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How Hepatitis C Affects The Body

Who Is More Likely To Clear The Virus On Their Own

KILLER DISEASES | How the Body Reacts to Hepatitis

The international meta-analysis31 identified groups of people that are more likely to clear the virus on their own:

  • Women are 1.5 times more likely than men to clear the virus on their own.
  • Indigenous people are 2.1 times more likely than non-Indigenous people to clear the virus on their own.
  • People with a symptomatic infection are 2.6 times more likely to clear the virus than those with an asymptomatic infection.
  • Black people are 2.6 times more likely than non-Black people to clear the virus.
  • Younger people are 1.9 times more likely to clear the virus than older people.
  • People who do not have HIV are 2 times more likely to clear hepatitis C than people with HIV.
  • People with hepatitis B are 4.2 times more likely to clear hepatitis C than people who do not have hepatitis B.
  • Those with hepatitis C genotype 1 virus are 1.6 times more likely to clear the infection than individuals with other hepatitis C genotypes.
  • People who do not use excess alcohol are 1.5 times more likely to clear the virus compared to people who use excess alcohol.
  • People who have no history of injecting drug use are 1.7 times more likely to clear the virus compared to people who have a history of injecting drug use.

What Are The Symptoms Of Hepatitis C

Most people infected with hepatitis C have no symptoms. Some people with an acute hepatitis C infection may have symptoms within 1 to 3 months after they are exposed to the virus. These symptoms may include

If you have chronic hepatitis C, you most likely will have no symptoms until complications develop, which could be decades after you were infected. For this reason, hepatitis C screening is important, even if you have no symptoms.

How Does Hepatitis Affect The Body

Typically, symptoms for all types of hepatitis occur once the infection begins causing damage to the liver. In acute cases, symptoms develop quickly and in chronic instances, signs may take up to 6 months to begin showing concern.

General signs and symptoms for acute and chronic hepatitis

All hepatitis types will have the following signs and symptoms in common:

  • Flu-like symptoms
  • Abdominal pain
  • Loss of appetite and unexplained weight loss
  • Dark urine

Other signs and symptoms for hepatitis A

  • Nausea
  • Muscle aches
  • Clay-coloured stools

Other signs and symptoms for hepatitis B and D

  • Abdominal discomfort
  • Headache
  • Tan-coloured stools

All symptom for hepatitis B must be assessed and treated by a medical professional as quickly as possible to prevent an infection developing into HDV and further health complications. If you are exposed to the virus and can seek treatment within the first 24 hours following exposure, an infection can be prevented with prompt medical attention.

A HDV infection may not always display obvious symptoms but when they do, they are very similar to those of hepatitis B. Symptoms of HDV can often make those of HBV worse, which can make diagnosis a little trickier.

Other signs and symptoms for hepatitis C

  • Abdominal discomfort
  • Itching skin
  • Nausea

If there are already signs of damage to your liver, you will display the following symptoms:

Other signs and symptoms for hepatitis E

  • Liver enlargement
  • Nausea and vomiting

Non-viral hepatitis signs and symptoms

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How Do Doctors Treat Hepatitis A

Treatment includes resting, drinking plenty of liquids, and eating healthy foods to help relieve symptoms. Your doctor may also suggest medicines to help relieve symptoms.

Talk with your doctor before taking any prescription or over-the-counter medicines, vitamins or other dietary supplements, or complementary or alternative medicinesany of these could damage your liver. You should avoid alcohol until your doctor tells you that you have completely recovered from hepatitis A.

See your doctor regularly to make sure your body has fully recovered. If you have symptoms for longer than 6 months, see your doctor again.

How Hepatitis C Virus Reprograms Human Liver Cells

Hepatitis C and the Immunosuppressed
University of North Carolina Health Care
Hepatitis C virus has evolved to invade and hijack the basic machinery of the human liver cell to ensure its survival and spread. Researchers have discovered how hepatitis C binds with and re-purposes a basic component of cellular metabolism known as a microRNA to help protect and replicate the virus.

Hepatitis C virus has evolved to invade and hijack the basic machinery of the human liver cell to ensure its survival and spread. Researchers at the University of North have discovered how hepatitis C binds with and repurposes a basic component of cellular metabolism known as a microRNA to help protect and replicate the virus.

In a paper published online in the Proceedings of the National Academy of Sciences Dec. 17, researchers in the laboratory of Stanley M. Lemon, MD, professor of medicine and microbiology and immunology and member of UNC Lineberger Comprehensive Cancer Center, the Center for Translational Immunology, and the UNC Center for Infectious Disease, outline the critical role the microRNA known as miR-122 plays in the life cycle of the hepatitis C virus.

“There is no cancer in the United States that is increasing in incidence as fast as liver cancer, and that is because of hepatitis C,” said Dr. Lemon.

One question has been why hepatitis C virus specifically targets the liver. The research of Dr. Lemon and his colleagues points to the interaction between the hepatitis virus and miR-122 as the explanation.

