is very important The liver…
Breaks down and removes waste products from your blood
Helps digest food
Fights infection
Stores vitamins and other nutrients
Produces bile to help digest fat 4

5. Symptoms of Hep C
When symptoms do occur, they can begin within months of infection
But most people do not have noticeable symptoms until the virus causes severe liver damage
Severe liver damage may take 10 years or more to happen
Even though the virus continues to cause inflammation and damage, a person may still exhibit no symptoms 5

6. Symptoms of Hep C (cont.)
Early symptoms, if they occur, include…
Fatigue
Achy muscles and joints
Nausea
Reduced appetite
Abdominal pain
Later symptoms, if they occur, include…
Fatigue
Nausea
Vomiting
Loss of appetite
Jaundice (yellowing of the skin and the whites of the eyes) 6

7. There are 2 types of Hep C:
What is acute Hep C?
There are 2 types of Hep C:
Acute Hep C...
Is a short-term infection with the Hep C virus
May cause symptoms for up to 6 months
May go away by itself as the immune system fights off the virus (in 15 to 25 of every 100 people who become infected with the Hep C virus)
Acute
Chronic 7

8. What is chronic Hep C? Chronic Hep C...
Is a long-lasting infection with the virus
Is diagnosed when viral load testing finds that the virus is still in the blood after 6 months or more
Occurs when the body cannot get rid of the virus by itself
If left untreated, Hep C can lead to liver damage, and potentially even liver cancer
For every 100 people infected with Hep C, over time, about:
75-85
Will develop chronic infection
60-70
Will develop chronic liver disease
5-20
Will develop cirrhosis
1-5
Will die of cirrhosis or liver cancer 8

9. How can chronic Hep C harm the liver?
Can prevent the liver from working as it should
Can cause fibrosis, liver scarring that can be mild to more severe
Can also result in cirrhosis, the most severe stage of liver scarring
With cirrhosis, scar tissue builds up and takes over most of the liver
Symptoms of cirrhosis include fatigue; difficulty thinking clearly; fluid in the abdomen; bleeding of the esophagus, stomach, or intestines; and poor blood clotting
Can also cause hepatocellular carcinoma (HCC), the most common form of liver cancer 9

10. Who has Hep C?
That makes Hep C one of the most common viruses spread by blood-to-blood contact
Each year about 17,000 Americans become infected with Hep C
Baby boomers, who are people born between 1945 and 1965, are 5 times more likely to have Hep C than adults of any other age group
That is why the CDC recommends that all baby boomers be tested for Hep C
Up to 75% of baby boomers who have Hep C do not know they have it
About 3.5 million people in the United States have chronic Hep C 10

11. How does someone get Hep C?
When the blood of an infected person gets into another person’s bloodstream
People can get Hep C by:
Less commonly, a person can also get Hep C by:
Sharing personal items like razors or toothbrushes
Having sexual contact with a person who has Hep C
Being born to a mother who has Hep C
Sharing needles, syringes, or other equipment used to inject drugs (even if only one time)
Receiving donated blood or an organ transplant before July 1992
Getting a tattoo or piercing with non-sterile instruments
Receiving hemodialysis 11

12. How Hep C is not spread Hep C is not spread:
By shaking or holding hands
By being sneezed or coughed on
By hugging
By sharing eating utensils
In food or water
In breast milk 12

13. How is Hep C diagnosed?
Hep C can be diagnosed with a simple blood test
If your Hep C test is positive, your healthcare provider may also:
Use FibroScan® to check the degree of liver damage. FibroScan® uses ultrasound and vibration waves to examine the liver
Do liver function tests that measure the levels of certain proteins and enzymes in the blood to check the liver’s health
Take a liver biopsy to check for liver damage. A small piece of tissue is taken from the liver through a needle and examined
Do an ultrasound test of the liver every 6 months to check for liver cancer if cirrhosis is diagnosed. The test takes a “picture” of your liver using sound waves 13

14. Can Hep C be treated and cured?
Hep C can be treated, and for many people it can be cured
Cure means the virus is not detectable in your blood 3 months after completing treatment
Recent scientific advances have made treatment
shorter and more effective than in previous
years. Before 2011, treatment for Hep C
could take as long as a year
Early diagnosis and treatment of Hep C can
help prevent further liver damage and cirrhosis 14

