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[av_slide_full slide_type='image' id='186' video='http://' mobile_image='' fallback_link='http://' video_format='' video_ratio='16:9' title='Hepatitis C' custom_title_size='34' custom_content_size='27' caption_pos='caption_bottom caption_bottom_framed caption_framed' link_apply='' link='lightbox' link_target='' button_label='Click me' button_color='light' link1='manually,http://' link_target1='' button_label2='Click me' button_color2='light' link2='manually,http://' link_target2='' font_color='' custom_title='' custom_content='' overlay_opacity='0.5' overlay_color='' overlay_pattern='' overlay_custom_pattern='' av-medium-font-size-title='' av-small-font-size-title='' av-mini-font-size-title='' av-medium-font-size='' av-small-font-size='' av-mini-font-size='' av_uid='av-8u52p' video_controls='' video_mute='' video_loop='' video_autoplay='' overlay_enable='']
Sanguen specializes in testing, treatment and outreach for those living with or who are at risk of Hepatitis C.
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<h2 style="text-align: center;">Hepatitis C and Your Liver.</h2>
Before we talk about Hepatitis C, it’s important for you to know a little bit about your liver and what it does.

The liver is the largest organ inside your body. It is about the size of a football, weighs about 1 kilogram, and is located in the upper right portion of the abdomen underneath the lower rib cage.
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<ul>
 	<li>It processes food, drugs and vitamins absorbed in the bloodstream for distribution throughout the body.</li>
 	<li>It stores vitamins, minerals, iron and sugars and later releases them into the bloodstream when needed by the body.</li>
 	<li>It removes environmental and internally produced toxins from the bloodstream.</li>
 	<li>It manufactures bile, protein and blood clotting agents.</li>
 	<li>It keeps hormones at the right levels.</li>
 	<li>It regulates cholesterol and chemicals in the blood.</li>
 	<li>It builds and breaks down body proteins and other compounds.</li>
</ul>
If you’re interested, <a href="http://youtu.be/wbh3SjzydnQ">here’s a great video</a> that explains how the liver works and what it does.
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[av_toggle title='What is Hepatitis' tags='' custom_id='' av_uid='av-mby2g1e1' sc_version='1.0']
The word hepatitis means inflammation (swelling) of the liver – the word is derived from the Greek word <i>hêpar </i>(meaning “liver”) and the suffix <i>-itis</i> (meaning “inflammation”). If your doctor tells you that you have hepatitis, it means that your liver is swollen.

There are many things that can cause hepatitis, including certain medications, drugs, alcohol, toxins, illnesses, and viruses. If you have hepatitis, it is important to ask your doctor what might be causing it and what you should do to help your liver.
<h3></h3>
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Hepatitis C is inflammation of the liver that is caused by the hepatitis C virus. Hepatitis C is spread through blood to blood contact.

It is estimated that between 250,000 – 300,000 Canadians are infected with hepatitis C.

1 in 12 people worldwide are estimated to have hepatitis C.
<h4>What Are Hepatitis C Genotypes?</h4>
If you have hepatitis C and are considering treatment, your doctor or nurse will need to know what genes make up your hepatitis C virus – this is called your “genotype”. There are 6 different genotypes (1a, 2a, 2b, 2c, 3a, 3b, 4a, 5a, 6a) with 1a being the most common in North America and 1b the second most common. It is possible, but rare, to have more than one genotype.

It’s okay if you don’t know your genotype – it only takes a simple blood test to find out. Knowing your genotype allows your doctor to select treatment medications that will best target the virus in your body. None of the genotypes is “the worst” – they are all hepatitis C and they can all damage your liver.
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Most people have no symptoms at all, but liver damage can occur with or without symptoms. It is also possible to have severe symptoms but no liver damage. The only way to know that you have hepatitis C is to get tested.

