Hepatitis C, or HCV, is a virus transmitted through blood. Transmission modes include drug use when needles or straws are shared; sharing such personal hygiene items as razors, toothbrushes or scissors; infected tattoo or piercing equipment; and some cases of sexual contact. HCV is usually asymptomatic for many years, so infected individuals are typically unaware of their infection. Meanwhile, the virus progresses slowly, causing liver damage. The National Digestive Diseases Information Clearinghouse reports that HCV is the cause of approximately 12,000 deaths annually in the United States.
How Long Until End-Stage Disease?
About a quarter of people who are newly infected with HCV will not be diagnosed with chronic HCV. In these cases, the infection will clear up within six months after the acute infection. In those people who do not recover spontaneously, HCV progresses slowly, taking anywhere from a decade to 40 years before serious liver damage is seen. For a person who tests positive for HCV antibodies---most often detectable as early as five weeks post-exposure---liver enzyme testing will be prescribed. Since the levels of enzymes that indicate damaged or dead liver cells can fluctuate in a person with chronic HCV, physicians recommend ongoing occasional liver enzyme testing.
What Is End-Stage Disease Like?
Some people with HCV will experience cirrhosis, or liver scarring, notes MayoClinic.com. According to the Hepatitis Foundation International, that number is around 20 percent. Liver failure and liver cancer are also possible. The National Digestive Diseases Clearinghouse states that up to 50 percent of cirrhosis, end-stage liver disease and liver cancer are due to hepatitis C.
By the time someone has had HCV for many years, an overall malaise is likely. Besides the often-cited jaundice, or yellowing of the skin and eyes, fatigue, nausea and ongoing abdominal discomfort are common. Cirrhosis can also lead to internal bleeding from resulting varicose veins in the gastrointestinal tract, which may present as bloody vomit or stool. Brain and nervous system damage, or hepatic encephalopathy, can result from a buildup of toxins because the liver is no longer functioning.
Treating End-Stage Disease
The primary treatment for HCV at its end stage is a liver transplant, in which the diseased liver is removed and a donor liver is put in its place. The Hepatitis Foundation International cautions that in most HCV cases, infection of the new liver occurs and a second transplant becomes necessary.
Avoiding End-Stage Disease
The earlier an HCV infection is discovered, the sooner the individual can make lifestyle changes to positively impact how the disease progresses. One especially productive change is the avoidance of alcoholic beverages, which can further damage the liver. The best course of action is to do all those things that people already know lead to better health: a diet of nutritional foods and daily activities that balance exercise, rest and work.
Medications to treat HCV include interferon injections and oral ribavirin, both of which carry their own side effects and require regular monitoring by a physician. In the "Hep-C Handbook" by the Hepatitis C Working Group of Georgia, Lucinda K. Porter, RN, warns against using herbal preparations without professional oversight. As with traditional medications, herbal remedies can also be damaging to the liver.
The Good News
A reliable antibody test exists for HCV. So even though a national U.S. survey published by the Institute of Medicine in 2010 found that millions are infected, many more might be spared infection with hepatitis C. Up to a quarter of newly infected individuals recover spontaneously.
References
- NIH National Digestive Diseases Information Clearinghouse: Chronic Heptatis C: Current Disease Management
- Mayo Clinic: Hepatitis C: What Happens in End-Stage Liver Disease?
- Hepatitis Foundation International: The ABC's of Hepatitis
- Institute of Medicine of the National Academies: Hepatitis and Liver Cancer: A National Strategy for Prevention and Control of Hepatitis B and C
