Lab Monitoring & Treatment of Hepatitis C

Hepatitis C is a disease that attacks and slowly destroys the liver. It is caused by the Hepatitis C Virus (HCV). Although you may never have participated in drug use with shared and contaminated needles, your risk for hepatitis C infection increases if you are a health worker who may be exposed to infected blood, if you receive a tattoo or a body piercing in an unclean environment or if you are HIV positive. Other possibilities include if you have received hemodialysis treatments for an extended period of time, a blood transfusion or organ transplant prior to 1992 or any clotting factor concentrates before 1987.

Beginning a Hepatitis C Treatment Regimen

• A hepatitis C infection proceeds slowly as it first inflames the liver and then proceeds to destroy this organ. The patient may not notice any symptoms for the first 10 years--by the time she does see a doctor, her liver may be permanently scarred. This damage is cirrhosis of the liver. A scarred or damaged liver cannot function adequately and continues to degenerate. Your family doctor or general practitioner can recommend a specialist in infectious diseases or a hepatologist who specializes in liver diseases. Then the patient can begin a series of treatments and laboratory monitoring of hepatitis C.

Testing, Monitoring and Treatment for Hepatitis C

• The physician will require several blood tests to determine if the HCV is present, and if so, what the viral load is or how much HCV the patient carries in her body. The ELISA (Enzyme-Linked ImmunoSorbent Assay) is a hepatitis C screening tool that is specific in detecting the hepatitis C antibody. A positive test indicates that the patient is likely to have hepatitis C. Genotyping, or evaluating the genetic makeup of the virus, will help the doctor to determine the treatment options for each patient. If the doctor finds that the liver abnormalities are only slight, treatment may not be required. But the doctor will probably recommend that the patient have follow-up laboratory blood testing on a regular basis to monitor for liver involvement.

Antiviral Medication Used in Treatment

• Antiviral medications are essential in the treatment to clear the virus out of the patient’s body. The physician may prescribe a combination of medications to be taken over a period of several weeks. Once the patient completes a round of treatments, he/she will undergo blood testing once again to discover what changes might have developed. These medications have side effects; they can cause depression and flu-like symptoms such as fever, headaches, aches, pains and fatigue. If the medications produce serious problems, the treatment may be altered or delayed in some cases.

Other Treatments

• If the specialist does diagnose hepatitis C, he will likely recommend several lifestyle changes in addition to the antiviral medications. The patient must refrain from alcohol intake because it induces cirrhosis of the liver and may speed up the progression of the liver damage. He/she should make healthy choices, including a diet with fruits and vegetables, exercise and sleep. The patient must also continue disease treatments and laboratory bloodwork testing that is monitored on a regular basis.

The Liver Biopsy: A Laboratory Testing Procedure

• In addition to the laboratory blood tests, the patient will likely require a liver biopsy. A sample of the liver tissue will be removed from the patient’s body for laboratory testing to help determine the severity of the hepatitis C infection. It will also allow the physician to make informed choices about the treatment regimen for the patient. The percutaneous liver biopsy is a mildly invasive test in which a long needle is inserted into the patient’s abdomen until it penetrates the liver and a tissue sample is removed. Two other methods of liver biopsy are used. One involves using the transjugular vein and the other uses a small abdominal incision to perform a laparoscopic examination in removing a liver sample with a needle to investigate the condition of the liver. An examination of the liver on the cellular level will indicate the severity of the disease and the progression of degeneration in the liver.

The Liver Transplant

• When the patient reaches the end stages of the disease, the liver has suffered damage such that it is almost nonfunctional. The patient will require a liver transplant. In the course of the surgery the surgeon will remove the damaged liver and replace it with a healthy organ. The transplant might not actually be a cure because treatment with antiviral medications will have to continue. The laboratory blood testing must also continue to monitor the success of the transplant. Some HCV will remain in the body so that, in time, the remaining HCV will repopulate and invade the new liver as the disease process begins again.