Hepatitis C

1 What is Hepatitis C?

Hepatitis C is an inflammation of the liver that is caused by a virus that attacks it. Most individuals with HCV ( Hepatitis C Virus) have no symptoms at all.

In fact, these individuals do dot know they have the infection until damage shows up at a later stage in their lives. Hepatitis C is of the several hepatitis viruses and is generally considered among the most serious among these viruses.

Hepatitis C is passed through contact with contaminated blood, commonly through needle sharing during drug use.

2 Symptoms

Hepatitis C usually causes no symptoms in the early stages. In its early stages beginning about  one or three months after exposure to the virus, the following signs and symptoms occur in a small group of individuals:

Hepatitis

  • Fatigue,
  • nausea,
  • poor appetite,
  • stomach pain,
  • dark-colored urine,
  • yellow discoloration in the skin and eyes (jaundice),
  • fever,
  • muscle and joint pains.

Signs and symptoms of chronic infection become quite evident after years and  are as a result of liver damage caused by the virus. These may initially include the symptoms of acute infection.

Then, over time, signs and symptoms may include: 

  • Bleeding and bruising easily,
  • itchy skin,
  • fluid accumulation in the abdomen (ascites),
  • swelling in the legs,
  • weight loss,
  • confusion,
  • drowsiness,
  • slurred speech (hepatic encephalopathy),
  • spider-like blood vessels on the skin.

3 Causes

Hepatitis C is caused by the Hepatitis C Virus (HCV). 

HVC is spread when one comes in contact with blood contaminated with the virus.

4 Making a Diagnosis

Making a diagnosis of hepatitis C is done by blood tests.

Anyone with suspicions that they might have Hepatitis C must initially see a family doctor or general practitioner. Once diagnosis have been completed, the doctor may recommend an appointment with a specialist. Hepatologists, who are doctors who specialize in liver diseases can be seen. Because appointments can be brief and because there is a lot of ground to cover, it is a good idea to be prepared beforehand. The following should be taken into account when trying to be prepared for the appointment. 

  • One must be aware of any pre-appointment restrictions.
  • At the time of the appointment, it is very crucial to ask if anything is needed to be done in advance, such as, making diet restrictions.
  • It is vital to write down any symptoms noticeable, including any that seem unrelated to the reason  for which the appointment has been scheduled.
  • Key personal information such as major stresses or recent life changes should also be included.
  • A list of all medications, vitamins or supplements taken must be made. 

For hepatitis C infection, some basic questions to ask a doctor include:

  • How much hepatitis C virus do I have in my body?
  • Should I be tested for other causes of liver disease, such as hepatitis B?
  • Has the hepatitis C virus damaged my liver?
  • Do I need treatment for hepatitis C infection?
  • What are my treatment options?
  • What are the benefits of each treatment option?
  • What are the potential risks of each treatment option?
  • Is there one treatment you think is best for me?
  • I have other medical conditions. How will these affect my hepatitis C treatment?
  • Should my family be tested for hepatitis C?
  • Is it possible for me to spread hepatitis C to others?
  • How can I protect the people around me from hepatitis C?
  • Should I see a specialist?
  • What will that cost, and will my insurance cover it?
  • Are there brochures or other material that I can take with me?
  • What websites do you recommend?
  • What will determine whether I should plan for a follow-up visit?
  • Is it safe for me to drink alcohol?
  • What medications should I avoid?

The doctor is  likely to ask  a number of questions. Being ready to answer them may allow more time later to cover points that need to be addressed. The doctor may ask:

  • When did you first begin experiencing symptoms?
  • Have your symptoms been continuous or occasional?
  • How severe are your symptoms?
  • What, if anything, seems to improve your symptoms?
  • What, if anything, appears to worsen your symptoms?
  • Have you ever had a blood transfusion or an organ transplant? If so, when?
  • Have you ever used self-injected drugs not prescribed by your doctor?
  • Have you ever been diagnosed with hepatitis or jaundice?
  • Does anyone in your family have hepatitis C?
  • Is there a history of liver disease in your family? 

Testing for hepatitis C infection in people who have a high risk of coming in contact with the virus may help doctors begin treatment or recommend lifestyle changes that may slow liver damage. This is recommended because hepatitis C infection often begins damaging the liver before it causes signs and symptoms. Individuals who may want to talk to their doctors about screening for hepatitis C infection include:

  • Anyone who has ever injected or inhaled illicit drugs.
  • Anyone with unexplained, unusual liver function test results.
  • Babies born to mothers with hepatitis C.
  • Health care and emergency workers who have been exposed to blood or accidental needle sticks.
  • People with hemophilia who were treated with clotting factors before 1987.
  • People who have ever undergone long-term hemodialysis treatments.
  • People who received blood transfusions or organ transplants before 1992
  • Sexual partners of anyone diagnosed with hepatitis C infection People with HIV infection.
  • Anyone born from 1945 to 1965.
  • Anyone who has been in prison.

