Chronic Vs Acute Hepatitis C
There are two types of hepatitis C: acute and chronic. The Mayo Clinic describes chronic hepatitis C as a long-term infection. Every chronic infection has an acute phase, but not every acute hepatitis C infection becomes chronic. Some people clear HCV from their bodies after the acute phase, an outcome known as spontaneous viral clearance, writes the Mayo Clinic. In studies of people diagnosed with acute HCV, rates of spontaneous viral clearance have varied from 14 to 50-percent.
Healthline also helps explain by defining the two on how they develop. Acute hepatitis C sets in quickly and can last a few weeks, whereas chronic hepatitis C develops slowly over a long period of time and will often not show any signs or symptoms. Its estimated by the World Health Organization that roughly 71 million people have chronic hepatitis C.
I What Every Physician Needs To Know
Autoimmune hepatitis is also known historically as chronic aggressive hepatitis, plasma cell hepatitis, lupoid hepatitis and chronic active hepatitis. It is a form of chronic hepatitis that is characterized by immunologic and autoimmunologic features two types have been identified on the basis of autoantibody patterns.
What Is Chronic Hepatitis
Hepatitis is an inflammation of the liver. In chronic hepatitis, liver inflammation continues for at least six months. This condition may be mild, causing relatively little damage, or more serious, causing many liver cells to be destroyed. Some cases lead to cirrhosis and liver failure.
Chronic hepatitis from infection is most often caused by these viruses:
- Hepatitis B and C. Often the person infected is unaware of any initial symptoms. Or the symptoms were so mild that the person did not seek medical attention. This is especially true for chronic hepatitis C. Over time, perhaps a decade or more, both types may lead to the serious complication of cirrhosis due to ongoing destruction of liver cells and resultant scarring. A minority of patients with cirrhosis develop liver cancer over time.
- Hepatitis D. Hepatitis D infects only patients already infected with hepatitis B, and it generally results in a flare of active hepatitis.
This information helps to determine the best treatment and to assess your risk of developing cirrhosis and liver failure. A liver biopsy also can help to check for other disorders, such as alcoholic liver injury or fatty liver.
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Is Liver Transplantation An Option For A Person With Hepatitis C
Hepatitis C is the leading reason for 40% to 45% of liver transplants in the U.S. Hepatitis C usually recurs after transplantation and infects the new liver. Approximately 25% of these patients with recurrent hepatitis will develop cirrhosis within five years of transplantation. Despite this, the five-year survival rate for patients with hepatitis C is similar to that of patients who are transplanted for other types of liver disease.
Most transplant centers delay therapy until recurrent hepatitis C in the transplanted liver is confirmed. Oral, highly effective, direct-acting antivirals have shown encouraging results in patients who have undergone liver transplantation for hepatitis C infection and have recurrent hepatitis C. The choice of therapy needs to be individualized and is rapidly evolving.
When To Seek Medical Advice
See your GP if you persistently have any of the later symptoms above, or if they keep returning. They may recommend having a blood test that can check for hepatitis C.
Read more about diagnosing hepatitis C.
None of the symptoms above mean you definitely have hepatitis C, but it’s important to get them checked out.
You should also speak to your GP about getting tested if there’s a risk you’re infected, even if you don’t have any symptoms. This particularly includes people who inject drugs or have done so in the past.
Read about the causes of hepatitis C for more information about who’s at risk of having the infection.
Page last reviewed: 21 June 2018 Next review due: 21 June 2021
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Getting Tested For Hepatitis C
A blood test, called an HCV antibody test, is used to find out if someone has ever been infected with the hepatitis C virus. The HCV antibody test, sometimes called the anti-HCV test, looks for antibodies to the hepatitis C virus in blood. Antibodies are chemicals released into the bloodstream when someone gets infected.
Test results can take anywhere from a few days to a few weeks to come back. Rapid anti-HCV tests are available in some health clinics and the results of these tests are available in 20 to 30 minutes.
What Are The Common Types Of Viral Hepatitis
Although the most common types of viral hepatitis are HAV, HBV, and HCV, some clinicians had previously considered the acute and chronic phases of hepatic infections as “types” of viral hepatitis. HAV was considered to be acute viral hepatitis because the HAV infections seldom caused permanent liver damage that led to hepatic failure. HBV and HCV produced chronic viral hepatitis. However, these terms are outdated and not currently used as frequently because all of the viruses that cause hepatitis may have acute phase symptoms . Prevention techniques and vaccinations have markedly reduced the current incidence of common viral hepatitis infections however, there remains a population of about 1 to 2 million people in the U.S. with chronic HBV, and about 3.5 million with chronic HCV according to the CDC. Statistics are incomplete for determining how many new infections occur each year the CDC documented infections but then goes on to estimate the actual numbers by further estimating the number of unreported infections .
