Hepatitis C

 

Hepatitis C is a viral infection that causes liver inflammation and damage. Inflammation is swelling that occurs
when tissues of the body become injured or infected. Inflammation can damage organs.

Many viruses cause infections that can be spread from person to person. The hepatitis C virus spreads through contact with an infected person’s blood.

Hepatitis C is something most of us have heard about, been warned about, and might even know someone who’s contracted it, but do we really know what it is? If the answer to this question is no, then don’t worry! We’ll do our best to explain it here. Hepatitis C can cause an acute or chronic infection.

Chronic vs. Acute Hepatitis C

There are two types of hepatitis C: acute and chronic. Chronic hepatitis C as a long-term infection. Every chronic infection has an acute phase, but not every acute hepatitis C infection becomes chronic. “Some people clear HCV from their bodies after the acute phase, an outcome known as spontaneous viral clearance,” writes the “In studies of people diagnosed with acute HCV, rates of spontaneous viral clearance have varied from 14 to 50-percent.”

Health line also helps explain by defining the two on how they develop. Acute hepatitis C sets in quickly and can last a few weeks, whereas chronic hepatitis C develops slowly over a long period of time and will often not show any signs or symptoms. It’s estimated by the World Health Organization (WHO) that roughly 71 million people have chronic hepatitis C.

Symptoms

Long-term infection with the hepatitis C virus is known as chronic hepatitis C. Chronic hepatitis C is usually a "silent" infection for many years, until the virus damages the liver enough to cause the signs and symptoms of liver disease.

Signs and symptoms include:

Bleeding easily

Bruising easily

Fatigue

Poor appetite

Yellow discoloration of the skin and eyes (jaundice)

Dark-colored urine

Itchy skin

Fluid buildup in your abdomen (ascites)

Swelling in your legs

Weight loss

Confusion, drowsiness and slurred speech (hepatic encephalopathy)

Spiderlike blood vessels on your skin (spider angiomas)

Every chronic hepatitis C infection starts with an acute phase. Acute hepatitis C usually goes undiagnosed because it rarely causes symptoms. When signs and symptoms are present, they may include jaundice, along with fatigue, nausea, fever and muscle aches. Acute symptoms appear one to three months after exposure to the virus and last two weeks to three months.

Acute hepatitis C infection doesn't always become chronic. Some people clear HCV from their bodies after the acute phase, an outcome known as spontaneous viral clearance. In studies of people diagnosed with acute HCV, rates of spontaneous viral clearance have varied from 15% to 25%.

Acute hepatitis C also responds well to antiviral therapy.

What causes hepatitis C?

The hepatitis C virus causes hepatitis C. The hepatitis C virus spreads through contact with an infected person’s blood. Contact can occur by

·         sharing drug needles or other drug materials with an infected person

·         getting an accidental stick with a needle that was used on an infected person

·         being tattooed or pierced with tools or inks that were not kept sterile—free from all viruses and other microorganisms—and were used on an infected person before they were used on you 

·         having contact with the blood or open sores of an infected person

·         using an infected person’s razor, toothbrush, or nail clippers

·         being born to a mother with hepatitis C

·         having unprotected sex with an infected person

You can’t get hepatitis C from

·         being coughed or sneezed on by an infected person

·         drinking water or eating food

·         hugging an infected person

·         shaking hands or holding hands with an infected person

·         sharing spoons, forks, and other eating utensils

·         sitting next to an infected person

 

 

 

 

 

Symptoms

Long-term infection with the hepatitis C virus is known as chronic hepatitis C. Chronic hepatitis C is usually a "silent" infection for many years, until the virus damages the liver enough to cause the signs and symptoms of liver disease.

Signs and symptoms include:

Bleeding easily

Bruising easily

Fatigue

Poor appetite

Yellow discoloration of the skin and eyes (jaundice)

Dark-colored urine

Itchy skin

Fluid buildup in your abdomen (ascites)

Swelling in your legs

Weight loss

Confusion, drowsiness and slurred speech (hepatic encephalopathy)

Spiderlike blood vessels on your skin (spider angiomas)

Every chronic hepatitis C infection starts with an acute phase. Acute hepatitis C usually goes undiagnosed because it rarely causes symptoms. When signs and symptoms are present, they may include jaundice, along with fatigue, nausea, fever and muscle aches. Acute symptoms appear one to three months after exposure to the virus and last two weeks to three months.

Acute hepatitis C infection doesn't always become chronic. Some people clear HCV from their bodies after the acute phase, an outcome known as spontaneous viral clearance. In studies of people diagnosed with acute HCV, rates of spontaneous viral clearance have varied from 15% to 25%.

Acute hepatitis C also responds well to antiviral therapy.

 

 

 

What are the complications of hepatitis C?

Without treatment, hepatitis C may lead to cirrhosis, liver failure, and liver cancer. Early diagnosis and treatment of hepatitis C can prevent these complications.

Cirrhosis

 Cirrhosis is a condition in which the liver slowly breaks down and is unable to function normally. Scar tissue replaces healthy liver tissue and partially blocks the flow of blood through the liver. In the early stages of cirrhosis, the liver continues to function. However, as cirrhosis gets worse, the liver begins to fail.

