Hepatitis C

What is Hepatitis C?

The term “hepatitis” refers to the inflammation of the liver which is caused by viruses, toxic substances, or immune system abnormalities. You may have heard people talk about Hepatitis A, B, C etc; this refers to the infectious form of hepatitis which is caused by viruses. There are a number of viruses that cause hepatitis and the most well described forms of hepatitis include Hepatitis A, Hepatitis B, Hepatitis C, Hepatitis D, and Hepatitis E.

Hepatitis C is a worldwide epidemic and there are approximately 170 million infected individuals. In the United States, about 4 million people have been infected with the virus. Hepatitis C is an important cause of chronic and often debilitating liver disease and accounts for an estimated 8,000-10,000 deaths each year in the United States.

Why is Hepatitis C An Important Medical Problem?

Hepatitis C has the potential to be a very serious medical problem because most people who become infected carry the virus for the rest of their lives. Most of these individuals have some mild, chronic liver damage but fortunately do not feel ill. Approximately 20% of individuals infected with Hepatitis C have a much worse experience with the disease and go on to develop cirrhosis (scarring of the liver) and liver failure. A small percentage of these patients will also develop liver cancer. Without a doubt, Hepatitis C is an important medical disease which we should all be aware of.

How is Hepatitis C Spread From One Person to Another?

The Hepatitis C virus is found in the blood of persons who have the disease. The virus is spread in the infected blood and has primarily been seen in intravenous drug abusers and in individuals who received blood transfusions prior to 1992. Hepatitis C can be spread sexually, but this form of transmission is fairly rare.

Hepatitis C is not spread by sneezing, hugging, coughing, or other forms of “casual” contact.

Who is at High Risk For Being Infected With Hepatitis C?

Any one can become infected with Hepatitis C, but the following individuals are at particularly high risk:

• Individuals with a history of injection drug use.
• Individuals with a history of receiving blood transfusions or blood products prior to 1992.
• People who received an organ transplant prior to 1992.
• End stage kidney patients on chronic hemodialysis.
• Individuals with greater than one abnormal liver function test and no other obvious cause.
• Health care workers after an occupational exposure to Hepatitis C infected blood.
• Children born to Hepatitis C positive mothers.

Signs and Symptoms

Many individuals with chronic Hepatitis C have no symptoms of liver disease. Some of the symptoms that have been reported include:

1. Fatigue (extreme tiredness)
2. Mild abdominal discomfort
3. Decreased appetite
4. Nausea
5. Joint and muscle pains.

Medical Evaluation and Diagnosis

Many doctors routinely screen for Hepatitis C in patients who are considered at “high risk” for having the disease (please see the section “Who Is at Risk for Being Infected with Hepatitis C”). The screening consists of a simple blood test which looks for the presence of antibodies to the virus.

Sometimes, doctors test for the presence of Hepatitis C infection after routine tests of liver function remain persistently elevated. While the test for the presence of antibodies toward the Hepatitis C virus is usually the first step in terms of laboratory testing for the virus, there are more sophisticated blood tests that your doctor may order (if necessary).

If the test results reveal that you have been infected with the Hepatitis C virus, additional studies of your blood and even a liver biopsy may be needed to determine whether or not you are in need of medical treatment.

Treatment

In previous years, the treatment options available for treating chronic Hepatitis C were limited and the success rates were not very impressive. Things are a little better today, and researchers are actively looking for new and exciting approaches to treating this disease. The mainstay of treatment for chronic Hepatitis C at this time is a combination therapy using the anti-viral medications Interferon and Ribavirin. This combination of medications works effectively for about 30-40 out of every 100 people infected with the Hepatitis C virus.

It is important to note that these medications have significant side effects and some patients will not be able to tolerate them.

Side effects of Interferon include:

• flu-like symptoms
• depression with suicidal thoughts
• thyroid disease
• decreased white blood cells and platelets in the blood.

Side effects of Ribavirin include:

• anemia
• nausea
• and this medication can cause birth defects and should not be taken by pregnant women.

Prognosis

Overall, the majority of individuals infected with Hepatitis C do quite well and live a full, healthy life. Some individuals, however, will develop cirrhosis, liver failure, and/or liver cancer. If you have Hepatitis C, a thorough evaluation by your physician will help you to manage your disease effectively and devise the best treatment plan for you.

Empowerment Points

• Hepatitis C is a liver disease caused by a virus that is found in the blood.
• Most people who have Hepatitis C carry the virus with them for life.
• The majority of people with this disease do quite well, although they may have some mild, chronic liver disease.
• Approximately 20% of individuals will develop cirrhosis and serious liver disease.
• About 5% of Hepatitis C infected individuals will develop liver cancer.
• There is treatment for Hepatitis C with anti-viral medications.
• Remember, knowledge is power!