Hepatitis means inflammation of the liver. Hepatitis C is caused by the hepatitis C virus (HCV) and is also called a silent killer because for a long time it shows no symptoms or the symptoms mimic those of a minor flu. Oftentimes, a patient has had HCV for 10 to 20 years before the more noticeable symptoms appear.
Risk Factors and Transmission
The virus is spread primarily through contaminated blood. Since 1992 it has been possible to test blood for HCV. Since then, it has been rare to get this disease from hemodialysis, organ transplantation, or blood products because all of them are tested to ensure that they are not contaminated. Sharing of contaminated needles among drug abusers remains one of the most common ways to transmit HCV. Unprotected sexual intercourse is also a common way to get HCV and having multiple sex partners increases the risk significantly. Health care workers have also been reported to get HCV after a needle stick with HCV-contaminated blood. A mother can also transmit HCV virus to her unborn child during childbirth. HCV can also spread through nonsterile instruments used in tattoo and piercing salons. Sharing personal items such as a toothbrush and intranasal use of cocaine with shared use of equipment also raises the risk.
Symptoms
During the first stage of Hepatitis C, called the acute stage, many patients show no symptoms. Some people never progress beyond this stage. If the immune system of the patient fails to kill the virus during this stage, the patient moves into a chronic stage. Even at this stage, the symptoms are fairly mild and may include fatigue, nausea, loss of appetite, muscle and joint pains, and minor right-upper-quadrant discomfort or tenderness, or liver pain. Up to 20 percent of all people who get chronic HCV will develop severe hepatitis C symptoms such as cirrhosis or death. Cirrhosis is an illness in which scarring damages the liver and replaces healthy tissue. In these patients, the liver gets enlarged, the stomach is filled with liquid, and the patient’s skin as well as eyes appears yellow. Urine may also have a dark, tea-like color. Bleeding and bruising is common, and spider veins are seen in different areas of the body. As HCV progresses it causes a slow, gradual liver failure and death.
Diagnosis
HCV is diagnosed based on possible exposure to HCV, the patient’s medical history, and finally, blood tests. Oftentimes, more than one blood test is needed to confirm the diagnosis. People suspected to have hepatitis C should be tested for anti-HCV as an initial screening test. Hepatitis C is diagnosed when blood tests show that anti-HCV is present. In some cases, this test does not confirm HCV infection. Sometimes patients, for example, cannot produce anti-HCV because they are immunosuppressed. A diagnosis can also be challenging if the patient has another form of liver disease, such as alcoholism, or iron overload. In these situations, the anti-HCV may represent a false-positive reaction. Thus, although current tests for anti-HCV are quite good, a small percentage of patients with hepatitis C test negative for anti-HCV, and a percentage of patients who test positive are not infected. Moreover, some patients who have resolved the infection may still test positive for anti-HCV. That is why HCV RNA testing may sometimes be required. From the patient’s point of view, both of these tests seem the same. In both of them, blood is drawn from the patient and taken to the laboratory for further study.
Treatments
HCV is usually treated by combining two medicines--pegylated interferon alpha (Pegasys, PEG-Intron) and ribavirin (Virazole). At home, patients should avoid medicines and substances that can cause harm to the liver such as acetaminophen or alcohol.
Prevention
There is no vaccination for HCV so the best way to prevent this illness is to inform people about how it spreads. Screening the blood supply has proved to be very effective, just like encouraging health professionals to take precautions when handling blood and bodily fluids. Informing people about the risks of unprotected sex, sharing needles, and getting tattoos may also save lives.