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Should I Be Screened For Hepatitis C

Doctors usually recommend one-time screening of all adults ages 18 to 79 for hepatitis C. Screening is testing for a disease in people who have no symptoms. Doctors use blood tests to screen for hepatitis C. Many people who have hepatitis C dont have symptoms and dont know they have hepatitis C. Screening tests can help doctors diagnose and treat hepatitis C before it causes serious health problems.

Who Is At High Risk And Should Be Tested For Hepatitis C Infection

The U.S. Preventive Health Services task force recommends that all adults born between 1945 and 1965 be tested once routinely for hepatitis C, regardless of whether risk factors for hepatitis C are present. One-time testing also is recommended for:

  • People who currently inject drugs or snort drugs, or ever did so, even once many years previously
  • People with persistently elevated alanine aminotransferase level, a liver enzyme found in blood
  • People who have HIV infection
  • Children born to HCV- or HIV-infected mothers
  • People who were ever on long-term hemodialysis
  • People who got a tattoo in an unregulated setting, such as prison or by an unlicensed person
  • People who received clotting factor produced before 1987
  • People who received transfusions or organ transplants before July 1992, or who were notified that they received blood from a donor who later tested positive for hepatitis C infection
  • Health care, emergency medical, and public safety workers after a needlestick, eye or mouth exposure to hepatitis C-infected blood

People who may have been exposed to hepatitis C in the previous 6 months should be tested for viral RNA load rather than anti-HCV antibody, because antibody may not be present for up to 12 weeks or longer after infection, although HCV RNA may be detectable in blood as soon as 2-3 weeks after infection.

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How A Healthy Liver Works

To understand the effects of liver damage, its helpful to know what the liver does. The liver has multiple responsibilities, says Saira Aijaz Khaderi, M.D., a liver disease expert and assistant professor of surgery at Baylor College of Medicine in Houston, TX. It makes proteins that help clot blood. It makes bile, which is important for digestion. It helps store sugars and releases them for energy. And it helps break down fats and produce cholesterol. If thats not enough, your liver also filters your blood to clear it of poisonous substances.

Is Screening For Hepatitis C Recommended During Pregnancy

How Does Hepatitis C Hurt Your Liver? | WebMD

There is a 4%-7% risk of transmitting HCV from mother to infant with each pregnancy. Currently, there is no CDC recommendation for routine hepatitis C screening during pregnancy, and there is no currently recommended medicine to prevent transmission from mother to infant . However, CDC is monitoring research findings and may make recommendations in the future as evidence arises.

While data is still limited, a recent study of over 1,000 cases in the United Kingdom found that 11% of infants had been infected at birth, and that these infants were likely to develop cirrhosis in their early 30s. The case for screening for HCV during pregnancy includes the potential to safely treat mothers during pregnancy with direct-acting antiviral agents to treat the mother before cirrhosis develops, prevent infant transmission, and prevent transmission to others. Children born to HCV-infected mothers may also be offered treatment at an early age to prevent cirrhosis, as well as transmission to others. Coordination of care between multiple specialists will be important to accomplish these goals.

Children of HCV-infected mothers may be screened for hepatitis C as early as 1-2 months of age using hepatitis C viral load or PCR testing . Antibodies to hepatitis C passed from the mother to child will be present for up to 18 months, so children should be tested for HCV antibody no earlier than this.

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How Hepatitis C Damages The Liver

HCV infects and kills hepatocytes, or the cells in the liver, explains Geoffrey D. Block, M.D., medical director of liver transplant at the University of Arizona College of Medicine in Tucson. This sets off an inflammatory response. As the liver works in overdrive to create more healthy cells and release immune cells to fight the virus, scar tissue accumulates. Over time, a continued immune response causes so much scar tissue to build up that the liver cant function properlycalled cirrhosis. When that happens, the following nine complications can pop up.

Is There A Cure For Hepatitis C

Hepatitis C treatment with direct-acting antiviral medications cures most people with the virus. Treatments are simple to take, have few side effects and are usually taken for 12 weeks or less. If a person is cured through treatment it means the virus is no longer in their body. The earlier that someone is treated, the less likely they are to develop advanced liver damage.

When a person is cured, the liver damage usually stops progressing and the liver will begin to heal in some people.34 This is less likely to happen for people who have advanced cirrhosis.35 For a small proportion of people who are cured of hepatitis C, the liver continues to become injured and progresses to cirrhosis. This is usually linked to other factors such as alcohol use or fatty liver disease.34 Being cured of hepatitis C decreases the likelihood of a person getting liver cancer, liver failure or dying from liver problems.36 People with advanced liver disease will need to be followed up with regular ultrasound scans after cure because there is still a risk of liver cancer developing. There are also many non-liver related health benefits from being cured of hepatitis C, including a reduced risk of diabetes mellitus, mixed cryoglobulinaemia , glomerulonephritis , porphyria cutanea tarda , and possibly non-Hodgkin lymphoma .37

Being cured of hepatitis C does not give a person immunity. A person can become infected again if they are exposed to the hepatitis C virus.

