Hepatitis C: Cured or Cleared, for Now or for Life?

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As I sit and listen to Robert speak about his experience in treatment, I am amazed at his resilience and will power to continue on. Robert cleared the virus after his 3rd week of treatment, or third shot of Peg-interferon, a drug that is helping his body fight the replication of the virus, and is now in his 22nd week of a 24 week treatment process. He is almost done and is looking forward to getting back to his life. He won`t receive a `cured` diagnosis until 3 months after his last treatment, when the medical staff will test him again for the presence of the virus in his blood.

There are two tests that are available for the positive diagnosis of Hepatitis C (HCV). The first test, the antibody test, looks for the antibodies produced by the body when contact with the hepatitis C virus has occurred. These antibodies indicate that there is, or was, a virus present in the body at one time. Even after an individual has cleared the virus through treatment, or their own natural immune system, which can occur within the first 6 months of coming into contact with the hepatitis C virus (Hepatitis C, 2012) and been given a diagnosis of `cured,` the antibodies will always remain present in the body. This is good to know, as this is the most commonly used test for HCV due to cost. A positive result with the antibody test only means that contact with the virus has occurred in the past, not that it is still present in the blood.

The second test, called a PCR test, a viral load test or an RNA test, is the confirmation required prior to a positive diagnosis of HCV. This test, which is very expensive and usually reserved for those individuals who have tested positive to the antibody test, is looking for the virus itself; rather than the antibodies as a response to the virus. This is the test Robert will take 3 months after his last treatment to confirm the virus is no longer present. This is when he will be affirmed cleared or cured of HCV, for life!

It is because the antibodies in the system will always remain present that some professionals state that we can never truly be `cured` of any virus. The term `cleared` has been used interchangeably with cured, by many professionals, though cleared can be considered as a more accurate way of defining a successfully treated client. Once cleared of the hepatitis C virus, you are cleared/cured for life. The virus will not return on its own. It must be passed again, into the blood, by another individual who carries HCV; therefore, precautions when engaging in risk activities are still required to prevent contact with the hepatitis C virus in the future which may cause reinfection.

There are several types or genotypes of the hepatitis C virus that are known. The most common genotype in North America is Genotype 1, affecting approximately 75% of the infected population (Watson, RN, BSN). The standard treatment for this type of HCV includes both weekly injections and daily medications for a period of 24 weeks. The medications prescribed are directly attacking the ability of the virus to make copies of itself, or to replicate. These are known as direct-acting antivirals or DAAs (Hepatitis C, 2012).

Robert is lucky to have cleared the virus as early as he did. This is not always the case. In many scenario’s, the 24 week treatment process must be repeated a second time in order to successfully fight the hardy HCV virus. This means that there is a potential for 48 weeks of treatment and side effects of that must be endured on the road to recovery. There is a new medication on the market which is less invasive, with a potential for no injections, and is a 12 week process. There is hope to see this more readily available for subsidized clients in the next couple of years.

Side effects of HCV treatment are individual, as are the treatment regimes. There are several forms of medication and combinations of medications that can successfully clear HCV and each person will respond in a different way. The 24 week program requires clients to access their medical facility and doctor weekly in order to monitor the effects of the medication and the side effects of the treatment. Some common symptoms are: drowsiness, nausea, weight loss, loss of appetite, fatigue, headaches, and body aches … and list goes on (Porter & Franciscus, 2014). Some clients will report no side effects at all, while others report many. Co-infection and general health all play a role in the body`s response to any treatment, including HCV.

Signed,

The VIP(er)

References:

Hepatitis C: An In-Depth Guide. (2012, January 1). Retrieved August 6, 2014.

Lynda Watson, RN, BSN: CUPS Calgary, Hepatitis C Program

Porter, L., & Franciscus, A. (2014, June 1). A guide to: Treatment side effect management. Retrieved August 6, 2014, from http://www.citationmachine.net/apa/cite-a-website/create

 

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