The word "hepatitis" comprises two elements:
- "-itis" at the end of the word indicates inflammation
- the first part comes from the organ called hepar, which means liver
Hepatitis therefore means inflammation of the liver, like appendicitis means inflammation of the appendix and colitis means inflammation of the colon.
Inflammation is the local reaction in the body to fight a damaging agent. There are multiple causes of inflammation and in the case of liver disease they include viruses (hepatitis A, B, C, etc.), alcohol and a variety of other diseases. Any disease that becomes chronic can lead to a scarred liver (cirrhosis).
Hepatitis C infection is infection of the liver by the hepatitis C virus. This infection may cause minimal disease, even after years, or major scar formation and cirrhosis.
Hepatitis C is one of five different kinds of hepatitis viruses (A-E). Only hepatitis B, C and D can become chronic conditions, and possibly cause cirrhosis.
Many patients who are infected may not have any symptoms whatsoever. Unfortunately, in many people the disease silently progresses and patients may not present until major liver damage has occurred.
Many patients learn for the first time that they have hepatitis c when donating blood or being checked for life insurance.
If symptoms do occur, they may be vague and non-specific: fatigue, joint complaints, generally not feeling well.
Patients with more advanced disease may present with symptoms like:
- Jaundice, or yellowing of the skin and whites of the eyes
- Dark urine
- Pain in the liver area (middle of the back, on the right side), or upper abdomen
- Swelling of the abdomen or legs due to fluid accumulation (sometimes after a minor surgical procedure)
- Bleeding varices (swollen blood vessels)
Hepatitis C is a blood-borne virus. It is transmitted by contact with the blood of a person who already has the virus. People with a higher risk of getting hepatitis C include:
- Those who share intravenous needles (as in injecting illegal drugs) with an infected person
- Those who have a job that brings them into contact with blood
- Those who got a blood transfusion before July 1992 (before strict blood-screening programs were in place)
- Those who have had sex with a person who has hepatitis C, specifically who have had sex with multiple partners. The risk for most people is very low.
- Those on long-term kidney dialysis
- Babies born to a mother with hepatitis C
If you are in one of the above categories, ask your doctor about testing for hepatitis C.
Hepatitis C is not easily transmitted.
- It is not passed by hugging, kissing, or sharing eating utensils.
- Sexual transmission in people with a single partner is so rare that preventative measures are not recommended.
- People in households with a patient who has hepatitis C are barely at risk at all, provided they do not share razor blades, tooth brushes or any object that has blood on it.
A person with hepatitis C has changes in their blood that will show up on a blood test within three months of getting infected. One or several of these blood tests may be ordered to tell for certain if you have hepatitis C.
The initial test is usually the hepatitis C antibody (anti-HCV). If positive, it tells that the person is or was exposed to hepatitis C. It does not indicate immunity for the disease.
If anti-HCV is present, the next step is demonstrating the virus in the blood (HCV RNA). If this test is positive, it confirms the presence of virus in the blood.
Testing for the strain of the virus (genotype) is not too important for severity of disease, but helps determine the plan of treatment
- Genotypes 1 and 4 usually require at least 48 weeks of therapy
- Genotypes 2 and 3 require 24 weeks or less of therapy
Current treatment of hepatitis C comprises weekly shots of pegylated interferon and daily tablets of ribavirin.
The treatment is a major challenge for patients, the people around them and the treatment team, because side effects can be very difficult. However, with advances in knowledge of how to treat the disease and the side effects, it is usually possible to control the side effects.
In proper candidates who are able to complete the therapy, cure rates varying from 40-60% in cases of hepatitis C genotype 1, and even higher cure rates in cases of genotype 2 and 3 are possible.
In our center, treatment and support are provided by a team that includes doctors, nurse practitioners and nurses.