Hepatitis C is liver disease, caused by the hepatitis C virus (HCV). Hepatitis C was first discovered in the 1980s when it became in knowledge that there was a new virus (not hepatitis A or B) causing liver damage. Before being properly identified in 1989 it was originally known as non-A non-B hepatitis. In 1991 a screening process was developed making it possible to detect Hepatitis C virus (HCV) in blood samples. As a relatively new disease there are still many aspects of hepatitis C which are yet to be fully understood.
The infection is often asymptomatic, but chronic infection may lead to scarring of the liver and finally to cirrhosis, which is mostly apparent after many years. Some cases of liver cirrhosis will go on to develop liver failure or liver cancer. Hepatitis C virus is mostly spread by blood-to-blood contact associated with I.V drug use, poorly sterilized medical equipment and transfusions, but less commonly by body fluids of an infected person.
How do you get hepatitis C?
Hepatitis C is caused by the hepatitis C virus. If you’re infected with hepatitis C, the virus is in your blood. It can be spread between people by contact with an infected person’s blood. The hepatitis C virus can be spread: through using contaminated needles and syringes to inject illegal drugs, through an open wound if it comes into contact with infected blood, from contaminated medical or dental equipment that isn’t sterilised properly, from contaminated tattooing equipment that isn’t sterilised properly, through sharing razors or toothbrushes that are contaminated with small amounts of infected blood, through receiving blood from an infected donor in countries where blood isn’t tested if you have unprotected sex with an infected person, although this is rare, from mother to baby during childbirth.
If you are a mother with hepatitis C, it is possible for you to infect your baby if you have cracked nipples that bleed when you breastfeed and your baby has a cut in his or her mouth. Hepatitis C can also be spread from accidental needle prick injuries. If you’re a healthcare worker, it’s important to take precautions and seek advice if you have a needle prick injury. The hepatitis C virus is present in the blood and, to a very low extent, the saliva and semen or vaginal fluid of an infected person. It is particularly concentrated in the blood, so it is usually transmitted through blood-to-blood contact. Less commonly, people can get hepatitis C through sex or being exposed to infected body fluids at work.
Signes and Symptoms of hepatitis C
Hepatitis C has an incubation period of about two weeks to six months. The incubation period is the time from when you are exposed to the virus to the start of your symptoms. If you do have symptoms, they may be similar to those of flu and include: fever, tiredness, aching joints, loss of appetite, feeling sick and vomiting, stomach ache and diarrhoea, intolerance to alcohol. You may also develop jaundice, which makes your skin and the whites of your eyes to yellow. This is caused by a yellow-coloured substance in your blood called bilirubin. Bilirubin is usually broken down by your liver, but this doesn’t happen if your liver is affected by hepatitis. Jaundice can also cause your urine to darken and your skin to itch.
These symptoms are not always caused by hepatitis C but if you have them, see your Doctor. In most cases, hepatitis C remain Asymptomatic until the liver has been significantly damaged. Because of this, many people remain unaware that they are infected by hepatitis C. However, some people have mild symptoms or do not have any symptoms at all. These people are still infectious and can unknowingly pass on the disease to others.
Stages of hepatitis C
Hepatitis C can be acute or chronic.
Acute infection; The first six months of a hepatitis C infection are known as acute hepatitis C. Around one in four people will fight off the infection and will be free of the virus. In the remaining three out of four people, the virus will stay in their body for many years. This is known as chronic hepatitis C. In acute infection, symptoms are generally mild and vague, including a decreased appetite, fatigue, nausea, muscle or joint pains, and weight loss and rarely does acute liver failure result. Most cases of acute infection are not associated with jaundice. The infection resolves spontaneously in 10-15% of cases, which occurs more frequently in individuals who are young and female.
Chronic infection; About 80-85% of those exposed to the virus develop a chronic infection. This is defined as the presence of detectable viral replication for at least six months. Most experience minimal or no symptoms during the initial few decades of the infection, although chronic hepatitis C can be associated with fatigue. Fatty changes to the liver occur in about half of those infected and are usually present before cirrhosis develops. Chronic infection after several years may cause cirrhosis or liver cancer. Around one in five people with cirrhosis will then develop liver failure, and 1 in 20 will develop liver cancer, both of which can be fatal.
Diagnosis of hepatitis C
If you think you have been exposed to the hepatitis C virus, contact your doctor. He or she will ask about your symptoms and examine you. You may have a blood test to check and find out if your body has produced antibodies against the hepatitis C virus. This test only shows that your body has made the antibody and does not actually show if you have hepatitis C. If your antibody test is positive, you will have a second blood test. This will be sent to a laboratory for polymerase chain reaction (PCR) testing to find out if you are infected with the hepatitis C virus.
You may also have a liver function blood test. This can measure substances in your blood that indicate if your liver is damaged. A liver biopsy can determine how severe the inflammation is and whether any scarring or cirrhosis has developed if you have chronic hepatitis C.
Complications of hepatitis C
The hepatitis C virus infects the cells in your liver, causing inflammation and fibrosis. If you have hepatitis C for a long time, inflammation and fibrosis continue to spread. Over time, usually after many years, this can lead to cirrhosis. If you have hepatitis C, you have around a one in three chance of developing liver cirrhosis, if you don’t have treatment. If you have cirrhosis, you’re at risk of developing liver failure or liver cancer. You may become so seriously ill that you need a liver transplant.
Hepatitis C treatment
Interferon is a protein that is naturally produced by your body when you are infected with a virus. It can prevent the hepatitis C virus multiplying inside your cells and prevent more liver damage. Hepatitis C can be treated with antiviral medicines that are designed to stop the virus from multiplying inside the body and prevent liver damage. Two widely used antiviral medications are interferon and ribavirin. The different strains of hepatitis C are known as genotypes, and some genotypes respond better to treatment than others. With treatment, around half of people with genotype 1 will be cured, and around 8 out of 10 people with genotypes 2 and 3 will be cured. Two new medications, introduced in 2011, called boceprevir and telaprevir, have been found to be effective in some people who do not respond to conventional antiviral treatments.
Prevention of hepatitis C
Unlike other forms of hepatitis, there is no vaccine for hepatitis C. You can reduce your risk of becoming infected with hepatitis C by: There are two ways to reduce your risk of catching hepatitis C. 1; never share any drug-injecting equipment with other people not just needles, but also syringes, spoons and filters. 2; use a condom during sex.