La référence en hépatite C au Québec depuis 2003

Hepatitis C is an inflammation of the liver caused by a virus transmitted solely through contact with blood of an infected person.

Worldwide, between 170 and 240 million people have hepatitis C. There are approximately 242,500 cases in Canada and 50,000 in Quebec, with 2,000 new cases each year.

In Canada, 245 587 would be living with this virus.

In Québec, there are 39 136 declared cases but it’s an old number and a more realistic estimate would be 70 000. In 2015 only, there were 1073 new cases. The prevalence would be 0.74%.

Hepatitis C is the first cause of liver transplant in Canada and, worldwide, the deceases curb is worst than that of HIV.

Transmission

Can I contract hepatitis C from having sex?

Sexual transmission is possible, but rare. If there is no blood-to-blood contact, the risk is very low. Sexual relationships including anal penetrations, fisting, bare-backing and sado-masochism are more at risk.

Persons under the influence of drugs are more at risk : pain can be lessened or not felt at all, so you can have injuries and blood without realizing it.

Symptoms

Why do we call hepatitis C « the silent disease » ?
traitement hepatite c

It is said that hepatitis C is a silent disease, because often the only symptom is low energy and tiredness or asymptomatic. The inflamation can still leads to serious issues like :

  • fibrosis
  • cirrhosis
  • liver cancer

There are some extra-hepatic symptoms :

  • skin problems
  • joints pain
  • depression
  • extreme mood swings
  • cryoglobulinemia

Does hepatitis C have specific signs or symptoms?

Most people (80% experience fatigue and a lack energy. Other symptoms may include sore muscles and joints, skin problems, cryoglobulinemia, irritability, night sweats, nausea, etc.

What does hepatitis C do to my liver?

It causes lesions that prevent the liver from doing its normal work. Since the liver is an organ that suffers in silence, you may not be aware of the damage being done to your liver.

What is « cirrhosis »?

Cirrhosis is a consequence of chronic liver disease characterized by fibrosis and liver lesions. The growth of these lesions leads to the death of liver cells, eventually resulting in liver cancer.

What are « enzymes »?

Enzymes are biological catalysts. Enzyme levels are an important indicator of a damaged or diseased liver. High enzyme levels are normally an indication that the liver has sustained a certain amount of damage. They are also an indication that the HCV virus is present.

If my enzyme levels are normal, does it means that hepatitis C virus is « dormant ? »

No. The hepatitis C virus does not sleep! A number of factors may cause enzyme levels to fluctuate, including alcohol, streets drugs and prescription medication; however, enzyme levels are not indicative of the seriousness of the lesions. It is possible the have normal enzyme levels and still have significant lever damage.

Is there a type of HCV (or genotype) that is more dangerous than another?

No. But the genotype you have is important because the treatment is successful in different percentages for each genotype. Also, the number of months required for treatment differs according to genotype.

New pangenotypic treatments (for all genotypes)  appeared on the market in 2017. It is possible that eventually the genotype will be irrelevent.

Prevention and testing

What is the testing ?

The first test is an antibody blood test. If there are antibodies, then you need to have a second test for the ARN, to be sure the virus is still present, since 25 to 40% of people cure on their own with the antibodies. For the majority of people, though, the infection become chronic.

Can you have a positive hepatitis C test and not have the infection ?

Yes, if you are in the 25 to 40% of people that cure on their own. The antibodies can stay and be detected for a long time after, even for the rest of your life..

Is there a vaccine for hepatitis C?

No vaccine exist for now. But hepatitis C is treatable and curable, with a cure pourcentage close to 100%!

Can we be vaccinated for other hepatitis viruses ?

Vaccines exist for hepatitis A and B, often offered at the same time under the brand name Twinrix.

Treatements

Is it true that you can cure by yourself from hepatitis C ?

Yes, in the first 6 to 12 months there is 25 to 40% probability that antibodies eliminate the virus. If not, it becomes chronic and the cure is onlu through medical treatment.

Is there still interferon in the new treatments?

Interferon isn’t used anymore. New DAA (direct-acting antivirals) treatments don’t have interferon anymore. Ribavirine is still offered for patients with advanced cirrhosis.

How are called the new treatments ?

New treatments are DAA, direct-acting antivirals. Known brands in Quebec are Epclusa, Harvoni, Maviret, Vosevi, Zépatier.

What’s the difference between old and new treatments ?

New treatments work directly against the virus cells and are thus a lot more effective, with practically no side effects. As they’re more effective, treatments are quicker, with higher rates of success (from 8 to 16 weeks depending of the case).

What are the side effects ?

There is practically no side effects. What is often reported is, like most medecines or antibiotics, body responses like fatigue, headache, nausea or dry mouth.

Hepatitis C and natural medecine?

Just because the label says « natural » doesn’t mean the product is harmless. Be very careful. These products must also be « processed » by your liver, and they may be toxic or cause interactions with your medication. You absolutely need to ask your doctor before you take any « natural products » or « over-the-counter medications ».What is written on the product label doesn’t necessarily tell you what’s inside the bottle. Be very careful. There is no such thing as a « magical natural product » that will cure your infection!

Day-to-day and nutrition with hepatitis C

How to be safe for the persons I live with?

There are vely little risks if there is no blood-to-blood contacts. Be careful not to share hygiene objects like a toothbrush, razors, nail clippers, etc.

What about pregnancy and hepatitis C?

Vertical transmission (from mother to child through birth) is 5% (or 35% if you also have HIV). You cannot have treatment during pregnancy. If you had ribavirine, it is also recommended to use protection 6 months after, because it can cause birth malformations. This is valid whatever person of the couple has had the treatment.

Do you have to have a particular diet when living with hepatitis C ?

It’s the rule of common sense and moderation. The priority is to go easy on the liver. No excess, varied menus and physical activity as much as you can. Drinking a lot of water during treatment can help with most side effects. If there is no particular diet recommended, there are some essentials to keep in mind :

  • Avoid toxins : alcohol, tobaccoe, drugs, food poisoning.
  • Reduce sugar and fat. It’s not aboit eliminating it, but about having it in moderation.
  • To have more energy (especially if you have fatigue or during treatment), try to have more complex carbohydrates (or natural sugar) by eating whole grains products, more fruits and vegetables. Fibers (which are also present in most of those food) help with natural insuline and digestion. You’ll feel more full and have better intestinal health. But to be sure for it to work, you have to drink at least a liter and half of water per day. Fibers are also present in legumes, beans and peas, nuts, psyllium, etc.
  • Animal proteins (meats, fish and sea food, dairy products) and vegetal proteins (legumes, beans, peas, whole grains, nuts, tofu, soy) help the immune system to fight infections and the liver to regenerate itself.
  • Fat and sugar are present in high quantity in chips, crisps and other candies. Try to eat none or the less you can.
  • Be careful of sodas, fruit drinks and even frui juices as most juices have as much sugar as sodas and none of the fibers and less nutrients than eating the whole fruit.

And also, try to spend more energy than you consume and lose some weight if you have a weight problem.

Eating is a pleasure of life, do not prive yourself. Be reasonnable and know an occasionnal excess or treat is permitted for everyone.

You have other questions? Do not hesitate to contact us during business hours through our online chat or 24/7 by phone :

Montreal : 514-521-0444
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