15. What factors can affect my treatment options?
Your genotype, your viral load, and the extent of your liver damage can all affect your treatment options
Your genotype
There are 6 Hep C genotypes numbered 1 through 6
Knowing your Hep C genotype will help your healthcare provider know which medicines to prescribe and for how long, and predict your chance of being cured 15

16. What factors can affect my treatment options? (cont.)
Your viral load
Viral load is how your healthcare provider measures how much Hep C virus is in your blood
A low amount of virus in the blood can mean a higher chance of a cure
The extent of your liver damage
The time it takes for the Hep C virus to damage the liver varies from person to person
Studies show that once a patient develops cirrhosis (severe liver scarring), the virus is harder to cure
Your healthcare provider can do some tests to find out if your liver is damaged and how much it is damaged 16

17. Talk with your healthcare provider about your treatment options
Understanding of the Hep C virus is evolving
The job of your healthcare provider is to help track your health, look for signs of liver damage, and help you decide if and when to start treatment and which treatment may be best for you
Talk with your healthcare provider about your
treatment options and the next best steps for you 17

18. How to Help Manage Hep C
Healthy lifestyle changes can help support your liver health.
Stop drinking alcohol
Consuming alcohol can increase liver damage
Move toward a healthy weight
If you are overweight, losing weight may decrease the risk of liver damage
Eat a well-balanced diet
This can make it easier for the liver to do its job and can help repair some liver damage
Talk with your healthcare provider
Tell your healthcare provider about all your medical conditions and all the medicines you take
Get rest
Getting a good night's sleep and resting when feeling tired can help with fatigue associated with Hep C 18

19. How can I avoid passing the virus to others?
To protect others from Hep C:
Do not share drug needles or other materials
Do not donate blood or blood products
Make sure that others wear gloves if they have to touch your blood or an open sore
Do not share your toothbrush, razor, or nail clippers
Tell your doctor, nurse, and dentist that you have Hep C
If you get a tattoo or body piercing, let the operator know that you have Hep C
Use a condom during sex 19

20. Can Hep C be spread through sex?
It is possible to pass Hep C to others through sex, but the risk is believed to be low
The risk is increased by having:
Multiple sexual partners
HIV or another sexually transmitted disease
Rough sex
The risk is decreased by:
Practicing safe sex (use a condom) 20

21. Can Hep C be spread during childbirth?
It is possible to spread Hep C to a baby during childbirth, but the risk is believed to be low
About 4 of every 100 infants born to mothers with Hep C become infected with the virus
Mothers who have both Hep C and HIV are more likely to spread Hep C to their babies 21

22. Can Hep C be spread by breastfeeding?
Hep C is not spread by breastfeeding
However, women who have cracked or bleeding nipples should stop breastfeeding until the nipple has healed and is no longer bleeding 22

23. Are my feelings normal?
Many people have strong reactions when they find out that they have Hep C
They may feel:
Fearful
Angry
Overwhelmed
Helpless
Sad
Anxious 23

24. What you should know
No matter what you are feeling, it is normal and you have a right to feel that way
Feelings are not “right” or “wrong”; they just are
These feelings may come and go
You don’t have a choice about how you feel, but you have choices about how you respond to your feelings 24

25. How you can cope
Learn as much as you can about Hep C so you can feel more in control
Join a support group so you can share
your feelings with others who are
going through similar experiences
Find healthy activities that help you
feel less stressed 25

26. How you can cope (cont.)
Get enough sleep each night so you feel rested
Learn relaxation methods, such as meditation or deep breathing
Eat small, healthy meals throughout the day
If you think you may be depressed or feel that you need more help to cope, be sure to speak with your healthcare provider 26

27. A quick review Hep C is a viral infection that can damage the liver.
Many people who have Hep C do not know that they have it, so testing is important.
Hep C can be cured. Talk with your healthcare provider about what treatment may be right for you.
There are many ways to cope with the challenges of having Hep C, such as joining a support group.
Learning as much as you can about Hep C can help you feel more in control.
Knowledge about Hep C has advanced significantly in recent years. There is a great deal of hope for people with Hep C. 27

28. For more information about Hep C, visit HepcHope.com
Thank you!
For more information about Hep C, visit HepcHope.com 28