Some symptoms may include:
<ul>
 	<li>Tiredness</li>
 	<li>Abdominal discomfort</li>
 	<li>Nausea</li>
 	<li>Poor appetite</li>
 	<li>Problems sleeping</li>
 	<li>Itching</li>
</ul>
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The inflammation caused by hepatitis C can lead to a build-up of scar tissue (called “fibrosis”), which can change the liver structure. It is harder for blood to reach all parts of the liver. Loss in blood supply will cause the liver cells to die.

As the cells die, it becomes more difficult for the liver to store nutrients and remove toxins.

If the virus is left untreated it can lead to cirrhosis (when the liver tissue changes in structure) which can cause the liver to stop functioning.

Even if your liver is not functioning well, getting treatment for hepatitis C can help to prevent further damage and keep you healthier.
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<h2>About Treatment</h2>
If you have been diagnosed with Hepatitis C, the clinical staff at Sanguen will meet with you to discuss treatment.

A lot of things have changed about treatment recently. There are several different medications used for the treatment of Hepatitis C. Most regimens are between 2 and 3 months long and require taking only one pill daily. Side effects are typically mild; some people do not notice any side effects, and others actually feel better once they start treatment!.

The clinical staff at Sanguen will talk to you about which medications are appropriate for you, any side effects that you might experience, and how to manage those side effects. During treatment, they will meet with you regularly to check in and see how you are doing.

For an overview of treatment, medications, side effects, or important things to know when you have completed treatment, please visit the <a href="https://catie.ca/en/treatment/hepatitis-c" target="_blank" rel="noopener">Catie website</a>.
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You may have heard that hepatitis C medications are very expensive. If you have questions about the cost of treatment, about whether you can afford treatment, or about whether you’re eligible for assistance, please talk to us.

At Sanguen, we can help you to understand your options, what’s available to you, how to apply for assistance, and/or how to contact your insurance company.

There are other ways that someone can be qualified for treatment if they don’t have private insurance. We will help in making sure you pay little to nothing out of pocket for the medication.

If you’d like to read some information about hepatitis C medication costs and coverage, please visit <a href="http://www.catie.ca/en/practical-guides/hepc-in-depth/treatment/treatment-coverage-your-region/ontario" target="_blank" rel="noopener">http://www.catie.ca/en/practical-guides/hepc-in-depth/treatment/treatment-coverage-your-region/ontario</a>
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The goal of treatment is to get a sustained virologic response (SVR) which means the virus cannot be detected in your blood 3 months or more after you’ve completed Hepatitis C therapy. The amount of times bloodwork is done while you are on treatment is dependent on your current health.
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It is very important that you keep all scheduled bloodwork appointments and the appointments with our clinical team. If you are unable to attend an appointment, or if you forget an appointment, please call us as soon as possible to reschedule. We understand that life can be busy and sometimes it’s not always easy to call to rebook. Please don’t be afraid to call and rebook if you’ve missed an appointment. We will be happy to hear from you!
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There is no way of telling in advance if you will respond to therapy. Over time, on treatment, the virus may be decreased to a level so low that it cannot be measured by blood tests. If the virus cannot be detected in your blood 3 months after completion of treatment you are considered to be a sustained responder.
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Less than 5% of patients that take hepatitis C treatment do not respond to treatment; meaning they are not a sustained responder.

Thankfully, there is medication that is available for people who have not reached a sustained response. This medication is also one pill, once-daily for 3 months. There are very little side effects, and it is very likely to work.
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<h2>Who Should Get Tested?</h2>
Everyone! Many people mistakenly think that they are tested for hepatitis C at their annual physical – but most doctors do <em>not</em> test for hepatitis C unless you have told them that you may be, or have been, at risk.

If you’ve never been tested for hepatitis C, or you’re not sure, we recommend that you get tested. It’s the only way to know if you have the virus.
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Any time! If you’ve done something that may have put you at risk for hepatitis C, you’ll need to wait for 3 months before you get tested – otherwise, the results may not be accurate.
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Testing for hepatitis C is done through two blood tests. <a href="http://www.catie.ca/en/basics/hepatitis-c#testing" target="_blank" rel="noopener">You can read about it here</a>. Unfortunately, there is no ‘rapid test’ for hepatitis C in Canada. Results can take up to 2 weeks.

