Chronic Hepatitis C Treatment in Israel

Hepatitis C is a bloodborne virus and cannot be spread through casual contact, breast milk, or sharing food and drinks with someone who is infected.

People who are at an increased risk of HCV include the following:

• Health care workers who have been exposed to infected blood, such as via a prick by an infected needle
• Born to a mother with hepatitis C infection (chance of infection is less than 4%)
• People who have injected street drugs
• Anyone who has unprotected sexual contact with a person infected with hepatitis C (chance of infection is less than 3%)
• HIV positive
• Anyone who received a tattoo or piercing with unsterile equipment
• Recipients of a blood transfusion or organ transplant before 1992 (when blood screening became available)
• People who shared a razor, toothbrush, or nail scissors with an infected person (rare)

Every case of chronic hepatitis C infection begins with an acute phase, but every case of acute HCV does not always develop into a chronic case. Only 15 – 25% of people are able to rid their bodies of HCV spontaneously after the acute phase. The acute stage generally remains undetected because it does not usually cause any symptoms. However, acute symptoms of jaundice, fatigue, nausea, muscle aches, and fever may sometimes appear between one to three months after exposure to HCV; these symptoms can last from a few weeks to a few months.

Chronic hepatitis C refers to the long-term infection of HCV. This type of disease is typically “silent” for many years until the virus damages the liver and leads to symptoms of chronic liver disease.

HCV exists in seven distinct viral genotypes (and more than 67 subtypes have been identified). Although all of these genotypes express themselves similarly, knowing the specific type is helpful for designing the most effective, personalized patient treatment.

Most people who have recently been infected with HCV do not have any symptoms. In general, people with chronic hepatitis C exhibit symptoms only after they suffer liver damage and develop liver cirrhosis (a condition where the normal liver tissue is replaced by non-functioning scar tissue).

The most common symptoms include:

• Bleeding and bruising easily
• Fatigue
• Loss of appetite, nausea, and vomiting
• Weight loss
• Fever
• Jaundice (yellow discoloration of the skin and eyes)
• Swelling in your legs
• Itchy skin
• Abdominal swelling due to fluid buildup (ascites)
• Confusion, drowsiness and slurred speech (hepatic encephalopathy)
• Spider-like blood vessels on your skin (spider angiomas)
• Upper gastrointestinal tract bleeding

The goal of all treatments for HCV is to clear the body of the virus, thereby preventing it from damaging the liver, leading to liver failure or primary liver cancer (hepatocellular carcinoma). Right now, there are highly successful anti-viral treatments for HCV and Sheba’s specialists are dedicated to keeping up with the latest medical advances.

Antiviral medications

Sheba’s team is pleased to offer cutting-edge antiviral therapy for patients with HCV. Recent studies on antiviral drugs have led to significant improvements in custom-tailoring treatments for patients with hepatitis C. More than 95% of patients can today be completely cured from hepatitis C with the new revolutionary direct acting antiviral agents (DAAs) that target the virus directly. The side effects are minor, the new drugs are easier to take (orally), and treatment period have been shortened (8-12 weeks). All HCV patients can be currently treated and cured with the DAAs irrespective of: the virus genotype (the second generation DAAs are pan-genotypic), the presence of cirrhosis and whether they have failed previous antiviral therapy.

To maximize the effectiveness of the personalized antiviral therapy, Sheba’s doctors will test the virus genotype and its level (PCR) in the blood serum before starting to administer the drugs. We will also perform a noninvasive procedure called Fibroscan or FibroTest to check the degree of liver inflammation and scarring (fibrosis stage), to evaluate the severity of liver disease.