Treatment & Care

Monitoring tests – Keeping Track of Your Health

Your doctor will keep track of how your liver is doing through blood tests called liver function and liver enzyme tests.

Biopsies (taking a very small sample of your liver) and ultrasounds (taking a picture of your liver using sound waves) are also used to monitor how your liver is doing.

Advice from the Mayo Clinic on Doctor’s Appointments: How to Prepare and Questions to Ask

(www.mayoclinic.com/health/hepatitis-c)

How to prepare
Because appointments can be brief and because there’s often a lot of ground to cover, it’s a good idea to be well prepared for your appointment. To prepare, try to:

Be aware of any pre-appointment restrictions. At the time you make the appointment, be sure to ask if there’s anything you need to do in advance, such as restrict your diet.
Write down any symptoms you’re experiencing, including any that may seem unrelated to the reason for which you scheduled the appointment.
Write down key personal information, including any major stresses or recent life changes.
Make a list of all medications, as well as any vitamins or supplements, that you’re taking.
Take a family member or friend along, if possible. Sometimes it can be difficult to absorb all the information provided during an appointment. Someone who accompanies you may remember something that you missed or forgot.

Questions to ask

Your time with your doctor is limited, so preparing a list of questions will help you make the most of your time together. List your questions from most important to least important in case time runs out. For hepatitis C infection, some basic questions to ask your doctor include:

How much hepatitis C virus do I have in my body?
Has the hepatitis C virus damaged my liver?
Do I need treatment for hepatitis C infection?
What are my treatment options?
What are the benefits of each treatment option?
What are the potential risks of each treatment option?
Is there one treatment you think is best for me?
I have other medical conditions. How will these affect my hepatitis C treatment?
Should my family be tested for hepatitis C?
Is it possible for me to spread hepatitis C to others?
How can I protect the people around me from hepatitis C?
Should I see a specialist? What will that cost, and will my insurance cover it?
Are there any brochures or other printed material that I can take with me? What Web sites do you recommend?
What will determine whether I should plan for a follow-up visit?

In addition to the questions that you’ve prepared to ask your doctor, don’t hesitate to ask questions during your appointment at any time that you don’t understand something.

Hepatitis C Treatment

GENERAL

The goal of hepatitis C treatment is to clear the virus from a person’s body. This is measured by a negative (or undetectable) PCR test. When the test is still negative six months after treatment is finished, it is called “sustained virological response” or SVR. An SVR is like a cure.

Treatment involves two different medications: peg-interferon (an injection taken once a week) and ribavirin (pills you take twice a day). Treatment usually lasts between six months and one year.

You will be monitored to see if the treatment is working. If it is not, treatment will be stopped after twelve weeks.

You may be referred by your doctor to a specialist (a gastroenterologist, hepatologist, infectious disease specialist) or to another family physician who has experience with hepatitis C treatment. Sometimes a liver nurse will spend time with patients as well.

Many factors affect how well your body will handle and respond to treatment and what your chances of success are. There are side effects to treatment and they can be tough. Your doctor or health care provider will talk with you to help you decide if you should take treatment. The discussion will cover areas like:

how much liver damage you have
the supports in place to help you stick to the medication schedule
making a plan to deal with side effects

Treating hepatitis C early may lead to better results but because treatment is not easy, some people may choose to wait to see if their liver disease gets worse.

That can lead to other problems: sometimes liver disease can become so advanced or severe that treatment is no longer an option.

Regular check-ups with your doctor and talking about treatment is important whether you find out very early or later on that you have hepatitis C.

Sometimes treatment doesn’t work or there are reasons that a person can’t take treatment. There may be new medications available in the future to treat hep C.

SUPPORT DURING TREATMENT

Treatment for hepatitis C can be very difficult. Treatment support groups are very useful in helping people prepare for, stay on and recover from treatment. Treatment support groups can be found at liver clinics in larger centres. Check with a physician, specialist or public health nurse for treatment support groups in your area.

Be sure to also check HepCBC at www.hepcbc.ca for their information, resources and support group listings.

Other forms of support include family and friends, online resources and connecting with others who have been on treatment by phone or email.

TRANSPLANT

If a person’s liver stops working, a liver transplant may be possible. A transplant doesn’t clear the virus, but it can help by replacing the damaged liver with a healthier one. Go to www.transplant.bc.ca for more information on liver transplantation in British Columbia.

Please also check further in this guide for resources and where to go for more information about hepatitis C care and treatment.