Hepatitis C: Your Questions Answered
Hepatitis simply means “inflammation of the liver.” It can be caused by infections including viruses like hepatitis A, B, and C, toxic substances like alcohol and amanita mushrooms, and certain medications. Here we are going to focus on Hepatitis C.
Hepatitis C is a virus spread by blood. At high risk for contracting hepatitis C are IV drug users and others who have shared needles, people who have reused tattoo needles from an infected person, healthcare workers with needle stick injuries from an infected person, people who have had blood transfusions prior to 1990, and people who have had sex with an infected person. Pregnant women with Hep C have a 5% risk of passing the infection to their baby.
Hepatitis C affects 3% of the worldwide population and 1% of the population in the US. People born between the years 1945 and 1964 should be screened for Hepatitis C by their doctor as there is a higher prevalence in this population. The incidence among young people is increasing reflecting the opiate epidemic.
Symptoms: Most people have no symptoms or mild nonspecific symptoms such as fatigue. Severe symptoms often do not arise until a person develops severe liver disease called cirrhosis or liver cancer which can occur after many years.
Testing for Hepatitis C: This can be done by a simple blood test. An antibody test can check for exposure to Hepatitis C and an RNA test can check to see if the person has an active infection. All adults should be tested at least once for Hepatitis C and people with persistent risk factors should have screening yearly.
Genotypes: There are different types of Hepatitis C viruses based on the genetic makeup of the virus. These are called genotypes. They are classified into genotypes 1 through 4. Once someone is diagnosed with Hepatitis C a special blood test is done to determine the variant. It is important to have this information because it helps determines which treatment option is appropriate.
Complications of Hepatitis C: Over time chronic inflammation caused by this virus can lead to permanent liver scarring and damage. This is called cirrhosis. End-stage liver disease is preventable by early detection of this virus and treatment. Even people with cirrhosis can be cured of Hepatitis C preventing further complications and even death.
Management and Treatment: People with Hepatitis C should avoid all liver-toxic substances including alcohol. Although there is no vaccination for Hepatitis C there are vaccinations for Hepatitis A (food poisoning) and Hepatitis B. These vaccinations as well as vaccinations to help prevent other illnesses such as pneumonia and the flu should be up to date. Imaging of the liver should be done every 6 months in patients with Hepatitis C and cirrhosis to look for cancer as the risk of liver cancer is increased.
It is an exciting time for this disease. Today most people with Hepatitis C can be treated and cured with an oral regimen lasting sometimes only 3 months! Most people tolerate the treatment without difficulty and with little to no side effects. This is why it is important to talk to your doctor or gastroenterologist if you have risk factors for contracting Hepatitis C.
