Hepatitis C

Medical quality assurance by Dr. Albrecht Nonnenmacher, MD at February 9, 2016
Start › Diseases › Hepatitis C

Inflammation of the liver can have many causes, but one of the more common is the group of viruses that cause hepatitis. Hepatitis C, a disease of the liver is caused by the hepatitis C virus. Understanding the risks and transmission routes can drastically reduce the rates of infection.

Contents

Definitions & Facts

In the earliest stages, hepatitis C often has little to no symptoms, but as it progresses, dark urine, stomach pain and nausea, unintentional weight loss, and jaundice (yellowing of the skin) can be present. For most people the disease can be present for years without any major symptoms, but over time, scarring (cirrhosis), liver cancer, and liver failure have significantly increased prevalence in untreated cases.

Though the disease is widespread, it cannot be passed casually; in fact, hepatitis C requires bodily fluid transfer, through blood or unprotected sexual contact. The primary means of transmission in America is through sharing needles during the use of intravenous drugs, or accidental needle pricks at hospitals.

The rate of transmission through mistaken blood transfusions is nearly non-existent thanks to modern screening, but it can happen. Mother-to-child infection is also possible during birth. The disease is chronic, but can be cleared up to non-detectable levels through diligent treatment strategies.

Symptoms & Complaints

Hepatitis C often has no symptoms in the early stages. Being that this is a chronic disease, this means years can go by with no complaints. As time goes on, however, patients may report a wide range of symptoms such as repeating low grade fever, stomach pain, dark urine, jaundice, unexplained weight loss, and other minor complaints such as muscle pain and loss of appetite.

As the virus causes more damage, cirrhosis, liver cancer, liver failure, and other life-threatening symptoms can take hold. For late-stage hepatitis C, extreme and chronic fatigue, extreme weight loss, blood in urine, and significant abdominal pain are possible. Though the disease can present symptoms and spontaneously clear from the body later on, it's not very common.

Causes

Hepatitis C is caused by the hepatitis C virus, of which there are 7 subtypes, with the subtype "1" being the most common in the United States, and causing nearly 70% of all total cases. The virus infects the liver and causes minor damage, but in certain people the disease can significantly impair the function of the liver, scarring it or even completely destroying its ability to heal or perform its job. The result is necessary liver transplant.

The virus is contracted most often from sharing needles with an infected person, though people infected prior to the drastic overhaul of blood and organ transplant methods in 1992 were far more likely to get the disease through medical accidents than people infected today.

Diagnosis & Tests

Hepatitis C can be detected in the blood after it has existed in the body for some time. The most sensitive blood tests can detect the virus in the blood after a few weeks, but antibody testing (the most common form of screening) can take longer as the body naturally takes more time to create antibodies after the infection.

In addition to blood screening, more advanced cases of hepatitis C can be assessed through biopsy of the liver. This gives doctors the ability to see the extent of the damage the virus has caused as well as the potential further course of the disease. A biopsy can also determine if there is cancer present, or if there are abnormal cells which can be precursors to cancer, which in turn will inform the future decisions of the doctor in treating the hepatitis.

The Centers for Disease Control recommends routine screening for hepatitis C to catch the disease earlier, making treatment more effective and reducing long-term damage. An STD panel done by a physician can rule out infection, and should be part of the yearly check up of any sexually active adult.

Treatment & Therapy

The first step in treating hepatitis C is determining what subtype is present in the blood. The primary means of treatment is antiviral drugs, administered based on subtype and the amount of liver scarring present. Though complications are possible, the earlier the disease is caught, the better the prognosis and more effective the treatment.

The common antivirals treat the disease by destabilizing the protein of the virus, making it more difficult for it to reproduce and more easily destroyed by the body's defenses. Even with treatment, however, the virus can go into "occult" status, which means it's hidden in the blood at undetectable levels, but could come back later on.

For significant scarring of the liver, transplant might be the only option. In addition, treatment of the side effects is advisable, helping to alleviate loss of appetite, fatigue, or muscle pains while the primary medicine is administered to clear the virus itself.

Prevention & Prophylaxis

There are a variety of ways to effectively prevent hepatitis C. Avoiding sharing needles is the best way to ensure the disease isn't contracted. Using protection during sexual activity, selective choice of partners, and monogamy are all recommended precautions to prevent any STD, hepatitis C included.

Even though casual transmission isn't likely, sharing of anything that may have contacted blood is considered unsafe, as the virus can exist in blood serum for up to several hours after leaving the body, and therefore no amount of exposure can be deemed safe. This means not sharing razors, toothbrushes, or any hygiene products that could potentially be contaminated with blood if you know the owner has hepatitis C.

It's worth noting that sharing food, kissing, and other basic contact is not likely to transmit the virus, and now that there are modern, vigilant practices for organ, tissue, and blood donation in place, medical transmission is highly unlikely as well.

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