Hepatitis C Survivor  

Hepatitis C  -  What is it?

By Teri Gottlieb







What is Hepatitis?  Hepatitis just means inflammation of the liver. The inflammation can be caused by a variety of things, including toxins, heavy alcohol use, certain drugs, some autoimmune diseases and bacterial and/or viral infections. Viral hepatitis is caused by an infection with one of a few specific viruses that primarily attack the liver. There are 6 categories of hepatitis, they are A, B, C, D, F and G.  The most common types of hepatitis in the United States are A, B and C. These three viruses are totally unrelated and their only connection is that they all affect the liver. On this site, we will be speaking exclusively about hepatitis C.


Hepatitis C (also referred to as HCV) is the most common blood borne infection in the United States. Somewhere between 2.7 and 3.9 million Americans have a chronic hepatitis C infection; this is up to 4 times as many people that have either hepatitis B or HIV. The largest group of people infected with chronic Hepatitis C are the Baby Boomer's, the generation born between 1946 and 1964.  About 75% of these people are unaware that they are HCV positive. Hepatitis C is a blood borne virus that was previously referred to as Non A/Non B Hepatitis. There are 6 genotypes of hepatitis C numbered 1 through 6 with type 1 being the most common in the United States and type 2 being the easiest to treat.


Hepatitis C is spread by blood to blood contact with an infected person. This is the ONLY way this virus is spread. Some ways of transmission are sharing drug paraphernalia such as contaminated syringes, water spoons and cookers, non-sterile tattoo practices, body piercing, sharing shaving razors or toothbrushes, or by an infected mother to her newborn during the birth process. Healthcare workers are also at risk due to needle sticks and contact with infected blood. There is also a small chance of infection by sexual contact but this is definitely less common.  if you are in a long term, monogamous relationship with a partner who has Hepatitis C, your risk of transmission is almost non-existent. Your risk does go up if you are HIV+. Hepatitis C was also spread by blood transfusions, organ transplants and dental work that were done prior to 1992, or by the use of clotting factors received before 1987. Once the HCV virus has entered the body, the virus replicates and mutates. Hepatitis C causes liver inflammation, kills liver cells and can lead to a build up of scar tissue on the liver, which can cause cirrhosis.  


Acute hepatitis refers to the first six months of infection. During this time, about twenty percent of the people who have contracted the virus will spontaneously clear on their own accord, with no medical intervention. They will, however, always carry the HCV antibody. Up to 80 percent of the people infected with HCV will become chronically infected, meaning they will not clear on their own.  Most of the people with Hepatitis C have absolutely no signs or symptoms of the virus and live normal lives. However, in 10 to 25 percent of the people who have a chronic HCV infection, the disease progresses over a period of 10 to 40 years and will lead to very serious liver damage including cirrhosis, liver cancer, liver failure, the need for a liver transplant, and in some cases, death. 


Most people who have Hepatitis C are totally unaware of its presence. Many are diagnosed when they attempt to donate blood or when they get an insurance physical and it comes as a complete surprise as they have no symptoms. Others have symptoms of the virus progressing but often pass it off as stress related. There are some definite symptoms of Hep C causing havoc, they include: fatigue, headaches, fever, loss of appetite, indigestion or

heartburn, nausea, muscle or joint pain, abdominal pain, depression and brain fog.


There is currently no vaccine to prevent Hepatitis C, but there are several pharmaceutical companies who are working on this right now.  Hopefully, over the next few years, we may see a vaccine. Hepatitis C can be CURED. The current Standard of Care treatment includes Peg-Interferon and Ribavirin, and depending on your genotype, the addition of a Protease Inhibitor like Victrelis or Incivek. Treatment can be as short as 24 weeks or as long as 48 weeks. Peg-Interferon is an injection that the patient gives himself once a week. Ribavirin, Incivek and Victrels are oral drugs that are taken every 8 or 12 hours.  Recently an all oral treatment was approved by the FDA for use with genotypes 2 and 3.  There are several more all oral treatment regimens that are currently being tested or are in front of the FDA seeking approval. If approved, we can expect to start seeing these medications later in 2014 or early 2015.

 


Hepatitis C Facts
         

  • The National Institutes of Health estimates that about 4 million Americans have Hepatitis C, but many researchers believe the true number may be over 5 million.

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  • An estimated 12,000 Americans die annually of complications related to a HCV infection.  This figure is expected to triple over the next 10 years.

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  • If you have Hepatitis C, drinking alcohol is strongly discouraged.  Drinking with HCV is like pouring gasoline on a fire.  

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  • HCV is the leading cause of liver transplants in adults in the USA.  

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  • Individuals with HCV should be vaccinated against hepatitis A and B.

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  • A healthy diet and exercise program will decrease the risk of fatty liver disease and improve the overall health of those infected with HCV.



 

Diagnosis and Monitoring of Hepatitis C


Unfortunately screening for HCV is not part of a routine physical.  You may think because you have gone in for your yearly physicals that you have been tested for Hepatitis C but this is just not the case.  You will more than likely need to request that your doctor run this test.
               

The first test to screen for HCV is an antibody test.  If the antibody is present, a confirmatory test called a Viral Load (HCV RNA) test is run to see if there is a chronic infection or if the antibodies are just present from a previous acute infection.  

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If it is confirmed that an individual has chronic Hepatitis C, a HCV Genotype test is run to determine what type(s) of HCV the person is carrying.  

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Liver Function tests are commonly run tests.  These are run as part of a chemical profile during many routine physicals.  These numbers are usually elevated when there is liver damage from Hepatitis C. By the time these numbers are elevated, there is usually already a significant amount of damage done to the liver.  

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Liver biopsies are done to evaluate the overall health of the liver.  They will show the amount of fibrosis (scarring) or cirrhosis.  A biopsy is usually done to determine if treatment is necessary. People with chronic HCV who do not have liver damage may not need to undergo treatment.