More than half of all people with an acute hepatitis C infection will eventually develop chronic hepatitis C, and those people will be at risk for liver damage such as cirrhosis, which is scarring of the liver. And the most common risk factor for liver cancer in the United States is long-term infection with hepatitis C, according to the American Cancer Society.
So, it’s probably unsurprising that people who have just been diagnosed with hepatitis C may be a little anxious or upset about their condition. You might not want to exacerbate their anxiety by asking certain questions or making certain comments. In fact, you might even spend some time learning more about hepatitis C. “If you have a loved one who is diagnosed, it’s important that you are also educated about it,” says Robin Lord Smith, community engagement coordinator for the National Viral Hepatitis Roundtable.

What Not to Say to Someone Who Was Recently Diagnosed With Hepatitis C

Here’s what not to say to someone who recently received a hepatitis C diagnosis:

“How did you get hepatitis C?”

Some people have a tendency to wonder how someone might have contracted hepatitis C because they know it’s an infectious disease—and they come right out and ask. “To me, that’s an exercise in futility,” says Dr. Anurag Maheshwari, MD, who specializes in liver disease at the Melissa L. Posner Institute for Digestive & Liver Disease at Mercy Medical Center in Baltimore. “It’s not really important to know how you got it but to instead move on and figure out how to treat it.” Dr. Su Wang, MD, medical director for the Viral Hepatitis Programs at Cooperman Barnabas Medical Center and a former president of the board of directors of the World Hepatitis Alliance, agrees. It’s not a good idea to ask because the infection could be the result of past drug use that the person isn’t particularly eager to talk about—or they might not even know how they were infected, she explains. The CDC didn’t introduce guidelines for universal precautions in an effort to prevent bloodborne pathogen transmission until 1985, so in the years prior to that, some people contracted hepatitis C through contact with contaminated blood or blood products in a healthcare setting. And there are numerous other risk factors to consider. Ultimately, hepatitis C is a medical condition, Dr. Wang says, and it doesn’t matter how you got it. “At this point, we just move forward and do what we can to get you healthy,” she says.

“Oh, no, you must be so scared!”

Asking if they’re scared might just make them wonder if they should be scared. It’s true that an untreated case of hepatitis C can lead to some pretty serious complications. Acute hepatitis C can lead to chronic hepatitis C, and chronic hepatitis C can lead to serious health issues such as liver damage, cirrhosis and even liver cancer, according to the CDC. And that can be scary to contemplate. But here’s the good news: Hepatitis C is not only treatable, but it’s now curable in the vast majority of cases. In fact, the World Health Organization notes that more than 95% of people with Hepatitis C can be cured with the direct-acting antiviral (DAA) medications that are now available.

“Is the treatment really awful?”

People who seem worried about the treatment for hepatitis C may be thinking about the old standard of treatment, which was typically interferon, often with ribavirin. Patients underwent regular injections of interferon for 26-52 weeks. The treatment regimen carried a long list of potential side effects, but some of the most serious side effects from long-term therapy with interferon used to treat hepatitis C were depression and suicidal thoughts. Ribavirin carried the risk of additional side effects. Today, treatment is much easier to tolerate–and you don’t have to take the medication for nearly as long. The direct-acting antiviral medications used to treat hepatitis C are oral medications that you take for eight to 12 weeks, depending on which specific medication your doctor recommends for you. The side effects are typically mild and may include fatigue, headache, nausea and diarrhea. But if the person is still coping with the news of the diagnosis, they may not know the full story about treatment, and your comment might make them anxious.

“You must be really worried about exposing your family.”

If you have contracted an infectious disease, it’s normal to worry that you might unintentionally expose your family to it. But Dr. Omar Massoud, MD, Cleveland Clinic gastroenterologist with extensive experience in liver disease, wants to put those fears to rest. “Don’t worry about your family,” he says. “They are not going to get hepatitis C from you.” Hepatitis C is spread through contact with the blood of an infected person, not through casual contact. So as long as you’re not sharing razors or toothbrushes or similar personal items, you don’t need to take any special precautions.

What You Should Say to Someone With Hepatitis C

One thing that you should say to a friend, family member or neighbor who reveals they’ve recently received a hepatitis C diagnosis: “How can I help?” The stigma surrounding the disease continues to exist, but you can refrain from perpetuating it by reaching out to the person and expressing your desire to help them. “As much as you can, be supportive of and accept that person,” says Dr. Wang. You can also remind them that treatment is available if they seem to be wavering about what to do. Emphasize a message of hope, says Smith. “There is a cure that can significantly impact your life, and everyone deserves access to that,” she says. Next up: What Is Hepatitis C and How Do You Get It? Expert Answers to Your Questions About This Curable Condition

Sources:

American Cancer Society. Liver Cancer Risk Factors.Broussard IM, et al. Universal Precautions.CDC. Hepatitis C Questions and Answers for the Public.HCVGuidelines.org. Initial Treatment of Adults with HCV Infection.HCVGuidelines.org. HCV Testing and Linkage to Care.HHS. Hepatitis C Basic Information.HHS. Viral Hepatitis in the United States: Data and Trends.Anurag Maheshwari, MD, Mercy Medical Center.Omar Massoud, MD, a Cleveland Clinic gastroenterologist with extensive experience in liver disease.Mayo Clinic. Interferon Alfa-2b (Injection Route).Robin Lord Smith, community engagement coordinator for the National Viral Hepatitis Roundtable.World Health Organization. Hepatitis C.