Hepatitis C

WHAT IS HEPATITIS C?

Hepatitis C is a serious infection that attacks the liver caused by the Hepatitis C virus (HCV). It is one of several liver targeting viruses, and considered the most serious. Most people with HCV have no symptoms and thus many do not know they have the infection. The virus is spread through contact with contaminated blood. No vaccine is available; however, treatment now exists that can cure the infection. Currently, chronic HCV is the leading cause of liver transplantation in the United States.

Microscope

HIV/HCV CO-INFECTION

Approximately 25% of Human Immunodeficiency Virus (HIV) infected individuals also have chronic Hepatitis C (HCV). It is important that all HIV positive individuals be tested for HCV as liver disease is one of the leading causes of death and declining health in the HIV-infected population. The progression to cirrhosis occurs more rapidly in individuals with both infections. For these reasons, if there are no contraindications, treatment of the HCV is strongly recommended in the HIV-infected individual. Unfortunately, the chances of clearing the HCV is much lower than in individuals that are HIV negative.

WHAT IS YOUR LIVER AND WHAT DOES IT DO?

The liver is a large reddish-brown solid organ that is approximately 3 to 4 pounds. Located in the upper part of the abdomen, it is tucked away under the right side of the rib cage. It is one of the largest organs in the body, second only to the skin. It is shaped like a pyramid and is divided into the right and left lobes.

The liver is a unique organ that performs many complex functions in your body every day. It acts as a filter to clean and clear your body of waste, thus helping your body fight infection. The liver is like a big chemical laboratory. It manages the nutrients that have been absorbed by the gut from food, removes toxins from the blood, makes big proteins like albumin and clotting factors (these help our blood clot), and secretes bile
which helps digest our food.

SIGNS AND SYMPTOMS

When one first becomes infected with HCV, this is considered “acute Hepatitis C infection”. During this time, the majority of people do not have any symptoms. If symptoms do occur, they are usually mild and include jaundice, nausea, dark urine, and abdominal pain. These symptoms will appear 2 to 26 weeks after an exposure and usually last 2 to 12 weeks. Most people infected with HCV do go on to develop chronic (lifelong) HCV; these people may continue to not show any signs or symptoms of the disease. Since most people do not have any symptoms during the acute and chronic stages, symptoms usually do not present until decades later when cirrhosis has developed.

SERIOUS COMPLICATIONS

Unless successfully treated, HCV can lead to:

  • Liver cirrhosis
  • Liver cancer
  • Liver failure

HOW DOES ONE GET HEPATITIS C?

HCV is spread through contact with blood of someone who is infected.

RISK FACTORS

  • Received a blood transfusion and organ transplant before 1992
  • Received blood products for clotting disorder (hemophilia) before 1987
  • Shared needles or syringes during IV drug use
  • Used nasal cocaine
  • Tattoo or piercing performed with a used/contaminated needle
  • Healthcare professional exposed to blood or accidental needle stick
  • Long term dialysis treatment
  • HIV positive
  • Babies born to HCV infected mother
  • Unprotected sexual contact with an infected person – very rare

PREVENTION

There is no vaccine available to protect against Hepatitis C. Currently, only hepatitis A and hepatitis B have vaccines. It is important that everyone does the following:

  • Never share needles, syringes, or cocaine straws
  • Always use a reputable professional who uses clean needles when getting a tattoo or piercing
  • Do not share toothbrushes, razors, nail clippers, or other personal items with someone infected
  • It is still safe to hug and kiss, share eating utensils, share handshakes, and breastfeed

WHO SHOULD CONSIDER BEING SCREENED FOR HEPATITIS C?

  • Anyone who has ever used IV drugs or snorted cocaine in the past Anyone who has received a blood transfusion or organ transplant before 1992
  • Anyone who has received a blood product for clotting disorders before 1987
  • Anyone born between the years of 1945 -1965, also known as a Baby Boomer
  • Anyone who has ever had a tattoo or piercing that was not professionally done
  • Anyone with unexplained abnormal liver enzymes on lab work
  • Health care workers who have been exposed to blood or an accidental needle stick
  • Anyone with HIV

HOW IS HEPATITIS C DIAGNOSED?

HCV is diagnosed with a simple blood test. Your doctor may also want to get a liver biopsy (sample of liver tissue) to see if the liver is damaged.

TREATMENT

Medications are available for the treatment of HCV that fight the virus with a goal to cure. The treatment for HCV is rapidly changing with multiple new medications expected to be available on the market within the next year or so. These new medications have higher chances to cure the infection, with cure rates reaching close to 100%. In addition, these new medications will likely involve only oral agents.