Hepatitis C

What is Hepatitis C?

Hepatitis C is a viral infection that primarily affects the liver and is caused by the hepatitis C virus (HCV). It can lead to both acute and chronic infections, with chronic hepatitis C potentially resulting in severe liver damage, cirrhosis, liver failure, or liver cancer.

Transmission of Hepatitis C

• Blood-to-blood contact: HCV is most commonly spread through contact with infected blood.
• Sharing needles: Common among people who use injectable drugs.
• Needle stick injuries: Risk for healthcare workers.
• Blood transfusions and organ transplants: Before 1992, when widespread screening of blood supply began.
• Mother to child: Can be passed during childbirth, although the risk is relatively low.

Symptoms of Hepatitis C

Many people with hepatitis C do not show symptoms, especially in the early stages. If symptoms do appear, they may include:

• Fatigue
• Fever
• Loss of appetite
• Nausea and vomiting
• Abdominal pain, particularly in the upper right side
• Dark urine
• Joint pain
• Jaundice: Yellowing of the skin and eyes

Acute vs. Chronic Hepatitis C

• Acute Hepatitis C:
  • Short-term illness that occurs within the first six months of exposure to HCV.
  • Can clear on its own without treatment, but often progresses to chronic hepatitis C.
• Chronic Hepatitis C:
  • Long-term infection that can last a lifetime if not treated.
  • Can lead to serious liver damage, cirrhosis, or liver cancer.

Causes and Risk Factors

• Sharing needles or syringes: Highest risk factor for HCV transmission.
• Receiving blood products: Before widespread screening in 1992.
• HIV-positive status: Increases risk of contracting hepatitis C.
• Being on long-term hemodialysis: Increased risk due to potential exposure to infected blood.
• Born to an infected mother
• Tattoos or body piercings: If done with unsterile equipment.

Diagnosis

• Blood tests:
  • Antibody test: Detects antibodies to HCV and indicates past or present infection.
  • HCV RNA test: Confirms active infection by detecting the virus in the blood.
• Liver function tests: To assess liver health and potential damage.
• Imaging tests: Ultrasound, CT scan, or MRI to detect liver damage.
• Liver biopsy: In some cases, a sample of liver tissue may be taken to assess the extent of liver damage.

Treatment Options

• Antiviral medications:
  • Direct-acting antivirals (DAAs): Highly effective in curing hepatitis C, with a treatment duration of 8-12 weeks.
  • Combination therapies: Such as sofosbuvir and ledipasvir (Harvoni) or glecaprevir and pibrentasvir (Mavyret).
• Lifestyle changes:
  • Avoid alcohol: To prevent further liver damage.
  • Maintain a healthy diet: Supports liver function.
• Monitoring: Regular check-ups to monitor liver function and detect any complications early.

Prevention Strategies

• Avoid sharing needles or syringes
• Practice safe sex: Use of condoms to reduce the risk of transmission.
• Ensure proper sterilization of medical and tattoo equipment.
• Screening blood donations: Ensures blood is free of HCV.

Complications of Hepatitis C

• Cirrhosis: Long-term liver damage that can lead to scarring.
• Liver cancer: Increased risk with chronic infection.
• Liver failure: Severe cases can result in the liver losing its ability to function.
• Other systemic issues: Such as type 2 diabetes, kidney disease, and cryoglobulinemia (a condition that affects blood vessels).