Testing Positive for HEPATITIS C

[jassi]

Good Morning,
I got my blood test report yesterday. It show that my HCV Ratio is 25.0 H high s/co ratio have been shown.  HCV AB is Reactive. I am trying to get pregnent. The doctor told me that I must get treament for HEPATITIS C first before she starts my treatment from pregency. My question is hoe long does the treament for HEPATITIS C will take me? and what stage or level I am at? Is this the worst or in between level? What are the chances of me getting rid of HEPATITIS C ? I am 34 years of age now. Please responde promtly.
Thanks

[chcnme]

Hi, has the doctor who has told you have Hep C and that you must be treated referred to a liver doctor?  That needs to be done,  and you will need more tests from the liver doctor to determine what stage you are  (how your liver is doing)  and what treatment will entail for you  (if you need it.)  

Some types of Hep C require 24 weeks;  others require 48 weeks;  some don't require treatment ; some types of Hep respond to treatment better than other types.  There is a lot you don't know now that you will need to know before you can assimilate all the information to help you make decisions about treatment / pregnancy / treatment / no treatment / waiting / etc.  All of that is going to depend on what a liver doctor finds out about your liver, mainly through labs and a liver biopsy - if you need a biopsy.  

The doc who is trying to help you get pregnant (if that's what you are talking about)  might not continue to go down this avenue with you if they are unsure about your hepatitis status.  

Have you been referred to a liver doctor?

[bobbyullc]

bummer, do not panic. you must not treat if pregnant, what you need to know is how far advanced it is? that is done with a biopsy. if only a stage 0 or 1 you have years to wait before you NEED to tx. new drugs are on the horizon and more info will be available in months. tx takes 24 to 48 weeks depending on what type you have AND THE CHANCES OF SUCCESS  go way up if geno 2. at your age you should be able to have the child first.
google "janis and friends" for info on hep c. read everything BEFORE making a decision. i got it before you were even born and just treated. this disease is very managable. 4 million in the usa have it now.
good luck.
bobby

[aquarius64]

i am not a doctor, nor genius, just so you know, but i found out i had hep c when i was 4 mo. pregnant. the gastro doc ran all the tests to find out my genotype and liver function tests to see where i stood. i am a geno 2b. my LFT's and viral load all came back low. 3 months after that baby was born i wanted to get pregnant again. after the last child was born the doc recommended treatment, but i had two babies and heard of all the side effects the meds had, so i decided to wait. it's been 3 years and i just had a liver biopsy, stage 1 grade 2. i'm still in pretty good shape as far as this disease goes so my doc recommends treating now so i have a better chance of clearing it. i will start tx this week. others here on this forum have been through tx before and have much more knowledge in all these areas, i am sure they will respond. as i heard here, tx is a personal choice. new studies for meds are going on and hopefully some will have less side effects in the future. some people are lucky and have few sx. i would just try to get as much info on the disease, tx and tests available so i could make an informed decision along with a good doc that knows this disease. good luck and stick around, the people here have helped me alot!!!

[jassi]

i am not pregnent yet, I have been trying to get pregnent for a while and unsuccessfull, so I went the doctor who I went to try to get pregnent, did my blood test and told me I have Hep C and I have to get treatment. Is this like a life threathing desease?

[jassi]

Does the HCV 25.0 ratio tells ehat stage I am at?

[painterlady13]

Jassi there are Many Mothers out there that have wsuccessfully had their children before treating for HCV and have NOT passed this disease on to their children....   I would talk to a liver doc and get the biopsy/stage and grade of your HCV and then in combination with your OB decide whether to treat first or not.  So very many of us have had this for 20 or 30 years and had children raised them and not even known we had it.  And yet our kids are neg for HCV.   Including bopth of mine.

Hopefully there will be some other moms out there who will chime in.

[NYgirl]

There is a chance that you COULD pass it on to a child but it is a very small chance (but it does exist).  I had two children while I had HCV and didn't know I had it. When I found out I rushed to get them tested and they were ok. It made me crazier than I can tell you though - wondering if I'd passed this silent killer disease to my kids. I could deal with anything but that!

However there HAVE been members who were BORN with it from their mothers or mothers who have given it to their child in here.  It's not impossible.

Perhaps it would be best to kill it off and THEN get pregnant.  I wouldn't really take the chance now...knowing I have it and could pass it on. It would drive me nuts.

But since we don't know all the details of your liver damage...I don't know if you need to treat right now for health or not.

Only a doctor could tell you that without your info.