Blood tests to diagnose hepatitis C may help to:

Determine whether you have the hepatitis C virus, measure the quantity of the hepatitis C virus in your blood (viral load), evaluate the genetic makeup of the virus (genotyping), which helps determine the treatment options, testing samples of liver tissue to determine severity of liver damage. The doctor may also recommend a procedure to remove a small sample of liver tissue for laboratory testing.

A liver biopsy can help determine the severity of the disease and guide treatment decisions. During a liver biopsy, the doctor inserts a thin needle through the skin and into the liver to remove the tissue sample.

5 Treatment

Hepatitis C  is always treated with antiviral medication intended to clear the virus from the body. The main objective is to have no virus in the system for at least two weeks after treatment is completed.

Although medication to treat hepatitis C have been available for quite  some time and improved over the years, they have had serious side-effects and required that a person be treated from 24 to 72 weeks. 

Side-effects include:

  • depression
  • flu-like symptoms,
  • and loss of healthy red or white blood cells.

Therefore, many individuals discontinued treatment. Reasearchers have recently made significant progress in treatment for hepatitis C, combining new anti-viral medications with existing ones. As a result, people experience better outcomes, fewer side effects and shorter treatment times — some as short as 12 weeks. Regimens may vary depending on the hepatitis C genotype, presence of existing liver damage, other medical conditions and prior treatments, but they're generally much more effective today than they were before.

Due to the pace of research, recommendations for medications and treatment regimens are changing rapidly, and treatment is also quite complex.  If the liver has been severely damaged, a liver transplant may be an option. During a liver transplant, the surgeon removes the  damaged liver and replaces it with a healthy one. Most transplanted livers come from deceased donors, though a small number come from living donors who donate a portion of their livers.

For individuals with hepatitis C infection, a liver transplant is not a cure. Treatment with antiviral medications usually continues after a liver transplant, since hepatitis C infection is likely to recur in the new liver. Although there is no vaccine for hepatitis C, doctors will likely recommend that one receive vaccines against the hepatitis A and B viruses. These are separate viruses that also can cause liver damage and complicate treatment of hepatitis C.

6 Prevention

Hepatitis C can be prevented by the following points: 

  • Illicit drugs must be avoided,
  • body piercing and tattoos should be done with caution, it is very advisable to ask about the equipment used, especially how they are cleaned.
  • Another preventive method is by practicing safe sex. Sexual transmission between monogamous couples may occur, but risks in these cases are low.

7 Lifestyle and Coping

For any individual who receives a diagnosis for hepatitis C, their doctor will usualy recommend certain lifestyle changes.

These measures will help keep them healthy longer and also protect the health of many other individuals around them.

The following lifestyle changes can be beneficial: 

  • Alcohol should be completely avoided as it accelerates the rate of progression of liver disease
  • It is also advisable to avoid medication that may cause damage to the liver.One can also prevent others from being infected through their blood by covering any wounds on their body.
  • Avoid sharing razors or toothbrushes.
  • Donating blood, body organs or semen must be discouraged.

Infected individuals must always advise health care workers that they have the virus, this can prevent other individuals from getting the infection.

8 Risks and Complications

There are several risks and complications associated with hepatitis C.

The following factors increase the risks of a hepatitis C infection: 

  • Being a health care worker who has been exposed to infected blood. This can happen if an infected needle pierces the skin.
  • One is also at the risk of infection if they have ever injected or inhaled illicit drugs. 
  • Being HIV also increases the risk.
  • Individuals who have received a piercing or tattoo in an unclean environment using unsterile equipment are also at a high risk of being infected with Hepatitis C.
  • Individuals who received a blood transfusion or organ transplant before 1992.
  • Received clotting factor concentrates before 1987.
  • Received hemodialysis treatments for a long period of time. 
  • A child born to a woman with a hepatitis C infection.

Hepatitis C infection that continues over many years can cause significant complications, such as:

  • Scarring of the liver tissue (cirrhosis).
  • After a period of 20 to 30 years of hepatitis C infection, cirrhosis may occur.
  • Scarring in your liver makes it difficult for the liver to function. A small number of people with hepatitis C infection may develop liver cancer.A liver that is severely damaged by hepatitis C may be unable to function adequately.
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