Hepatitis C
Overview
Hepatitis C is a liver disease caused by the hepatitis C virus (HCV), which is carried in the blood of infected people. According to various estimates, there are anywhere from approximately 3 to 10 million people in the United States who are carriers of the virus. One reason for this is that the virus wasn't even diagnosed until the late 1980s. In fact, a majority of carriers are still unaware of their HCV status.
Hepatitis C is spread primarily through contact with infected blood. The disease is serious for some people, but not for others. Most persons who get hepatitis C carry the virus for the rest of their lives. The majority will experience some liver damage, but may not feel sick from the disease. Some persons with liver damage due to hepatitis C may develop cirrhosis (scarring) of the liver and liver failure, which may take many years to develop.
Causes
Hepatitis C is primarily spread through contact with infected blood, such as:
- injecting illicit drugs with shared needles
- receiving HCV-infected blood transfusions (before 1992) or blood clotting products (before 1987)
- receiving an HCV-infected organ transplant
- receiving long-term kidney dialysis treatment (dialysis machines can be tainted with HCV-infected blood)
- sharing toothbrushes, razors, nail-clippers, or other personal hygiene items that have HCV-infected blood on them
- being accidentally stuck by an HCV-infected needle (a concern for health care workers)
- frequent contact with HCV-infected people (a concern for health care workers)
- receiving a tattoo, body piercing, or acupuncture with unsterilized or improperly sterilized equipment
Hepatitis C can also spread through:
- an HCV-infected mother to her baby at the time of birth
- sexual contact with someone infected with HCV
- sharing a straw, when inhaling drugs such as cocaine, with someone infected by HCV
- receiving a transfusion of HCV-contaminated blood
HCV cannot spread through:
- the air
- unbroken skin
- casual social contact
- breast-feeding
Risks
Risk factors that may increase your chance of getting hepatitis C include:
- receiving a blood transfusion before 1992
- receiving blood clotting products before 1987
- long-term kidney dialysis treatment
- tattooing
- body piercing
- injecting illicit drugs, especially with shared needles
- having sex with partners who have other sexually transmitted diseases
Symptoms/Consequences
While HCV can be detected in blood between one to three weeks after the initial exposure, 80 percent of people with hepatitis C have no symptoms, and thus go undiagnosed. Within approximately 50 days, most patients will begin to develop liver cell injury, although they will be asymptomatic (symptom-free). About 15 percent of those exposed to HCV will clear their system of the virus within six months. The remaining 85 percent will develop some level of chronic hepatitis C. Over time, this can cause serious liver damage, although the rate of progression can vary significantly from individual to individual. Symptoms may include:
- fatigue
- loss of appetite
- jaundice (yellowing of the eyes and skin)
- darker colored urine
- abdominal pain
- aches and pains
- itching
- hives
- joint pain
- cigarette smokers may suddenly dislike the taste of cigarettes
- loose, light-colored stools
- nausea
- vomiting
Chronic hepatitis C infection may cause some of the above symptoms, as well as:
- weakness
- severe fatigue
- loss of appetite
Serious complications of hepatitis C infection include:
- the possibility that the infection will become chronic, leading to progressive liver failure
- increased risk of carcinoma (liver cancer)
- cirrhosis — Within about 20 years of exposure, about 20 percent of individuals develop cirrhosis, which leads to end-stage liver disease. Alcohol use can dramatically speed the onset of cirrhosis.
Diagnosis
To diagnose hepatitis C, your doctor will ask about your symptoms and medical history, and perform a physical exam. Your doctor will also want to discuss your risk factors for hepatitis C. Tests that may be conducted include:
Blood Tests — to look for hepatitis C antibodies or genetic material from the virus (The antibodies are proteins that your body has made to fight the hepatitis C virus.)
Liver Biopsy — removal of a sample of liver tissue to be examined
Treatment
Hepatitis C is treated with medications, including:
- interferon, given by injection
- ribavirin, given orally
- combination of interferon and ribavirin
These medications have limited success rates and can cause difficult side effects.
Even with treatment, hepatitis C infection may not clear up within six months. Over a long period of time, chronic hepatitis C can cause serious liver damage. In rare cases, a liver transplant may be needed.
Prevention
To prevent becoming infected with hepatitis C:
- Do not inject illicit drugs, especially with shared needles. Seek help to stop using drugs.
- Do not have sex with partners who have sexually transmitted diseases.
- Practice safe sex (using latex condoms) or abstain from sex.
- Limit your number of sexual partners.
- Avoid sharing personal hygiene products (toothbrushes, etc.).
- Avoid handling items that may be contaminated by HCV-infected blood.
- Donate your own blood before elective surgery to be used if you need a blood transfusion.
To prevent spreading hepatitis C to others if you are infected:
- Tell your dentist and physician before receiving checkups or treatment.
- Get both hepatitis A and hepatitis B vaccinations.
- Do not donate blood or organs for transplant.