Patients Care

HEPATITIS C

Hepatitis C is an infectious disease affecting the liver, caused by the hepatitis C virus (HCV). The infection is often asymptomatic, but once established, chronic infection can progress. In some cases other complications occur including liver failure.

Causes

  • Hepatitis C is a liver disease that is caused by infection with the hepatitis C virus.
  • You cannot get hepatitis C from casual contact such as hugging, kissing, sneezing, coughing, or sharing food or water with someone.
  • You can get hepatitis C if you come into contact with the blood of someone who has hepatitis C.
  • The most common way to get hepatitis C is by sharing needles and other equipment used to inject illegal drugs.
  • If you are injecting drugs, the best way to protect yourself is by not sharing needles or other equipment with others.
  • In rare cases, a mother with hepatitis C spreads the virus to her baby at birth, or a health care worker is accidentally exposed to blood that is infected with hepatitis C.
  • Experts are not sure whether you can get hepatitis C through sexual contact. If there is a risk of getting the virus through sexual contact, it is very small.
  • If you live with someone who has hepatitis C or you know someone with hepatitis C, you can help protect yourself by not sharing anything that may have blood on it, such as razors, toothbrushes and nail clippers.
  • The incubation period is the time it takes for symptoms to appear after the hepatitis C virus has entered your body and it is any time from 2 weeks to 6 months.
  • Anyone who has hepatitis C can spread the virus to someone else. If testing shows you have hepatitis C, do not share needles and keep cuts, scrapes and blisters covered.


Sign and symptoms

  • In the minority of patients who experience acute phase symptoms, they are generally mild and nonspecific and rarely lead to a specific diagnosis of hepatitis C.
  • Symptoms of acute hepatitis C infection include decreased appetite, fatigue, abdominal pain, jaundice, itching and flu-like symptoms.
  • Chronic hepatitis C is defined as infection with the hepatitis C virus persisting for more than six months. Clinically, it is often asymptomatic (without symptoms) and it is mostly discovered accidentally (e.g. usual checkup).
  • The natural course of chronic hepatitis C varies considerably from one person to another. Although almost all people infected with HCV have evidence of inflammation on liver biopsy.
  • Once chronic hepatitis C has progressed, signs and symptoms may appear that are generally caused by either decreased liver function or increased pressure in the liver circulation, a condition known as portal hypertension.
  • Possible signs and symptoms of liver cirrhosis include ascites (accumulation of fluid in the abdomen), bruising and bleeding tendency, enlarged veins especially in stomach and jaundice.

Diagnosis
  • Hepatitis C testing begins with serological blood tests used to detect antibodies to HCV.

Management

  • Current treatment is a combination of, Conventional Interferon/Pegylated interferon and the antiviral drug ribavirin for a period of 24 or 48 weeks.
  • Treatment is generally recommended for patients with proven hepatitis C virus infection and persistently abnormal liver function tests.
  • Treatment during the acute infection phase has much higher success rates (greater than 90%) with a shorter duration of treatment.
  • Current guidelines strongly recommend that hepatitis C patients be vaccinated for hepatitis A and B if they have not yet been exposed to these viruses, as infection with a second virus could worsen their liver disease.
  • Alcoholic beverage consumption accelerates HCV associated fibrosis and cirrhosis and makes liver cancer more likely; insulin resistance and metabolic syndrome may similarly worsen the hepatic prognosis. This is also evident that smoking increases the fibrosis (scarring) rate.