[Kalio1]

It sounds like you are seeing a fetility doctor to try to get pregnant, is that correct? I get from your post that you are not pregnant now but are attempting to get pregnant.(?)

Hep C affects our immune sytems and our livers. Your liver plays a big role in the production of hormones and metabolic processes. Im not suprised the doc thinks dealing with Hep C prior to trying to trying to get pregnant is a good idea. You probably are feeling like you are runningout of time and now this problem has arisen, but try not to let it get to you. Try not to get discouraged.

I agree with the others, you need to see a Heptologist if possible and you need a lot more info. about your condition. Your genotype and viral load is a good place to start.

Treatment length depends on your genotype and your condition, some genotypes treat for 24 weeks, some for 48 weeks, some longer. A lot depends on your current liver condition and a lot of other factors.

You can not get pregnant and treat the illness concurrently because the drugs used to treat this illness can cause dramatic birth defects, so you will need to deal with them one at a time.

See a liver specialist if you can, learn all you can about your disease and your current condition and go from there. If the fertility doc sees this as an obtacle to you becoming pregnant, that would explain why he/she advised you to deal with Hep C first, then undergo fertility treatments.

try not to freak out, it is a serious illness but you can beat it. Knowledge is power, the more you learn about it the better you will feel. There is a lot to learn, try to pace yourself.
Are you feeling ok? Do you have any symptoms of Hep C now? Do you know what your liver function tests said? How about your platelet count? Have you had a biopsy? All of these things and more will offer you important info. you will need to decide what to do.

[Tallahassee]

I agree with all the recommendations.
Only I would like to add some additional info.

I was going through fertility treatments in 2004 (unfortunately, unsuccessfully).  My Dr. was very concern with my long history of Hep.C.  He questioned his colleague (also from University of FL). His response was that as long as patient has a compensated liver disease, patient may proceed with pregnancy (of course, it is a patient's judgment call, but as long as platelets levels are in normal range, there is no danger to pregnancy.  Also, he recommended at 30th week of pregnancy to check a viral count, and if it is high, at 34 weeks of pregnancy do c-section delivery.  Dr. referred to some study that they conducted in University of FL.

Good luck & be more concerned about your own health - I subjected myself to multiple hormonal/ steroidal treatments and I'm sure it did not help my liver condition (as far as fibrosis). If I had to do it all over again, I would go straight to adoption... But hindsight is a 20/20 vision! :)

All the best and remember to have a consult with a hepatologist.

[NYgirl]

Hey what a GREAT surprise to see you pop on...I just smiled ear to ear and HAD to say hello!

[cuteus]

First, there are no doctors here as stated in the disclaimer, or there weren't the last time I was here, which was quite a while ago, so all you are getting here are suggestions and opinions.

HCV 25.0 ratio tells nothing about your Hep c status.  It only states that you were exposed to it.  Has he done a viral count yet?  A qualitative or quantitative PCR will determine if you are still infected, 80% of exposed people are.  There is a syndrome associated with hep c that prevents pregnancy in some women, you might want to test for Anti-phospholipid syndrome.  If your viral load comes back positive, the only way to know your level of damage is by biopsy.  You need to know your genotype before deciding on how long to treat also.  It seems that you do not have all the facts yet in order to make a decission about treatment.  Given your age, you want to speed up all these tests so that you have time to treat (if you choose it) and get pregnant.  There is a small chance of transmission if you choose to get pregnant while infected, if you are infected.  This risk increases with a high viral load and coinfection with other illnesses.  You need more tests.

[aquarius64]

it's me aquarius from above, just so you know, i am 42yrs old and may have had hcv for 27 yrs.i have 4 kids that are all negative for hcv and i breast fed them all and had natural childbirth. my current hubby and i have been together for almost 9yrs and he is negative also. hcv can be scary, that's why it's important to get all the right info and a good doctor. i still have questions and a lot of things are new to me. i get a lot of help here on this forum from people who have been through the same things. getting all the right tests done will help to tell you where you are at. if and when you do have a child, they should be tested after 12-18 months of age because the baby can carry the mom's antibodies for that long. this disease, for a lot of us, is not like we are going to our grave tomorrow or anything, but it can progress to cirrhosis and liver cancer in some, but usually takes a long time. i am scared at times, but i make myself aware of the disease and how to live better with it. i read a lot of info online. i do not drink alcohol or do drugs. i am cautious of ways of spreading hcv. i try to exercise(ha). i do however indulge in hagen daas rocky road by the pint. that's one addiction i am not rady to give up!!

