Hepatitis C is an inflammation of the liver that is caused by the Hepatitis C virus. In the past, before the
specific test for C was available, many persons who had received a blood transfusion and developed hepatitis
symptoms were said to have "transfusion hepatitis" or "nonA nonB hepatitis". While a few patients may be very
ill during the acute phase, approximately ninety percent of infected persons have mild or no symptoms.
Hepatitis C is a very serious illness because up to seventy percent of infected individuals develop chronic
hepatitis and twenty percent of those individuals will ultimately develop liver cirrhosis or cancer. The
damage may not be evident for up to 20 years after the initial exposure to the virus.
ARE YOU AT RISK?
The Hepatitis C virus is spread by blood infected by the virus. The following are risks for the infection.
- Receiving blood transfusions before 1992
- Occupational exposure to blood
- Receiving hemodialysis
- Using illegal drugs (intranasal and/or needle use)
- Use of contaminated equipment for tattooing/body piercing
- Sharing razors, toothbrushes, etc
- Multiple sexual partners may also be a risk
WHAT ARE THE SYMPTOMS?
Symptoms during the acute phase may occur from two weeks to six months after exposure; however, the
usual incubation period is 6-9 weeks. Onset of symptoms is usually insidious and may include
loss of appetite, tiredness, nausea and vomiting, vague stomach pain. Jaundice (yellowing of the
skin and whites of the eyes) occurs less frequently than in Hepatitis B. After the symptoms of the
acute phase, if any are present, the patient may appear to recover with no evident problem.
Persons who develop chronic hepatitis may appear healthy for many years until symptoms of liver
damage appear. For this reason persons with risk factors are encouraged to be tested for the disease.
TEST FOR HEPATITIS C
An antibody test is used to detect infection with Hepatitis C. It is able to detect the antibody in about 97% of
infected persons. False positive tests can be limited by the use of a supplemental test on blood reported as
positive on the initial test. The antibody test does not distinguish between acute, chronic, or resolved infections.
Liver function tests can help the physician determine if the infection is chronic.
There are at least six different genotypes and 90 subtypes of the virus. Evidence is limited regarding
differences in disease outcomes among persons with different genotypes. Differences in responses to antiviral
therapy according to genotypes do occur.
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WHY BE TESTED?
Persons who have risk factors for Hepatitis C should be tested for the antibody and receive additional
evaluation if they test positive. If chronic hepatitis infection is present the patient can avoid placing
additional stress on the liver by limiting certain medications and/or alcohol. Immunizations for Hepatitis A
and B can be given to protect against further damage that could be caused by those illnesses. The patient can
also take steps to limit the spread of his disease. About twenty five percent of patients with chronic Hepatitis
C may benefit from therapies using Interferon Alpha. The drug can be given alone or in combination with another drug.
The drug has significant side effects that require careful monitoring.
Persons who have had risk factors for the disease may want to be tested to reassure themselves that they are not
infected and not at risk of spreading the disease.
WHEN ARE PATIENTS INFECTIOUS?
A person with Hepatitis C is contagious for up to two weeks before symptoms appear (or approximately 4-7 weeks
after being infected) and remain infectious until the virus is cleared from their blood. If the virus is not
cleared from the body within six months, the infection is said to be chronic and the person remains infectious.
WHAT ARE THE COMPLICATIONS OF HEPATITIS C?
At least twenty percent of chronically infected persons will eventually develop cirrhosis (scarring of the liver) or
cancer of the liver. Hepatitis C is now a main reason for receiving liver transplants. Each year, up to 8,000
Americans die from complications of Hepatitis C.
CAN THE DISEASE BE PREVENTED?
Immune Globulin has not shown to be effective for prevention of the infection and there is no vaccine for
prevention of Hepatitis C. On the positive side, blood for transfusion is now tested for the virus to prevent
contaminated units reaching the blood supply. Blood derived products also undergo routine virus inactivation
during production. Risk reduction counseling for persons at high risk for infection is also recommended because
users of illegal drugs have a high incidence of infection.
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