Hepatitis C

What is hepatitis C?

Hepatitis C is a liver disease which is diagnosed and treated by the GI Division at Premier Medical Group. Hepatitis means inflammation of the liver. It is not a condition, but is often used to refer to a viral infection of the liver. The most common types are Hepatitis A, Hepatitis B, and Hepatitis C. At least 3.2 million Americans are infected with the Hepatitis C virus. About 2.5 million of them don’t know it. They risk becoming the victims of a silent epidemic.

The virus was first discovered in 1975 but not fully identified until 1989. By then, Hepatitis C had become a global epidemic, as a result of blood transfusions, hemodialysis, and the use of injections to deliver drugs both medicinal and illegal. Nationally, about half of all cases of cirrhosis are the result of chronic HCV infection, as are almost all the cases of primary liver cancer (hepatocellular carcinoma), and a large proportion of liver failure cases. Currently 12,000 deaths a year in the U.S. are due to Hepatitis C–related disease. Scientists expect that number rise significantly over the next two decades.

What is chronic Hepatitis C?

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Chronic Hepatitis C is described as the inability of the body to rid itself of the virus. Some people clear the virus from their bodies in a few months, but most Hepatitis C infections become chronic. Without treatment, chronic Hepatitis C can cause scarring of the liver, called cirrhosis, liver cancer, and liver failure.

 

 

What causes hepatitis C?

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The most common way to get Hepatitis C is by sharing needles and other equipment (such as cotton, spoons, and water) used to inject illegal drugs. HVC is transmitted by blood-to-blood contact. Researchers are not certain whether you can get Hepatitis C through sexual contact (most believe it’s very small risk), but the risk is greater for people who have many sex partners. Anyone can get Hepatitis C, but some people are at higher risk, including:

  • Anyone who has ever injected illegal drugs, including those who injected only once, many years ago.
  • People who were born to a mother with Hepatitis C, or children born to HCV-positive mothers.
  • Anyone who has HIV.
  • People who received blood transfusions before July 1992 when dependable screening for HCV was put in place.
  • People with hemophilia who received blood products before 1987.
  • People with multiple sex partners or have a history of sexually transmitted disease.
  • Patients who received long-term hemodialysis treatment for kidney failure.

Hepatitis C cannot be spread through casual contact such as hugging, kissing, sneezing, coughing, or sharing food or water with someone. You can get Hepatitis C if you come into contact with the blood of someone who has Hepatitis C. You can take protective measures by not sharing anything that may have blood on it, such as razors, toothbrushes, and nail clippers.

What are the symptoms of hepatitis C?

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Most people who are infected with Hepatitis C have no symptoms, until the virus causes liver damage. This can take ten or more years to occur. The most common symptoms include:

  • Fatigue
  • Joint pain, swollen ankles ,sore muscles
  • Abdominal pain, swelling
  • Itchy skin
  • Fever
  • Dark urine
  • Jaundice, a condition in which the skin and the whites of the eyes look yellow
  • Bruising easily
  • Loss of appetite
  • Light-colored stools
  • Diarrhea
  • An unusually long time for blood-clotting

How is hepatitis C diagnosed?

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Hepatitis C is diagnosed through blood tests. These tests will show if you have chronic Hepatitis C or another type of Hepatitis. Depending on the results of these blood tests, your health care provider may want to perform a liver biopsy (a needle is used to remove a tiny sample of your liver, which is analyzed under a microscope in a lab).

Your doctor will also want to take a complete medical history and perform a physical exam. The blood test will show if your liver enzymes are elevated. A rapid blood test is available which show results in about twenty minutes.

Other diagnostic tools used are imagining tests such as CT scan, MRI, or ultrasound to make sure you do not have liver cancer. If you do have the Hepatitis C virus, it is suggested that you get tested for HIV as well.