[aiuta]

I agree with what the others said: go to liver Dr, find out your genotype, VL and get a biopsy.  Only with that info on hand can you make a more informed decision about if you should treat or wait.  Also, like bobbyullc said, I'd go to the Janis site AND I'd read some of the archives here as well.  There is a lot of info on both sites.  By the way, as NYgirl said, the chances of passing it onto a child are very low (I think around 5%) but, if you have a Cesarian, I believe you can almost entirely eliminate the risk.  It's passed from blood to blood contact, so I was told it doesn't get passed when the baby is in the womb, but rather in the act of delivery, when you and the baby may both have exposed blood.  I am NOT a Dr., so please check out what I said before taking it as fact, but I wanted to pass along the info I had heard and perhaps give you some hope in the process.  All my best, Aiuta

[jmjm530]

Jassi,

I understand your concerns but you have to take things in steps.

First, you need to find out if you really have Hep C, or just the antibodies. Two different things. Best person to discuss this with is a liver specialist who are called Hepatologists. If that is not convenient, at least make sure you see a GI and take a PCR or viral load test to confirm your hep c status.

If it turns out you have Hep C, next step is to find out what strain (genotype) of Hep C you have and also get yourself evaluated for liver damage. Again, a liver specialist (hepatologist) is the  best person to do this. Depending on your genotype, how much damage and other factors, you and your doctor may decide to treat now, or the decision may be made to wait while monitoring your liver.

As to children, many people have children while they have Hep C but there is a very small chance it could be passed on to the child. This is a decision again, best discussed with both a liver specialist and your obstetrician.

One very important thing is that you should not get pregnant while on the current standard treatment drugs, and for six months following treatment because of the possiblity of birth defects. So, if treatment lasts for a year, that means there will be a 1.5 year period you cannot get pregnant. So, if you really want to have children, you could reasonably have them before or after treatment but not during. But again, first step is to really get yourself evaluated. It may turn out that you don't have Hep C at all and only the antibodies. In that case you can start having children right away.

All the best,

-- Jim

[aquarius64]

this may be jumping the gun a bit but when i was pregnant with hcv, my obgyn wanted an amniocenthesis due to my age of 39. i was scared that it could add more of a chance of passing this to my baby. the response i got was that for me it was a matter of choice. they really didn't have a lot of info to give me. i looked online and still came up with not much. i went ahead and had an amnio during both pregnancies and all was well. i would try to find out tht info as well as fetal monitoring when you go into labor. that's when they attach little electodes(?) to the baby's head through the vagina to find out how the baby is. i am sure this could possibly increase the risk of transmission. as i said before, i am getting ahead of myself. personally, and i am only saying this for myself, if i wanted to get pregnant and my disease ws in good shape, i would get pregnant first then treat. i have no idea how long the after effects of these meds could have an effect on me or my baby. good luck.

[avidreader]

REV: I'm not sure where you got the info re: c-section. A c-section was never recommended to me by my doctors (gastro, internist and obstretrician) even though they were fully aware of my HEPC status. My child is a teenager now and never tested positive and it was way down on our list of concerns throughout my pregnancy. I've never heard of a c-section as a routine reccomendation for a Hep C infected woman and many, many of my friend have HCV and have children.

Jassi: Reading between the lines it sounds as you may be considering fertility treatment and perhaps that is why your doctor want you to treat the Hep C first? I wonder if the fertility drugs are contradicted in someone with a liver disease? If this is not the case, I would consult with both a hepatoligist and another fertility doctor before I made any decisions. If you are anxious to get pregnant now a year and a half wait (48 months treatment time + 6 months to get the drugs out of your system for the most common genotype in the US) is a long time to wait. Do lots of research and talk to lots of people who know what they are talking about. Lots of doctors know VERY little about Hep C. FYI--I had it for 30 plus years before I treated and I treated at the ripe fun age of 55 and so far treatment seems to have worked. So--good luck--whatever you decide to do.

[latecomer]

I have been reading a lot on drugs that are FDA approved but can help the increase the odds of succeeding with interferon treatment.  If you are being treated for infertility  related to synrome x (basically insulin resistance) some of the drugs they use to treat that, specificaly metformin and pioglitazone as well as colesterol drugs like fluvastatin are all showing promise of improving you success rate with pegasys/ribavarin--especially if you type 1genotype.  So if you are taking thosedrugs you may want to keep on with them during hepc treatment even if you decide to wait to conceive.