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Your Immune System And Hepatitis C

The job of our immune system is to defend the body from invasion by foreign substances or organisms, such as bacteria or viruses like HCV. Think of the redness and swelling you experience when you get a splinter in your finger. Your immune system reacts to the splinter and the bacteria that enter the body with it by sending a range of immune system cells to the site of invasion or injury to fight infection. These cells produce chemicals that serve as tools in fighting the invasion. The inflammation at the site of the splinter is a sign that your immune response is working.

When the immune system encounters HCV, specialized cells called macrophages bring the antigen to B-cells and also display part of the antigen to circulating Th cells . The antigen is fingerprinted by the B-cell and this information is used to develop an antibody, a protein that specializes in attacking that antigen. The cells also closely examine the antigen and determine whether they should stimulate production of B-cells for antibody production or stimulate production of killer T-cells. Killer T-cells are produced if the antigen has invaded cells. The killer T-cell attaches itself to an infected cell and in most cases destroys that cell.

How Many People Can Clear The Virus On Their Own

Is it a hepatitis C rash?

Based on six studies in a recent international meta-analysis, 19.8% of people cleared the virus from their body within three months 27.9% within six months and 36.1% within 12 months. After two years, the percentage of people who cleared the virus only increased by 1% .31

One of the studies used in the analysis consisted of data from nine cohorts from Canada, Australia, the Netherlands and the USA. The combined 12-month clearance rate from this study was 27.4%, a lower rate than that found in the meta-analysis.29

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How Is Autoimmune Hepatitis Treated

The goal of treatment is to stop the bodys attack on itself by suppressing the immune system. This is accomplished with a medicine called prednisone, a type of steroid. Often times, a second drug, azathioprine is also used. Treatment starts with a high dose of prednisone. When symptoms improve, the dosage is lowered and azathioprine may be added. In most cases, autoimmune hepatitis can be controlled but not cured. That is why most patients will need to stay on the medicine for years, and sometimes for life. Unfortunately, long-term use of steroid can cause serious side effects including diabetes, osteoporosis, high blood pressure, glaucoma, weight gain and decreased resistance to infection. Other medications may be needed to control these side effects.

What Medications Cure Hepatitis C Infection

Interferons, for example, Roferon-A and Infergen, and pegylated interferons such as Peg-IntronT, Pegasys, were mainstays of treatment for years. Interferons produced sustained viral response of up to 15%. Later, peglatedll forms produced SVR of 50%-80%. These drugs were injected, had many adverse effects, required frequent monitoring, and were often combined with oral ribavirin, which caused anemia. Treatment durations ranged up to 48 weeks.

Direct-acting anti-viral agents are antiviral drugs that act directly on hepatitis C multiplication.

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How Can I Prevent Passing On The Virus To Others

If you have a current hepatitis C infection you should:

  • Not share any injecting equipment such as needles, syringes, etc.
  • Not donate blood or carry a donor card.
  • Not share razors, toothbrushes or anything else that may possibly be contaminated with blood.
  • Use condoms when having sex. The risk of passing on HCV during sex is small but risk is reduced even further by using condoms.
  • Advise anybody with whom you have had sex or shared needles to have tests as well, to check they do not have HCV.

There is currently no vaccine available to protect against hepatitis C.

What Exactly Is Hepatitis C

What does hepatitis do to the body?

Hepatitis C is a liver infection caused by the hepatitis C virus and is transmitted through the blood. Most people become infected with the virus by sharing needles or other equipment to prepare or inject drugs, getting tattooed or pierced with an unsterile needle, and sometimes by sharing personal care items that may have come into contact with someones blood, such as razors or toothbrushes. Hepatitis C may also be transmitted through unprotected sex.

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Managing Injection Site Discomfort

Many vaccine injections may result in soreness, redness, itching, swelling or burning at the injection site for one to 2 days. Paracetamol might be required to ease the discomfort. Sometimes a small, hard lump at the injection site may persist for some weeks or months. This should not be of concern and requires no treatment.

What Are The Treatment Guidelines For Hepatitis C

Hepatitis C treatment is best discussed with a doctor or specialist familiar with current and developing options as this field is changing, and even major guidelines may become outdated quickly.

The latest treatment guidelines by the American Association for the Study of Liver Disease and Infectious Disease Society of America recommends use of DAAs as first-line treatment for hepatitis C infection. The choice of DAA varies by specific virus genotype, and the presence or absence of cirrhosis. In the U.S., specific insurance providers also might influence the choice due to the high cost of DAAs. Although the individual, public health, and cost benefits of treating all patients with hepatitis C is clear, the most difficult barrier to treating all people with HCV is the very high cost of the drug regimens. Patients are encouraged to discuss options with their health care professional.

Treatment is recommended in all patients with chronic hepatitis C unless they have a short life expectancy that is not related to liver disease. Severe life-threatening liver disease may require liver transplantation. Newer therapies with DAAs have allowed more and more patients to be treated.

What are the goals of therapy for hepatitis C infection?

The ultimate goals of antiviral therapy are to

  • prevent transmission of hepatitis C,
  • prevent progression to cirrhosis and liver cancer, and
  • improve survival and quality of life.

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