The hepatitis C virus (HCV) is an organism that affects the liver. The liver is the largest internal organ in the body and among its many functions is processing products of digestion by storage and distribution. It also makes proteins and substances to help the blood clot and to break down medications and alcohol. Approximately 80% of the people who are exposed to the virus will be chronic carriers. HCV can cause chronic inflammation and scarring of the liver. When the liver becomes inflamed, it cannot perform the necessary functions that keep the body working efficiently. There are typically no symptoms of HCV so people do not know if they have been infected until they get a blood test. It is estimated that more than 4 million Americans have been infected with HCV, with 9,000 to 10,000 people dying from it each year.
Fortunately, most people live normal healthy lives and will not be affected by the virus.
Hepatitis C is passed from person to person by blood. Some people never know how they caught the virus. The top ways that people are exposed to HCV are:
- Blood transfusion before 1992 (when tests for HCV became available and the blood was tested)
- Intravenous drug use (street drugs such as heroin, cocaine, etc.)
- Snorting cocaine
- Tattoos, body piercing
- Sharing razors, needles, nail clippers, or toothbrushes
- Environmental or occupational exposure to infected blood
- Healthcare workers, paramedics, etc.
- Infants born to HCV infected mothers
- High-risk sexual behavior, multiple partners, and sexually transmitted diseases
If you have any of these risk factors, you should consider being tested for HCV. Spouses of those with HCV should also be tested. It is not always necessary to have children tested, since household transmission of HCV is extremely rare.
You should also know that Hepatitis C is not transmitted by social contact such as kissing, hugging, shaking hands, or sharing food. Sexual transmission is not common, but can occur, and appropriate precautions should be taken.
If you have been diagnosed with hepatitis C, you should not share razors, nail clippers, toothbrushes or any items that may be contaminated with your blood and can mix with someone else’s blood. Cover cuts with waterproof dressing and clean up any leftover blood with paper towels.
Diagnosis of Chronic Hepatitis C
Individuals that are infected with HCV are often identified due to their elevated liver enzymes on a routine blood test. Once an antibody is found, other tests can be used to provide additional information. These exams include the following:
- Viral load: an actual count of how much of the virus is in the blood.
- Genotype: identifies the strain of the virus. There are currently 6 known genotypes and several known subtypes of HCV.
- Liver function tests: These can tell us how the liver is working and if there is inflammation.
- Abdominal ultrasound: useful to show if there is too much fat or tumors in the liver.
- Liver Biopsy: a sample of liver tissue is examined under a microscope to see if there is inflammation or scarring.
Complications of Hepatitis C
The majority of patients with chronic Hepatitis C will never develop a complication related to the disease. Hepatitis C is a slow-working virus and usually signs of inflammation in the liver don’t show up until 10-20 years after an exposure. If HCV goes undetected and untreated, HCV can cause cirrhosis (scarring of the liver), liver failure, and liver cancer. Alochol intake can raise the risk of developing cirrhosis and cancer. It is strongly advised that if you are diagnosed with HCV, you stop all alcohol intake.
Treatment of HCV
Long-acting interferon and ribavirin are currently treatments of choice for HCV. Treatment can last 12 months or longer depending on your body’s personal response. Response time can be affected by the amount of virus in the blood, the genotype of the virus and the presence of scarring in the liver. It is especially important to consult with a doctor about your current medications and anything that you plan on taking. Some medications, both prescribed or over-the-counter, and dietary supplements, can be harmful to the liver.