Types D, E, and G Hepatitis
Individuals who already have chronic HBV infection can acquire HDV infection at the same time as they acquire the HBV infection, or at a later time. Those with chronic hepatitis due to HBV and HDV develop cirrhosis rapidly. Moreover, the combination of HDV and HBV virus infection is very difficult to treat.
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When To See A Healthcare Provider
If you develop any of the symptoms of chronic hepatitis, liver damage, or liver cancer, see your healthcare provider. It takes only a blood test to detect the presence of a hepatitis virus in your body .
A blood test also can determine which hepatitis virus you’re infected with, which will determine what your treatment should be .
What Is Chronic Viral Hepatitis
Patients infected with HBV and HCV can develop chronic hepatitis. Doctors define chronic hepatitis as hepatitis that lasts longer than 6 months. In chronic hepatitis, the viruses live and multiply in the liver for years or decades. For unknown reasons, these patients’ immune systems are unable to eradicate the viruses, and the viruses cause chronic inflammation of the liver. Chronic hepatitis can lead to the development over time of extensive liver scarring , liver failure, and liver cancer. Liver failure from chronic hepatitis C infection is the most common reason for liver transplantation in the U.S. Patients with chronic viral hepatitis can transmit the infection to others with blood or body fluids as well as infrequently by transmission from mother to newborn.
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Some People Can Fight Infection
Before we get into the available treatments for hepatitis C, its important to note that not everyone needs treatment. According to Healthline, some people have immune systems that are strong enough to fight the infection and clear it from their body. In this case, the doctor will monitor the state of your liver with regular blood tests.
How Do Doctors Treat The Complications Of Hepatitis C
If hepatitis C leads to cirrhosis, you should see a doctor who specializes in liver diseases. Doctors can treat the health problems related to cirrhosis with medicines, surgery, and other medical procedures. If you have cirrhosis, you have an increased chance of liver cancer. Your doctor may order an ultrasound test to check for liver cancer.
If hepatitis C leads to liver failure or liver cancer, you may need a liver transplant.
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Hepatitis C Symptoms In Men
Hepatitis C symptoms in men are the same as in women. However, a 2014 study indicated that men may be less likely to clear the virus than women.
Hepatitis C in men may stay in their systems longer. It may also be more likely to cause symptoms in men compared to younger women.
Currently, there isnt a hepatitis C vaccine, though research is underway. However, avoiding contact with the blood of someone who has an HCV infection can help prevent you from acquiring the hepatitis C virus.
You can do this by:
- avoiding using someone elses razor, nail clippers, or toothbrush
- not sharing needles or syringes
- getting tattoos or piercings only at licensed facilities
- practicing safer sex with your partner by using condoms or other barrier methods
If you think you may have been exposed to HCV, its important to get tested as soon as possible.
Some people with hepatitis C may need a liver transplant.
If you believe you contracted HCV, the sooner you receive a hepatitis C diagnosis, the sooner your doctor can start a treatment plan to help you avoid complications.
Symptoms And Signs Of Acute Hepatitis C
If the anti-HCV test is positive, HCV RNA is measured to distinguish active from past hepatitis C infection .
In hepatitis C, serum anti-HCV represents chronic, past, or acute infection the antibody is not protective. When cases are unclear or when suspicion for hepatitis C is high, HCV RNA is measured. Anti-HCV usually appears within 2 weeks of acute infection but is sometimes delayed however, HCV RNA is positive sooner.
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What Are The Risk Factors For Hepatitis C
In the United States, having been born between 1945 and 1965, and the use of illicit injection drugs are the two most common factors associated with hepatitis C. Other risk factors include
- having received blood transfusions prior to 1990,
- hemodialysis, and
- having greater than 10-lifetime sex partners.
Population studies show that hepatitis C is more common among males, non-Hispanic blacks, those with low income, and those with less than a high school education.
People who have HIV/AIDS have an increased risk for hepatitis C, because both these diseases are transmitted in the same ways, through blood and body fluids. If someone has both infections, that person is said to be co-infected with HIV and HCV.
What Laboratory Studies Should Be Ordered To Help Establish The Diagnosis How Should The Results Be Interpreted
The criteria used are: serum aminotransferase levels greater than 10 fold the upper normal limit, serum gamma globulin level greater than twice the upper normal limit, elevated conjugated bilirubin, interface hepatitis on biopsy.
Autoantibody testing includes ANA , ASMA with titers of 1:320 or greater generally reflective of the presence of specific antiactin antibodies which are usually not measured in most clinical laboratories, atypical perinuclear antineutrophil cytoplasmic antibodies , soluble liver antigen and liver-pancreas antigen which is seen in 30% of patients, liver-kidney microsomal antibody type 1 , and anti-liver cytosol antibody type 1 . AMA may sometimes be seen although are typically seen in primary biliary cirrhosis.
