Questions to Ask Your Health Care Provider

• Questions about a health care provider's experience with hepatitis C.
• Questions about testing.
• Questions about medical treatment.
• Questions about alternative and complementary treatment.
• Questions about hepatitis C and HIV co-infection.
• Questions about follow-up care.

Questions About a Health Care Provider’s Experience with Hepatitis C:

• Do you have many other patients with hepatitis C?
• Do you feel up-to-date on all the latest changes and advancements in hepatitis C treatment?
• Do you think I should be referred to a liver specialist for my care?

Questions About Testing:

The following questions relate to routine and one-time liver tests:

What is my hepatitis C viral load? (If you have already gotten a viral load test)

• What are the test results?
• How often should I have my viral load checked?
• May I have a copy of the test results for my records?

What is my hepatitis C genotype?(This is a one-time liver test)

• (If you have already gotten a genotype test) What are the test results?
  
• How does my genotype affect my illness and possible treatment?
• May I have a copy of the test results for my records?

What are my liver function test levels?
(Liver function tests are ALT/AST, ALP, and SGTP, bilirubin, albumin, and prothrombin time)

• (If you have already gotten liver function tests) What are the test results? How do they compare with normal levels?
  
• How often should I have liver function tests done?
  
• May I have a copy of the test results for my records?

Do you recommend I have a liver biopsy?

• If yes, why? If no, why not?
• What is involved in getting a biopsy?
• What are the risks?
• How is the procedure performed?
• How long does the procedure take?
• What experience do you have, or does the doctor performing the procedure have in doing liver biopsies? (The more experience they have, the better.)
• If a liver biopsy shows that I have fibrosis or cirrhosis (scarring), how does that affect my treatment options?
• (If you have already gotten a biopsy) What are the results of my liver biopsy and what does it mean? Will the result affect my treatment?
• May I have a copy of the biopsy report for my records?

Questions About Medical Treatment (if you are on treatment or thinking about treatment):

Do you feel I am a good candidate for interferon and ribavirin combination therapy? What about pegylated (peg-a-lated) interferon therapy?

• If so, why?
• If not, why?

What are the pros and cons of beginning treatment?

• What are the potential side effects of the interferon and ribavirin, or pegylated interferon?
• How long do you think I will have to be on therapy?
• How is the treatment taken?
• How may the treatment affect my life and my lifestyle?
• What is the likelihood that the treatment will be successful?
• Do I have to change how or when I eat if I choose to be treated?
• Should my partner or I take birth control pills while on the medications?
• Can my partner (or I) get pregnant safely while I am on the medications?

If I have a history of mental health issues (depression/anxiety), will I be a candidate for hepatitis C treatment?

• How will my mental health be managed?
• What will be done if my mental health gets worse?

If I am on methadone, how will this affect my eligibility for hepatitis C treatment?

• How do you feel about treatment for hepatitis C while a person is on methadone?
• Will you work together with my dispensing/treatment agency to coordinate my care?

Do you exclude patients from interferon/ribavirin or pegylated interferon treatment if they have advanced liver scarring?

Are there new therapies that will soon be available, and do you think I should wait for them?

Questions About Alternative and Complementary Treatment (if you are receiving treatment or thinking about treatment):

Before beginning any type of complementary treatment for hepatitis C, ask your health care provider the following:

• How do you feel about complementary and alternative medicine such as Chinese herbs, supplements, and acupuncture to help treat my hepatitis C?
• Have you read any research on the benefits of herbs and other complementary or alternative therapies for hepatitis C?
• Will you work together (share medical information) with my complementary care provider should I choose to have one?
• Can you refer me to a good complementary and alternative medicine provider in my area?

When choosing a complementary practitioner you should use as much care as when you choose your health care provider. Here are some useful questions to ask:

• What is your treatment philosophy or treatment style?
• How did you become a complementary treatment practitioner? Do you have specific credentials as a practitioner?
• What is your experience in treating someone with hepatitis C?
  Is this therapy safe and/or effective in treating hepatitis C?
• Are there any side effects from this therapy?
• How long will treatment last?
• Can I do this treatment while being treated with the standard medications (interferon and ribavirin, or pegylated interferon)?
• What is the cost of this treatment, and is it covered by health insurance?
• Will you work together (share medical information) with my primary care provider, and/or my liver specialist?

Hepatitis C Self Care:

• How does my diet affect the hepatitis C virus?
  • Do I have to change how and when I eat now that I have hepatitis C?
  • May I be referred to a dietitian or nutritionist for help with my dietary needs?
• How do my social habits (drinking alcohol, using drugs, smoking) affect my liver or the hepatitis C virus?
• Do I need to stop drinking alcohol completely?
• If I want to stop using alcohol and/or other drugs, can you refer me to an alcohol and drug counselor?
• If I want to stop smoking, can you refer me to someone to help me quit?
• Do I have to change my sexual practices? Should my partner(s) be tested?
• What kinds of symptoms/signs can I expect now that I have been diagnosed with hepatitis C?
• What if I feel fine? Does that mean my liver is not damaged?
• Do you recommend that I have tests done to see about the condition of my liver? If yes, which tests?
• Do you recommend that I begin treatment for hepatitis C? If yes, which treatment do you recommend and why?
• Is there a support group in the area that I can attend?

Other Infections:

• Do I need to be tested to see if I am immune to hepatitis A and/or hepatitis B?
  
• Am I immune to hepatitis A and/or hepatitis B? If not, do you recommend I be vaccinated for either or both hepatitis A and B viruses?
• Should I be tested for HIV or other infections?

Questions About Hepatitis C and HIV Co-Infection 

If you have been diagnosed with both hepatitis C and HIV, you may want to ask these questions in addition to the other questions provided:

• Do you provide care or work with many patients with both HIV and hepatitis C?
• Do you feel up-to-date on all the latest treatments for HIV and hepatitis C?
  • If not, can you refer me to a health care provider who treats co-infected clients?
• Do I need to treat my hepatitis C before I start on HIV medications?
• If I am already on HIV medications, do you recommend treatment for hepatitis C?
  • How long will I need to take medications?
  • What side effects can I expect from taking HIV and hepatitis C medications together?
  • Are there certain combinations of medications that are better tolerated or easier to take than others?
  • Do I have to change how and when I eat if I choose to have treatment for the HIV and/or
    hepatitis C?

Questions About Follow-Up Care: 

• How often should I return for follow-up?
• Can I schedule an appointment now?
• What should I do if my health gets worse between now and the next time I see you?
  • Can I call your office and make an earlier appointment?
• Are you available by phone