What is hepatitis C and what causes it? Hepatitis C is a liver disease caused by infection with the hepatitis C virus…
What is Hepatitis C and what causes it? Hepatitis C is a liver disease caused by infection with the Hepatitis C virus. It is the most common blood-borne infection in the United States, affecting at least 4 million people
Other viruses, most commonly Hepatitis A and hepatitis B, also can cause hepatitis. However, hepatitis has many causes, including some medications, long-term alcohol abuse, and exposure to industrial chemicals.
Viral hepatitis can be spread from one person to another, but the other types cannot.
Most infections begin with a sudden (acute) illness, often so mild that people do not notice symptoms. About 85% of people with acute illness will go on to develop long-term (chronic) infection. Hepatitis C is considered chronic when the liver is inflamed for longer than 6 months.
What are the symptoms of Hepatitis C infection?
In cases of acute infection , young children usually have no symptoms. Older children and adults may develop some mild symptoms, such as:
Constant tiredness (fatigue).
Widespread abdominal pain or pain that is concentrated in the of the abdomen.
Dark urine or light (clay-colored) stools.
Loss of appetite or weight loss.
Aversion to some foods, particularly those that are fatty or fried or high in protein.
Less commonly, yellowing of the skin and the whites of the eyes (jaundice).
In cases of chronic infection , most people, especially young children, have no symptoms. If symptoms do develop, they may include:
Constant tiredness (fatigue).
A general sense of not feeling well (malaise).
Mild abdominal pain.
How does Hepatitis C spread?
The Hepatitis C virus (HCV) spreads through contact with blood, most commonly by sharing needles and other equipment used to inject illegal drugs. Health care workers face a risk (although low, less than 2%) of infection from accidental needle sticks and other occupational exposures.
The virus can spread through sexual contact, but the risk is low, especially for long-term monogamous couples. Risk increases for those who have multiple sex partners. Having a sexually transmitted disease or being infected with HIV may increase the risk of becoming infected with HCV.
In the past, the virus was spread through infected blood used in transfusions and infected solid organs used in transplantation. However, the risk of infection from these procedures is now extremely low; since 1992, blood and organs have been routinely screened for hepatitis C.
An infected mother can spread the virus to her baby at birth. The transmission rate is about 6% and can be higher if the mother also is infected with HIV.3
How is Hepatitis C diagnosed?
Hepatitis C can be diagnosed with a blood test. People often don’t know they have the virus until they try to donate blood. All donated blood is screened for Hepatitis C and other blood-borne diseases. Donors whose blood tests positive for Hepatitis C are notified by the blood donation center.
Blood tests are done to look for signs of liver inflammation, antibodies to the Hepatitis C virus, and the virus’s genetic material.
A liver biopsy may be done to see whether the liver has been damaged by the virus and, later, to see whether treatment is successful. People with mild to moderate liver damage tend to respond better to treatment than those who have more extensive damage.
How is Hepatitis C treated?
Chronic HCV infection may be treated with medications that fight viral infections. Standard treatment combines two antiviral medications: interferon and ribavirin. However, this treatment is not an option for everyone because of significant side effects. Response rates to treatment are about 40% to 50%.
Recent studies show that a new form of interferon, called peginterferon, combined with ribavirin stops the virus more effectively than standard interferon and ribavirin. One large study recently found that high-dose peginterferon alfa-2b combined with ribavirin lowered the virus to an undetectable level in 54% of people, compared with 47% of people treated with standard interferon and ribavirin.4 As a result of this and other promising studies, a panel of experts has recommended that peginterferon with ribavirin become the new standard of treatment.
Hepatitis C has 6 major strains, or genotypes. Genotype 1 is the most common type in the United States. Types 2 and 3 are found worldwide; type 4 is found throughout Africa, 5 is common in South Africa, and 6 is common in Asia. Your response to interferon depends in part on the genotype you have. (You may be infected with more than one genotype.) Genotype 1 does not respond as well to treatment as the less-common genotypes 2 and 3.
What are the long-term effects of hepatitis C?
The outcome of HCV infection varies widely:
The acute stage, which occurs 2 weeks to 6 months after infection, usually is so mild that most people don’t know they are sick.
About 80% of people who become infected with HCV develop chronic infection, which they often have for the rest of their lives. However, the majority of people with chronic HCV infection will not develop severe liver damage.
Although it may take many years, up to 20% of people who have chronic HCV infection develop liver scarring (cirrhosis ). Of these people, 1% to 4% also develop liver cancer every year.
If liver failure or cancer develops, liver transplantation usually is the only way to prolong life. HCV infection is the most common reason for liver transplantation in the United States.