Liver Disease

Yes, your HCV antibody test could be a false positive test, which means the test looks as if it is positive, but it is really negative. This happens more often in people who have a low risk for the disease for which they are being tested. Sometimes there could be some blood reactants that can turn a screening test positive.

It is very important that a case of a false positive test is confirmed with a more sophisticated test and repeat at least twice over a period of time. Only a qualified physician in the evaluation and management of Hepatitis C should be able to determine if your test is a false positive or not. By far, most positive HCV antibody tests are indeed truly positive, even in a person with unknown risk factors.

Treatment is strongly recommended for all patients with acute or chronic Hepatitis C infection.

At your first evaluation your doctor might order some blood work that includes Hepatitis C viral load, Hepatitis C genotype, liver function tests, complete cell blood count and, it is often required, blood work to rule out concomitant infections or some other illnesses that might change the treatment approach.

Liver function tests (LFT's), which include liver enzymes, are groups of clinical biochemistry laboratory blood assays designed to give information about the state of a patient's liver. These tests can be used to (1) detect the presence of liver disease, (2) distinguish among different types of liver disorders, (3) gauge the extent of known liver damage, and (4) follow the response to treatment. ALT and AST are enzymes present in hepatocytes (liver cells). When a liver cell (hepatocyte) is damaged, it leaks these enzymes into the blood, where they can be measured. ALT and AST levels rise frequently on patients with chronic viral hepatitis, and other conditions, such as alcohol use. A normal level should be interpreted with carefulness because it does not always correlate with a healthy liver.

Your viral load is the amount of specific viruses that you have, in a given volume of your blood (usually 1 milliliter = 1 cubic centimeter). More precisely, it means that the amount of Hepatitis C genetic material found in your blood corresponds to as many Hepatitis C viruses as the given number says.

Viral load varies between infected individuals and varies from time to time in the same individual. Your viral load becomes useful for your doctor to follow and monitor the response to Hepatitis C treatment and cure.

The hepatitis C genotype (GT) is a type or "strain" of hepatitis C virus. There are 6 genotypes of hepatitis C around the world. In the United States, 3 genotypes are common: GT 1, 2, and 3. The GT of hepatitis C does not change over time. It needs to be tested only once. Approximately 75% of Americans with hepatitis C have GT 1 whereas GT 2 and 3 share the remainder 25%.

Liver biopsies for HCV evaluation are becoming less necessary. There are other non-invasive staging methods such as laboratory fibrosis score (blood sample collection) and transient elastography (fibroscan) that can assist the provider in determining the extent of liver damage. Rarely, a liver biopsy is still required; this biopsy is a procedure that involves obtaining a small piece of liver tissue, which is then analyzed in the laboratory. A liver biopsy may be recommended to diagnose a problem or to determine the severity of liver disease. As a general rule, a liver biopsy is recommended only when the results would affect the planned treatment or management.

Cirrhosis is the term used to describe a diseased liver that has been severely scarred, usually due to many years of continuous injury. The most common causes of cirrhosis include fatty liver disease, longstanding alcohol abuse, hepatitis B or hepatitis C. Although cirrhosis cannot be cured, there are a number of things you can do to prevent the disease from worsening. Patients with cirrhosis are at higher risk of liver cancer therefore they need to have surveillance lifelong for prompt identification and treatment.

Many herbal products claim that they may help to detoxify the liver, and in patients with significant liver inflammation it is possible that some of these agents may be marginally effective in decreasing liver inflammation, but they do not cure the virus. Many herbal products claim to "cure" or improve hepatitis C; none of these claims have been proven true. In addition, some herbal medications can seriously injure the liver.

There are several new and highly effective treatments eliminating the need for interferon. These treatments are extremely effective also reaching 95 to 100% with improved tolerability. A person treated in the past with no response should look for re-treatment as soon as possible.

Your doctor should be able to determine when you need to be considered for liver transplant consultation. Patients are considered for liver transplant when there is irreparable damage to the liver that leads to permanent impairment of its regular function jeopardizing the patient's life. In adults, the most common reason for a liver transplant is cirrhosis. Cirrhosis is caused by many different types of liver injuries that destroy healthy liver cells and replace them with scar tissue. Cirrhosis can be caused by viruses such as hepatitis B and C, alcohol, autoimmune liver diseases, buildup of fat in the liver, and hereditary liver diseases. The transplant process is elaborate, involving an extensive screening process for eligibility. Thus, not all patients with cirrhosis are eligible, and only those with the most advanced, severe cirrhosis are placed on the transplant registry.