Hepatitis C

Hepatitis C is a viral infection of the liver. Infection may go undetected for months or years because symptoms may be absent or very mild. Chronic liver disease is the main danger of hepatitis C. This may lead to scarring of the liver (cirrhosis), liver failure, and liver cancer.

CAUSES

Hepatitis C is caused by the hepatitis C virus (HCV). Formerly, hepatitis C infections were most commonly transmitted through blood transfusions. In the early 1990s, routine testing of donated blood for hepatitis C and exclusion of blood that tests positive for HCV began. Now, HCV is most commonly transmitted from person to person through injection drug use, sharing needles, or sex with an infected person. A caregiver may also get the infection from exposure to the blood of an infected patient by way of a cut or needle stick.

SYMPTOMS

Acute Phase

Many cases of acute HCV infection are mild and cause few problems. Some people may not even realize they are sick. Symptoms in others may last a few weeks to several months and include:

  • Feeling very tired.

  • Loss of appetite.

  • Nausea.

  • Vomiting.

  • Abdominal pain.

  • Dark yellow urine.

  • Yellow skin and eyes (jaundice).

  • Itching of the skin.

Chronic Phase

  • Between 50% to 85% of people who get HCV infection become "chronic carriers." They often have no symptoms, but the virus stays in their body. They may spread the virus to others and can get long-term liver disease.

  • Many people with chronic HCV infection remain healthy for many years. However, up to 1 in 5 chronically infected people may develop severe liver diseases including scarring of the liver (cirrhosis), liver failure, or liver cancer.

DIAGNOSIS

Diagnosis of hepatitis C infection is made by testing blood for the presence of hepatitis C viral particles called RNA. Other tests may also be done to measure the status of current liver function, exclude other liver problems, or assess liver damage.

TREATMENT

Treatment with many antiviral drugs is available and recommended for some patients with chronic HCV infection. Drug treatment is generally considered appropriate for patients who:

  • Are 18 years of age or older.

  • Have a positive test for HCV particles in the blood.

  • Have a liver tissue sample (biopsy) that shows chronic hepatitis and significant scarring (fibrosis).

  • Do not have signs of liver failure.

  • Have acceptable blood test results that confirm the wellness of other body organs.

  • Are willing to be treated and conform to treatment requirements.

  • Have no other circumstances that would prevent treatment from being recommended (contraindications).

All people who are offered and choose to receive drug treatment must understand that careful medical follow up for many months and even years is crucial in order to make successful care possible. The goal of drug treatment is to eliminate any evidence of HCV in the blood on a long-term basis. This is called a "sustained virologic response" or SVR. Achieving a SVR is associated with a decrease in the chance of life-threatening liver problems, need for a liver transplant, liver cancer rates, and liver-related complications.

Successful treatment currently requires taking treatment drugs for at least 24 weeks and up to 72 weeks. An injected drug (interferon) given weekly and an oral antiviral medicine taken daily are usually prescribed. Side effects from these drugs are common and some may be very serious. Your response to treatment must be carefully monitored by both you and your caregiver throughout the entire treatment period.

PREVENTION

There is no vaccine for hepatitis C. The only way to prevent the disease is to reduce the risk of exposure to the virus.

  • Avoid sharing drug needles or personal items like toothbrushes, razors, and nail clippers with an infected person.

  • Healthcare workers need to avoid injuries and wear appropriate protective equipment such as gloves, gowns, and face masks when performing invasive medical or nursing procedures.

HOME CARE INSTRUCTIONS

To avoid making your liver disease worse:

  • Strictly avoid drinking alcohol.

  • Carefully review all new prescriptions of medicines with your caregiver. Ask your caregiver which drugs you should avoid. The following drugs are toxic to the liver, and your caregiver may tell you to avoid them:

  • Isoniazid.

  • Methyldopa.

  • Acetaminophen.

  • Anabolic steroids (muscle-building drugs).

  • Erythromycin.

  • Oral contraceptives (birth control pills).

  • Check with your caregiver to make sure medicine you are currently taking will not be harmful.

  • Periodic blood tests may be required. Follow your caregiver's advice about when you should have blood tests.

  • Avoid a sexual relationship until advised otherwise by your caregiver.

  • Avoid activities that could expose other people to your blood. Examples include sharing a toothbrush, nail clippers, razors, and needles.

  • Bed rest is not necessary, but it may make you feel better. Recovery time is not related to the amount of rest you receive.

  • This infection is contagious. Follow your caregiver's instructions in order to avoid spread of the infection.

SEEK IMMEDIATE MEDICAL CARE IF:

  • You have increasing fatigue or weakness.

  • You have an oral temperature above 102° F (38.9° C), not controlled by medicine.

  • You develop loss of appetite, nausea, or vomiting.

  • You develop jaundice.

  • You develop easy bruising or bleeding.

  • You develop any severe problems as a result of your treatment.

MAKE SURE YOU:

  • Understand these instructions.

  • Will watch your condition.

  • Will get help right away if you are not doing well or get worse.