What to ask the doctor?

[JadeHa]

Hi everyone.

My mother found out she has Hep C through a routine blood test two weeks ago.  The test was ordered through her therapist to track her medications and thankfully she found it.

So while we don't know much because it was a therapist that found it and not her primary doctor here is what we do know.

She is severely vitamin D deficient
She has type 2 diabetes (does not run in family)
And was told to take care of liver. Some number didn't look good?

Her appointment with her primary is coming up. My mom is very bad with doctors and just clams up when she sees them. What can we expect and what questions should we ask?

Thanks in advance for your replies!

[Mike]

Hi JadeHa,

Somethings your mom will need to ask the doctor:

What can you tell me about Hep-C?

Will you be referring me to a specialist who treats Hep-C?

What additional blood work will I need?

In general, the primary care physician will refer your mother to a physician who specializes in Hep-C, such as an infectious disease specialist, hepatologist or gastroenterologist.

The specialist will order a battery of tests, including a liver study which may include a liver imaging study, liver function blood tests and possibly a biopsy. This information is needed to determine overall liver health, the presence of liver disease, and if present, the degree of any liver damage.

In discussing treatment options, the specialist will need to know the extent of any liver damage, the viral load (number of viruses present in the blood) and genotype of the virus.

Once this information is obtained, your mother can then discuss treatment options with the specialist.

Current treats are very effective and are tailored to the individual patient..

Best wishes, Mike

[Lynn K]

Was she tested for hep c antibodies or the virus itself?

The antibody test only shows if you were ever exposed to the hepatitis C virus. About 25% of people are able to spontaneously clear the virus on their own. So even if you tested positive for the hepatitis C antibodies she may not be currently actively infected with hepatitis C.

The only way to know for sure is to get the hepatitis C virus test called the HCV RNA by PCR. This test will show conclusively if he is currently infected with appetite see virus. This will likely be the next test that she has done.

Best of luck to you both

[JadeHa]

Thank you for your replies! I was hoping her primary wouldn't pass her to another doctor.  That just makes it that much longer until she can get treatment.  . But at least we know now and not at the appointment!

She definitely has Hep C. But I will make sure she did have the test done! The psychiatrist ( I thought she saw a therapist but now I have been informed she sees a psychiatrist) said she needs to find out what strain. The psychiatrist says her Vitamin D deficiency and diabetes are a result from the hep C.

Thanks again for your time. It has helped us be more prepared for the first step!

[Mike]

Hi JadeHa,

The diabetes/Hep-C link has been debunked and there is no correlation between the two.

Best wishes, Mike

[Lynn K]

Hi Mike

Do you have a link for that? All I can find is similar to this link from HCV Advocate August 2014 article that says having Hep c is a risk factor for diabetes would really like to hear it is not a risk

http://www.hcvadvocate.org/hepatitis/factsheets_pdf/Diabetes_FS.pdf

[Mike]

This  paper provides a good analysis and summary regarding the research studying the link between diabetes and HCV. The early research supported a link; the current research, not so much:

https://www.google.com/url?sa=t&rct=j&q=&esrc=s&source=web&cd=7&cad=rja&uact=8&ved=0CEwQFjAG&url=http%3A%2F%2Fwww.healio.com%2Fendocrinology%2Fdiabetes%2Fnews%2Fprint%2Fendocrine-today%2F%257Bd495b9ae-301b-49e0-b5b7-b2b9ccc0da2f%257D%2Fresearchers-unravel-complicated-relationship-between-diabetes-and-hcv&ei=G53aVPDqKMbesASf2YD4Cg&usg=AFQjCNERMGThulwwZjmjeg-pIDaG4_j-8A

Best wishes, Mike

[Lynn K]

Thanks brand new info from last month that is great! reading now

[Mike]

HCV and diabetes is a topic of interest to me.

I was diagnosed with diabetes in 2000 and 1 week later I found out I also had an active Hep-C infection.

At that time, my specialist told me that the diabetes was most likely caused by HCV, as there appeared to be a correlation between the two and higher prevalence of diabetes is noted in the HCV population when compared to the general population, hence the relationship.

The early studies, however, failed to control for other factors, such as obesity, family history and so forth.

As the research progressed, the correlation became less clear - especially when weighed against the increased prevalence of type II diabetes in the general population.

What is clear is that having diabetes can complicate  liver functioning and other effects associated with HCV.

It  also appears that having diabetes and contracting HCV can increase the effects of diabetes.

It has also been established that having  concomitant HCV and diabetes can decrease the effectiveness of treatment for HCV and vice versa.

Current research, however, is not conclusive regarding the HCV link with diabetes.

Most promising for me, is that the research appears to suggest that clearing the  virus can significantly reduce the long term impact of diabetes on overall health.

Best wishes, Mike