If your <strong>first</strong> blood test is <em>negative</em>, it means that you do not have hepatitis C. A negative result is a good time to talk about harm reduction and how to keep yourself safer. You do not need to have a second blood test if the first one is negative.

If your <strong>first</strong> blood test is <em>positive</em>, it does not mean that you have hepatitis C, only that you have been <em>exposed</em> to it. You will need to have a second blood test done to confirm whether you have the virus. Approximately 1 in 4 people are able to clear the virus without medical help – but they’ll still show up positive on the first test.

If the <strong>second</strong> blood test is <em>positive</em>, it means the virus is in your blood.
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<ul>
 	<li>Dried blood spot testing: This is when your finger gets pricked and blood is dropped onto a piece of paper. Once dry, this can be sent to the lab for hepatitis C antibody testing, and sometimes other tests as well. It can take up to 3 weeks for the results to come back, and may not always be an option for testing.</li>
 	<li>Point-of-care: This includes a finger prick where a small drop of blood is tested and results given within 20 minutes. This test is only checking for hepatitis C antibodies (known as the “first test” above).</li>
 	<li>Venipuncture: This is when a needle is inserted into your vein just like when going to the lab. The results of the first test for hepatitis C antibodies takes around one week to come back. The second test results looking for the actual virus takes 2 weeks.</li>
</ul>
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Your family doctor or nurse can test you for Hepatitis C. Testing is also available at most Public Health units. You can also contact Sanguen to make an appointment for testing.

We strongly recommend that you call ahead to the location where you would like to be tested to make sure they are open and that someone will be available to do the testing.
<h4>Free testing is also available in Waterloo Region at:</h4>
<ul>
 	<li><a href="http://www.theworkingcentre.org/st-johns-kitchen/143"><strong>St. John’s Kitchen</strong></a> (97 Victoria St. North, Kitchener) Mondays from 11 to 1pm
(drop-in or by appointment)</li>
 	<li><strong><a href="https://2025.sanguen.com/outreach-program/mobile-van-outreach/">The Sanguen Community Health Van</a></strong> (Tuesday nights in Cambridge, Wednesday nights in Kitchener and Guelph, Thursday nights in Kitchener and Guelph)-
(drop-in or by appointment)</li>
 	<li><a href="http://chd.region.waterloo.on.ca/"><strong>Waterloo Region Public Health</strong></a> (99 Regina St South, 2nd floor, Waterloo)
(no health card required, call for drop-in times or to make an appointment – 519-575-4400)</li>
 	<li><a href="http://chd.region.waterloo.on.ca/"><strong>Waterloo Region Public Health</strong></a> (150 Main Street, 1st floor, Cambridge)
(no health card required, call for drop-in times or to make an appointment – 519-883-2267)</li>
 	<li><a href="http://acckwa.com/"><strong>ACCKWA</strong></a> (5 – 1770 King St East, Kitchener)
(drop-in, no health card required – Thursdays from 4-7pm (519) 570–3687)</li>
</ul>
<h4>And in Guelph-Wellington at:</h4>
<ul>
 	<li><strong><a href="http://www.archguelph.ca/">ARCH</a>
</strong>89 Dawson Road, Unit 115 – please refer to <a href="http://www.archguelph.ca/" target="_blank" rel="noopener">their homepage</a> for updates. – (519) 763-2255 or 1-800-282-4505</li>
 	<li><a href="http://www.wdgpublichealth.ca/"><strong>Wellington-Dufferin-Guelph Public Health</strong></a>
160 Chancellors Way, call to book 1-800-265-7293</li>
 	<li><strong>Guelph Community Health Centre
</strong>By appointment with Sanguen.</li>
</ul>
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