I too have a daugher who I believe conceived long after hep c infecton and didnt find out til she was 15.  I ended up having a c section for other reasons, but I breast fed for two years.

[Kalio1]

Im sorry but what you are saying simply isn't true. C section is NOT recommended for pregnant women giving birth who have HCV.You do not cite any references to back up your claim, I tried to locate some but there weren't any, in fact what I found was lots of info. saying C section is NOT recommended for HCV poitive women.

C section is recommended if a woman is experiencing a Herpes Simplex II outbreak at the time of delivery, but not for women who have HCV.

[avidreader]

The articles you cite were from 2000 and 2001. The article from 2000 posits that C-sections MIGHT reduce the chance of infection and the 2001 article is talking specifically about forceps assisted deliveries vs c-sections and seems to be more focused on co-infected pregnant women. The med help link is just that--a link to another thread like this one where people are expressing their opinions. I was talking to one of the OBY nurse practitioners at our clinic today and she also practices at nearby Albany Medical Center which is a large regional hub for the treatment of HIV. Because of the co-infection rates of HIV and HCV they see a lot of pregnant women with HCV and she says emphatically that C-sections are not and should not be routinely reccommended for HCV infected women. She attributes the tendency of some docs to do it to the general increase in C-sections in this country by doctors who are afraid of lawsuits.

[sass_blue]

I was told the same thing about c sections with my last child (the only one that I knew I had hep c whilst carrying).  I wanted a planned c section as it reduces the risk by about 4%.  I was told by the obst...that there is a 6% chance of mother to child transmission with natural and 2% with planned c section.  I ended up with an emergency c section at 37 weeks because I heammoraged (spelling wrong I know!) and my baby now aged 5 still didnt get HCV...!!!!

[aquarius64]

i believe my docs told me the same about being safer to deliver with a c section. i don't remember any percents but then i was newly dx. they didn't seem to have any info on the amnio or internal fetal monitors and my ob gyn checked with a specialist to find out what the risks were, but no one gave me any percents on that.  i avoided the internal fetal monitors but had 2 amnio's with 2 pregnancies. thank GOD above it didn't hurt my kids. i know my vl was low at time of delivery. that probably helped.

[Kalio1]

I agree with Avid the sources cited are outdated. Also your sources are referring to co infected women. C sections are recommended for CO INFECTED HIV/HCV pregnant women, or for women who are experiencing a Herpes outbreak at the time of delivery, however if you ONLY have HCV they are not recommended. Any hospital or doctor who is recommending them is doing so for some other reason(liability) and NOT for you and your babies' best interest.
Far too many c sections are done for liability reasons in the US unfortunately and not for the "right" reasons. HCV is not a legitimate reason to have a c section.

[Tallahassee]

If you check my post in this thread, my Dr.(Professor at teaching hospital) received an e-mail from his colleague from the same teaching hospital regarding C-Section delivery.  He quoted studies conducted by his research team at the University of FL.  This University determined that without C-section about 1% of patients transmitted to their child (contradictorily to generally reported 5%), but with C-Section delivery they had 0 (ZERO!) transmission rate.  1% is still very low, but 0% is even better!

I hoped it helps.
All the best to everyone!!

[aquarius64]

This is from Hepatitis Info Center  http://www.hepinfo.ie/q_a/pregnancy.htm                                                                                         What are the chances of transmitting Hep C from pregnant mum to her baby?

The risk of transmission is thought to be around 5%, but this risk increases to between 15-30% if the Mum also has HIV infection.
How is Hep C passed from pregnant mum to baby?

Research is being carried out to determine how the Hep C virus is transmitted from Mum to Baby, but it is thought that it mainly occurs around the time of birth.
  Some activities that may increase the risk of transmission include the use of foetal scalp monitoring, the use of forceps or prolonged rupture of membranes during labour.
Foetal scalp monitoring is where a small electrode is placed on the scalp of the baby before birth, to monitor the baby- this causes a scratch to the scalp, which may provide a way for blood to pass from mum to baby.
Can caesarean section reduce the risk of transmitting Hep C to the baby?

There is no concrete evidence as to whether caesarean section should be recommended to mothers and approaches may differ from hospital to hospital.
Where the mum has HIV and Hep C, it is likely that caesarean section will be discussed to try to reduce the risk of transmission to baby.
When an Obstetrician or Midwife knows that the Mum has Hep C, they may avoid using foetal scalp monitors and forceps where possible.