Intro
Hepatitis C is one of three common viral infections of your liver
(Hepatitis A and Hepatitis B are the others), and until relatively
recently we did not even know it existed. There are approximately
35,000 new cases of hepatitis C in the U.S. each year, and only
about one-third of these produce symptoms. Hepatitis C is more
dangerous, though thankfully far less common, than Hepatitis A
or B because it usually develops into a chronic infection –-
even in people with normal immune systems. It can lead to cirrhosis
(scarring), liver cancer, liver failure and death. Unfortunately,
no vaccine protects you from this disease. Of late, there has
been buzz about hepatitis C, leaving many people worried about
possible infection. It still, however, remains a relatively rare
disease and may not even be one-tenth as common as hepatitis B.
What
is it?
Hepatitis C is a viral infection that attacks your liver. Doctors
still do not fully understand various aspects of this infection.
We do know that many people don’t know they have (or had)
the infection, until a blood test turns up positive. Hepatitis
C can also produce a severe and life threatening infection which
can lead to liver failure and death. The real danger of hepatitis
C comes from your body’s inability to rid itself of the infection.
So, in 90 percent of people with normal immune systems, hepatitis
C becomes chronic, and in about 20 percent of these cases, progress
to cirrhosis. Hepatitis C infection also increases your chances
for liver cancer (hepatoma), liver failure and death. Hepatitis
C is even more dangerous for people with HIV and other immune
compromising conditions. They almost always develop chronic hepatitis
with more rapid deterioration of their liver.
Symptoms
Hepatitis C symptoms are extremely variable, both in severity
and duration. Some people are deathly ill while many others don’t
even realize they are sick. The most common symptom is profound
fatigue –- some feel that they can’t even get out of
bed. Other common symptoms include nausea and vomiting (generally
worsening as the day progresses), loss of appetite, fever, muscle
aches and dull upper abdominal discomfort. Most people develop
jaundice (they turn a lovely shade of yellow, most noticeably
in the whites of their eyes). This results from your liver’s
inability to process bile. Your urine darkens and your stool can
turn to a sand color.
Diagnosis
Many times your doctor first notices that your eyes and skin have
taken on a yellow cast. A blood test will detect liver inflammation
(enzymes from diseased liver cells spill into your blood and are
elevated over normal levels). Now your doctor knows you have hepatitis,
but doesn’t know what kind. Different blood tests check for
parts of the hepatitis C virus or antibodies that your body manufactures
to fight it. If either of these is present your doctor knows that
you have hepatitis C. Hepatitis C virus particles and antibodies
differ from those found with other types of hepatitis.
How
do you get it?
Hepatitis C is most often spread through contaminated blood, but
you don’t need a transfusion to catch it. A microscopic amount
of infected blood may be enough to give you the infection. Shared
needles (even tattooing needles), razors, toothbrushes and sex
toys can all pass the virus between individuals. People on kidney
dialysis and who have received organ transplants before 1992 are
at increased risk for hepatitis C. The Centers for Disease Control
and Prevention (CDC) classifies hepatitis C as a sexually transmitted
disease in men who have sex with men, but it is not clear how
it is spread. Although the virus is probably in semen, it appears
difficult to catch from unprotected anal or vaginal sex. Hepatitis
C has not been shown to pass through unprotected oral sex.
How
to treat it?
There are no medications designed specifically to treat acute
hepatitis. Treatment is generally described as "supportive,"
with the key components being rest, good nutrition, and careful
monitoring to be sure your liver recovers. Nausea is common with
hepatitis and because it often worsens as the day progresses,
most doctors recommend that you eat your bigger meals earlier.
Medication can help those with severe nausea. Hospitalization
is rare, but occasionally necessary if you cannot take in adequate
food and water or if you are too weak to remain at home.
Avoid
all alcohol and drugs, which further tax your liver, until you
are fully recovered -- your doctor, not your symptoms, determine
whether or not you are recovered. See your doctor regularly to
monitor your liver function and nutritional status.
Your
doctor may recommend a liver biopsy if you are interested in pursuing
treatment with interferon (your doctor may prescribe a combination
therapy of interferon and ribaviron). A pretreatment biospsy will
assess the progression of inflammation and fibrosis in your liver.
Some doctors feel that if your liver function tests and platelets
are normal, however, and you're not planning to take interferon,
then there is little reason to have a biospy.
You
don't need to isolate yourself if you have hepatitis C, just avoid
anything that would put your blood in contact with others, including
shared razors, needles and toothbrushes or improperly disposed
menstrual pads… you get the idea.
Anyone
who has had hepatitis C should be vaccinated against hepatitis
A and B. Either of these infections coupled with hepatitis C could
seriously destroy your liver.
Prevention
Fortunately doctors now have tests that check for hepatitis C
virus in blood transfusions and this has drastically reduced your
risk. There is no vaccine available yet to protect you from hepatitis
C. Never share needles, razors, toothbrushes, sex toys or anything
that can transmit even a minute amount of contaminated blood.
If you have hepatitis C, you may be contagious before you know
you have the infection and after you think you’re over it.
Incubation
period
If you do get symptoms, they usually appear from two weeks to
six months after exposure. Keep in mind that many infected people
don't develop any symptoms and can spread this disease unknowingly.
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