Facts You Need to Know about Hepatitis C
by Beth G. Hodges, MD

Hepatitis C is an infection of the liver by a virus known as the Hepatitis C virus. Unlike Hepatitis B infection, which is often cleared by the body, 75% of Hepatitis C victims go on to develop chronic Hepatitis C. Hepatitis C is one of the most common causes of chronic liver disease in the United States., whereas Hepatitis B is more endemic to Asia.

Twenty percent of all cases of acute hepatitis are due to the Hepatitis C virus, as are 50% of all cases of liver cirrhosis and cancer.

Hepatitis C is transmitted through the blood by transfusion (donation of blood products from one person to another), sharing of needles by IV drug abusers, and in hemodialysis patients prior to 1992, when better screening methods were developed. A mother can pass the infection to her child during the birthing process (called vertical transmission), and there have been documented cases of transmission through sexual intercourse and the sharing of razors and toothbrushes.

Eighty percent of those infected experience no symptoms at the time of infection. Symptoms do not occur until 10-20 years later, when symptoms of chronic liver disease (fatigue, loss of appetite, nausea, weight loss, jaundice) develop.

Hepatitis C infection is diagnosed through blood tests and liver biopsy to evaluate the extent of the damage. Once the Hepatitis C infection is found, further blood work to evaluate the genotype (genetic makeup of the viral strain) and the viral load (number of viral particles present in the body) will be done to further direct treatment.

Different genotypes of the Hepatitis C virus have been found to require different lengths of treatment. The standard treatment regimen consists of pegylated interferon alpha (Pegasys) with the antiviral drug ribiviron (Virazole.)

Side effects of interferon include fatigue, anemia, irritability, itching, rash, and cough. Interferon cannot be used in cases of uncontrolled depression, as it can worsen the depression and place the patient at risk for suicide. It also cannot be used with ongoing alcohol abuse, in cases of moderate to severe cirrhosis, previous chronic anemia, rheumatoid arthritis, systemic lupus erythmatosis (SLE), or psoriasis.

To avoid Hepatitis C infection, prevention must be utilized, as there is no vaccination. Blood products are now carefully screened prior to transfusion. Safe sexual practices with emphasis on the use of condoms is recommended. IV drug abusers are discouraged from sharing needles and homemade tattoos and body piercing are not recommended.

Published - February, 2010