Type 1 AIH is typically characterized by positive smooth muscle antibodies , +pANCA, +ANA, and +SLA/LP antibodies . Type 2 is usually characterized by antibodies to ALKM-1 and ALC-1. However, autoantibody testing alone is not diagnostic as positive testing can be seen in other liver disease. Additionally, circulating antibodies are absent in about 10% of patients.
Serologies for viral hepatitides should be ordered to exclude these from the diagnosis.
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Treatment Of Hepatitis C
Hepatitis C is treated with antiviral medications that aim to clear the virus from your body.
New all-tablet treatments have greatly improved the outcomes for people with hepatitis C. These treatments can cure more than 95% of individuals with chronic hepatitis C. There are several new tablets that are used in combination to treat all hepatitis C strains . They are effective for people with no liver damage and those who have more advanced liver damage or cirrhosis.
These new tablet medications are available and subsidised on the Pharmaceutical Benefits Scheme, and can be prescribed by specialists, general practitioners and specialised nurse practitioners.
There are no restrictions on accessing treatment it is available for all adults with a Medicare card. People under 18 are able to access treatment and it is recommended they are referred to a pediatrician experienced in the treatment of hepatitis C.
For more information on the new medications for the treatment of hepatitis C, see our video: Hepatitis C Cure what it means for Victorians.
If your doctor does not know about the new treatments, you can call the LiverLine on for information, and to find a GP who can help you.
Talk with your doctor about treatment options and the potential for interactions with other medications, herbal preparations and other drugs. If you take prescribed medication this will be managed so you can access treatment.
In general, if you have hepatitis C you will feel better if you:
C History Part : Competing Diagnoses That Can Mimic Autoimmune Hepatitis
Primary biliary cirrhosis , which may be characterized by isolated presence of anti-mitochondrial antibodies . Liver biopsy shows bile duct paucity with inflammation or periductular fibrosis.
Primary sclerosing cholangitis .
Overlap syndromes account for 7% of PBC/AIH and 6% of PSC/AIH cases. The nomenclature and diagnostic criteria for these variant forms of AIH have not been standardized yet.
Acute viral hepatitis secondary to hepatitis A to D, hepatitis E in some parts of the world, cytomegalovirus, Epstein-Barr virus and herpes virus.
Chronic hepatitis C. Antibodies to hepatitis C may not develop until 6 to 12 months after infection so carry out a measurement of circulating hepatitis C virus ribonucleic acid by polymerase chain reaction . Approximately 5 % of patients with chronic hepatitis C have antinuclear antibody , anti-smooth muscle antibody and anti-liver kidney microsomal antibody titers of 1:100 or greater which can confound the diagnosis. In case of patient having both AIH and hepatitis C, it is prudent to first treat the AIH.
Liver disease associated with lupus. ANA are seen in both conditions but ASMA and AMA are rare in lupus.
Non-alcoholic steatohepatitis. Liver biopsy for this condition typically shows fatty infiltration, presence of polymorphonuclear leukocytes and central fibrosis.
Hemochromatosis . Exclude by measurement of hepatic iron concentration and HFE mutations.
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Preventing The Spread Of Hepatitis C
There is no vaccine available to prevent a person from being infected with hepatitis C. Recommended behaviours to prevent the spread of the virus include:
- Always use sterile injecting equipment. This can be accessed from your local needle and syringe program service.
- Avoid sharing personal items such as toothbrushes, razors, nail files or nail scissors, which can draw blood.
- If you are involved in body piercing, tattooing, electrolysis or acupuncture, always ensure that any instrument that pierces the skin is either single use or has been cleaned, disinfected and sterilised since it was last used.
- If you are a healthcare worker, follow standard precautions at all times.
- Wherever possible, wear single-use gloves if you give someone first aid or clean up blood or body fluids.
- Although hepatitis C is not generally considered to be a sexually transmissible infection in Australia, you may wish to consider safe sex practices if blood is going to be present, or if your partner has HIV infection. You may wish to further discuss this issue and personal risks with your doctor.
Questions For Your Doctor
When you visit the doctor, you may want to ask questions to get the information you need to manage your hepatitis C. If you can, have a family member or friend take notes. You might ask:
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Hepatitis C: Symptoms Causes And Treatment
Health Check Certified By: Dr. Gerald Morris
Hepatitis C is a viral infection that causes liver damage. Its spread through contaminated blood. Its estimated that about 3.9 million Americans suffer from the hepatitis C virus , according to WebMD. And even though this disease is now curable if treated with medication, it also unfortunately exhibits very few symptoms, which means people dont realize they have it until more serious damage is done to their bodies.
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Youve probably heard of hepatitis A and B, because we have vaccines to protect ourselves from these infections. Unfortunately, there is no vaccine to protect us from hepatitis C, and the virus is highly contagious, says Healthline. Researchers continue to work towards creating a vaccine.
To stop this virus from spreading and to protect ourselves, we need to get better informed on the topic. This article dives into everything there is to know about hepatitis C, including the symptoms, causes, risk factors, and available treatments.