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Hepatitis FAQ’s

Answers to frequently asked questions


Frequently Asked Questions

Listed below are several important questions for both patients and providers. Don’t see what you are looking for specifically? Submit your question below, and we will post it to our FAQs list.

AASLD (American Association for the Study of Liver Diseases) practice guidelines recommend a liver ultra sound every 6 months for hepatitis B infected males over 40, females over 50 and other high risk persons (cirrhosis/family history of HCC).

Once chronic HCV infection has been confirmed with a positive HCV RNA, it does not need to be repeated unless your patient is being treated.

The exact level does not correlate well with disease activity or severity at the time it is drawn. The level does correlate with response to treatment, as persons with a higher level do not respond as well as those with a lower level.

ALT is usually abnormal (> 40) in persons with chronic HCV infection. The level fluctuates and does not correlate well with amount of disease activity. For example, there is no evidence that an ALT of 100 indicates more severe disease than an ALT of 50.

Moderate fibrosis is best determined by liver biopsy. Advanced fibrosis is the presence of bridging fibrosis or cirrhosis on liver biopsy or APRI score > 1.5.

If bridging fibrosis or cirrhosis fibrosis is present, order a right upper quadrant ultrasound every 6 months to screen for hepatocellular carcinoma.

Acute symptomatic hepatitis C occurs in about 25% of persons who get HCV infection and may be difficult to diagnose since the anti-HCV may not become positive for 8-12 weeks. An HCV RNA will be positive after several weeks and can be ordered if acute hepatitis C is suspected but the anti-HCV is negative. Persons who get acute hepatitis C have up to a 50% chance of recovering spontaneously. If they still have a positive HCV RNA after 12 weeks and are treatment eligible, they will respond very well to a shortened treatment course.

Some common liver conditions we treat include: chronic viral hepatitis, including hepatitis B and C, autoimmune hepatitis, primary biliary cholangitis and fatty liver disease. Your primary care provider will refer you to be seen and evaluated at the liver clinic if your liver lab tests are abnormal and indicate you may have a liver disease.

You will have your height, weight, blood pressure, pulse and temperature taken before you see the provider. The provider will review your medical records, examine you and discuss your liver health with you. Most clinic appointments will include a blood draw either before or after the visit.

You should expect to be in the clinic for an hour for your first visit (including time for blood draw if needed) and 30-45 minutes for follow up visits.

The first appointment is a pre-treatment evaluation of your liver disease. Treatment will be set up following that appointment if hepatitis C treatment is appropriate for you.

The word “hepatitis” only means inflammation of the liver. There are 3 major types of viral (infectious) hepatitis and there are non-infectious liver diseases, like autoimmune hepatitis, alcohol hepatitis, and non-alcoholic steatohepatitis.

Most liver clinic patients have a Fibroscan® at least once. It is different from an ultrasound of your liver. Fibroscan® is a noninvasive way to measure the amount of scarring and fat in the liver. The test takes about 15 minutes. A probe is placed against the skin in the right upper abdominal area and a wave of energy passes from the probe, through the skin to measure liver density. You will need to fast (no food or water) for 3 hours before the test.

An ultrasound is a non-invasive way to screen for liver cancer and it show the shape and size of your liver, the ducts surrounding the liver, the blood vessels to/from your liver, and it can show if there is fluid (ascites) around the liver.

Heavy alcohol consumption can damage a person’s liver cells which can lead to scarring the liver. When you have liver disease, abstaining from alcohol use will help repair the liver.

Most people with chronic hepatitis B infection do not need treatment unless their liver blood tests are high and they have a high level of virus in their blood. Anyone who has hepatitis B needs a blood draw for liver tests and liver cancer screening every 6 months. If you have been diagnosed with hepatitis B, you will be sent a reminder letter every 6 months to have your blood tested.

There is no risk of transmitting hepatitis B or C while breastfeeding unless your nipples are cracked and bleeding. All newborns should be vaccinated against hepatitis B starting at birth.

Most people with hepatitis C do not have any symptoms, but the virus can still be spread to others. Also, if hepatitis C is left untreated, you can develop chronic liver disease, cirrhosis, or liver cancer over time.

If you are a mother with hepatitis C, your child should be tested once after one year to 18 months of age for hepatitis C antibody testing. A viral load can be drawn as early as 2 months of age if needed.

Blood draws that are done monthly during treatment are for safely monitoring you and to determine if the treatment is working. Some patients may need more frequent monitoring due to the medications they are on or if they have advanced liver disease.

You no longer have hepatitis C if the viral load is not detected 12 weeks after treatment completion.

You are not immune to hepatitis C after treatment. You can get hepatitis C again if exposed to the virus.

Avoid risk factors for hepatitis C: Do not share needles or drug works, razors, toothbrushes, nail clippers and cover all cuts. Only obtain tattoos from licensed tattoo artists. Practice safe sex.

Yes, there are very effective treatments available and you will likely have to take these daily for the rest of your life. Also, you will need to have your liver blood tests monitored every 3-6 months. If diagnosed with one of these autoimmune liver diseases, you will be sent a reminder letter every 6 months to have your blood tested.

Your provider will check you for other causes of liver disease and if you have fatty liver, you will undergo a FibroScan® to measure how much fat and scarring is in your liver. If you have a lot of scarring and fat, your liver clinic provider will discuss with you the benefits and risks of having a liver biopsy.

A liver biopsy is a medical procedure to remove a very small piece of your liver to find out more about the health of your liver. It is done with IV and local anesthesia in the hospital. You will have a liver clinic appointment with a blood draw a day or two before a liver biopsy and you will be at the hospital for about 3-4 hours on the day of your liver biopsy. You will need an escort to be with you when you leave the hospital after a liver biopsy.

Currently, there is no medication available to treat NAFLD. Gradual weight loss and exercise are recommended. In the future, there may be drugs FDA licensed to treat this condition.

We offer definitions to frequently used terms in hepatitis and liver disease. Can’t find the definition you need? Please contact us or submit your question in our Q&A section.

Adult Hepatitis Clinic
Internal Medicine Clinic
Healthy Communities Building
3rd Floor
Phone: (907) 729-1500

Pediatric Clinic
Anchorage Native Primary Care Center
First Floor
Phone: (907) 729-1000

Liver Disease & Hepatitis Program
Phone: (907) 729-1560
1-800-655-4837

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