Having Hepatitis C doesn’t always mean you need to get drug treatment right away. If tests show that you have only slight liver abnormalities or a low viral load, you and your physician might decide that it’s wise to wait. Your age, overall physical and emotional condition and other health concerns will factor into the decision. In this case, what’s called “watchful waiting” you’d have regular follow-up blood tests done to monitor your condition. You may also be advised about lifestyle adjustments (such as nutrition, alcohol and drug consumption, and weight control) that will help protect your liver.

What are the types of hepatitis C?

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A series of blood test is used to determine the existence of an HCV infection and, if there is one, the amount of virus in your system (viral load), and its genotype (genetic makeup). There are six known genotypes of the Hepatitis C virus, and each responds differently to treatment.

How is hepatitis C treated?

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The current standard treatment for HCV is a combination therapy using two or three drugs. The duration of treatment ranges from twenty-four to fourty-eight weeks, depending on the genotype of HCV the patient is infected with. About 80% of people with genotype 1 HCV—the most common type in the U.S.—are cured by this treatment, as are about 90% of people with genotype 2 or 3. New drugs and drug combinations have been upping the success rate every year. Hepatitis C is not treated unless it becomes chronic. Chronic Hepatitis C is treated with drugs that slow or stop the virus from damaging the liver.

Side effects, ranging from mild to severe, are common during Hepatitis C therapy and some patients have trouble sticking to it. These medicines can also be expensive, and don’t work for everyone. Yet successful treatment requires keeping to the appropriate dose for the prescribed length of time. A diagnosis of Hepatitis C can change your life. You may need help and support to cope with the illness. Though Hepatitis C is a major risk factor for liver disease, it is both treatable and curable. When identified early enough, a change can be made in the course of the disease. The most important thing is for people whose history puts them at risk for Hepatitis C to see their doctors to be fully evaluated and, when needed treated appropriately

If the liver is much damaged or if chronic Hepatitis causes liver failure, a liver transplant may be necessary. This requires surgery to replace a failed liver with a healthy one from a donor. Drug treatment often must continue because Hepatitis C usually comes back after surgery.

Frequently Asked Questions

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Is it possible for someone to become infected with HCV and then spontaneously clear the infection?

Yes. Approximately 15%–25% of persons clear the virus from their bodies without treatment and do not develop chronic infection; the reasons for this are not well known.

How likely is HCV infection to become chronic?

HCV infection becomes chronic in approximately 75%–85% of cases.

Why do most persons remain chronically infected with HCV?

A person infected with HCV mounts an immune response to the virus, but replication of the virus during infection can result in changes that evade the immune response. This may explain how the virus establishes and maintains chronic infection.

What are the chances of someone developing chronic HCV infection, chronic liver disease, cirrhosis, or liver cancer or dying as a result of Hepatitis C?

Of every 100 persons infected with HCV, approximately

  • 75–85 will go on to develop chronic infection
  • 60–70 will go on to develop chronic liver disease
  • 5–20 will go on to develop cirrhosis over a period of 20–30 years
  • 1–5 will die from the consequences of chronic infection (liver cancer or cirrhosis)

Can persons become infected with a different strain of HCV after they have cleared the initial infection?

Yes. Prior infection with HCV does not protect against later infection with the same or different genotypes of the virus. This is because persons infected with HCV typically have an ineffective immune response due to changes in the virus during infection. For the same reason, no effective pre- or postexposure prophylaxis (i.e., immune globulin) is available.

Is Hepatitis C a common cause for liver transplantation?

Yes. Chronic HCV infection is the leading indication for liver transplants in the United States.

How many deaths can be attributed to chronic HCV infection?

A recent CDC analysis of death certificate data found that HCV-attributable deaths increased significantly between 1999 and 2007. CDC estimates that there were 15,106 deaths caused by HCV in 2007. The citation can be found at “The increasing burden of mortality from viral hepatitis in the United States between 1999 and 2007.” Ly, K., et al. Annals Of Internal Medicine, 2012. 156(4): p. 271-278

Is there a Hepatitis C vaccine?

No vaccine for Hepatitis C is available. Research into the development of a vaccine is under way.

Source: Centers for Disease Control and Prevention