Liver failure

Also called end-stage liver disease,   liver failure progresses over months, years, or even decades. With end-stage liver disease, the liver can no longer perform important functions or replace damaged cells.

 

How do doctors diagnose hepatitis C?

Doctors diagnose hepatitis C based on your medical history, a physical exam, and blood tests. If you have hepatitis C, your doctor may perform additional tests to check your liver.

Medical history

Your doctor will ask about your symptoms and whether you have any history of blood transfusions or injected drug use.

Physical exam

During a physical exam, your doctor will typically examine your body to check for signs of liver damage such as

·         changes in skin color

·         swelling in your lower legs, feet, or ankles

·         tenderness or swelling in your abdomen

 

 

 

What tests do doctors use to diagnose hepatitis C?

Doctors use blood tests to diagnose hepatitis C. Your doctor may order additional tests to check for liver damage, find out how much liver damage you have, or rule out other causes of liver disease.

Blood tests

Your doctor may order one or more blood tests to diagnose hepatitis C. A health care professional will take a blood sample from you and send the sample to a lab.

Blood tests for hepatitis C include the following:

·         Screening test for antibodies to the hepatitis C virus. A screening blood test will show whether you have developed antibodies to the hepatitis C virus. A positive antibody test means you were exposed to the hepatitis C virus at some point. However, the virus may no longer be present in your blood if your body fought off the infection on its own or if you received treatment that cured the infection.

·         Hepatitis C RNA test. If your antibody test is positive, your doctor will use a hepatitis C RNA test to detect RNA—a type of genetic material—from the hepatitis C virus. The hepatitis C RNA test can show whether you still have the hepatitis C virus and how much virus is in your blood. This information can help your doctor treat the infection. To see if you are responding to treatment, your doctor may order this test while you are undergoing treatment to find out if the amount of virus in your blood is changing.

·         Genotype test. Your doctor can use this test to find out what strain, or form, of hepatitis C virus you have. At least six specific strains—called genotypes—of hepatitis C exist. Genotype 1 is the most common hepatitis C genotype in the United States.¹ Your doctor will recommend treatment based on which hepatitis C genotype you have.

 

 

Risk factors HCV

Your risk of hepatitis C infection is increased if you:

Are a health care worker who has been exposed to infected blood, which may happen if an infected needle pierces your skin

Have ever injected or inhaled illicit drugs

Have HIV

Received a piercing or tattoo in an unclean environment using unsterile equipment

Received a blood transfusion or organ transplant before 1992

Received clotting factor concentrates before 1987

Received hemodialysis treatments for a long period of time

Were born to a woman with a hepatitis C infection

Were ever in prison

Were born between 1945 and 1965, the age group with the highest incidence of hepatitis C infection

Hepatitis C can often be treated successfully by taking medicines for several weeks.

If the infection is diagnosed in the early stages, known as acute hepatitis, treatment may not need to begin straight away.

Instead, you may have another blood test after a few months to see if your body fights off the virus.

If the infection continues for several months, known as chronic hepatitis, treatment will usually be recommended.

Your treatment plan

Treatment for chronic hepatitis C (those infected for 6 months or more) involves:

•       tablets to fight the virus

•       a test to see if your liver is damaged

•       lifestyle changes to prevent further damage

There are 6 main strains of the virus. In the UK, the most common strains are genotype 1 and genotype 3. You can be infected with more than 1 strain.

You'll be offered the medicine most appropriate   for your type of hepatitis   C.

During treatment, you should have blood tests to check that your medicine is working.

If it's not, you may be advised to try another medicine. This will only affect a small number of people.

Your doctor will also assess your liver for damage (scarring), either with a blood test or a scan called a fibro scan.

At the end of your treatment, you'll have a blood test to see if the virus has been cleared and a second blood test 12 or 24 weeks after treatment has stopped.

If both tests show no sign of the virus, this means treatment has been successful.

Hepatitis C medicines

Hepatitis C is treated using direct-acting antiviral (DAA) tablets.

DAA tablets are the safest and most effective medicines for treating hepatitis C.

They're highly effective at clearing the infection in more than 90% of people.

The tablets are taken for 8 to 12 weeks. The length of treatment will depend on which type of hepatitis C you have.

Some types of hepatitis C can be treated using more than 1 type of DAA.

NHS-approved hepatitis C medicines include:

•       sofosbuvir

•       a combination of ledipasvir and sofosbuvir

•       a combination of ombitasvir, paritaprevir and ritonavir, taken with or without dasabuvir

•       a combination of elbasvir and grazoprevir

•       a combination of sofosbuvir and velpatasvir

•       a combination of sofosbuvir, velpatasvir and voxilaprevir

•       a combination of glecaprevir and pibrentasvir

•       ribavirin

Prevention HCV

Protect yourself from hepatitis C infection by taking the following precautions:

Stop using illicit drugs, particularly if you inject them. If you use illicit drugs, seek help. Be cautious about body piercing and tattooing. If you choose to piercing or tattooing, look for a reputable shop. Ask questions beforehand about how the equipment is cleaned. Make sure the employees use sterile needles. If employees won't answer your questions, look for another shop.

Practice safer sex. Don't engage in unprotected sex with multiple partners or with any partner whose health status is uncertain. Sexual transmission between monogamous couples may occur, but the risk is low.