What Is Hepatitis C
Hepatitis C is a liver infection that can lead to serious liver damage. Itâs caused by the hepatitis C virus. About 2.4 million people in the U.S. have the disease. But it causes few symptoms, so most of them don’t know. The virus spreads through an infected personâs blood or body fluids.
There are many forms of the hepatitis C virus, or HCV. The most common in the U.S. is type 1. None is more serious than any other, but they respond differently to treatment.
Whats The Difference Between Acute And Chronic Hepatitis C
Hepatitis C is a contagious disease caused by HCV, which is spread through contact with blood and bodily fluids that contain HCV. This disease damages your liver. There are two types of hepatitis C infection: acute and chronic.
Acute hepatitis C is a short-term viral infection. People with acute hepatitis C carry the infection for a small window of time, often just several months . Most people with the acute form of hepatitis C will experience illness and mild symptoms such as fatigue and vomiting within the first six months after exposure. In many cases, the disease causes no symptoms at all.
Acute hepatitis C may improve or resolve without treatment. It leads to chronic infection in 75 to 85 percent of cases. The chronic form may cause long-term problems in your liver, including liver damage and liver cancer.
HCV is spread through direct contact with blood or certain bodily fluids that contain HCV. Its safe to engage in the following activities without worry of transmission:
If your doctor suspects that you have hepatitis C, they will draw blood to check for HCV antibodies. Antibodies are substances your body produces when its fighting an infection. If you have them, your doctor may order a second test to confirm that the virus is still present.
History And Physical Exam
To diagnose all forms of hepatitis, your doctor will first take your history to determine any risk factors you may have.
During a physical examination, your doctor may press down gently on your abdomen to see if thereâs pain or tenderness. Your doctor may also check for any swelling of the liver and any yellow discoloration in your eyes or skin.
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Can Hepatitis C Be Treated
Yes, since 2010 enormous progress has been made in the treatment of chronic hepatitis C. New therapies called direct-acting antivirals are pills that act on the virus itself to eradicate it from the body, unlike older medicines like interferon injections which work by stimulating an immune response. These new treatments are very effective and can achieve cure rates of over 90%. In most situations now, there is no need for interferon, which was responsible for many of the side effects previously associated with HCV treatment. The new treatment combinations require shorter treatment durations , have reduced side effects and appear to be effective at all stages of the disease.
Because these new therapies are very new, they remain very expensive. As such, drug coverage from both government and private companies may require that your liver disease has progressed to a certain stage before they are willing to cover the cost of these drugs.
Your primary care physician may refer you to a specialist to determine whether you are eligible for treatment. A specialist will help you decide which drug therapy is best for you based on the severity of your liver disease, your virus genotype and whether or not you have been treated in the past.
What Do You Do If You Become Ill
Talk to your health care provider about getting tested if you think you:
- are at risk
- may have hepatitis C
If you have hepatitis C, tell those who may have been exposed to your blood or bodily fluids. They should get tested and be treated if necessary. Bodily fluids, like semen and vaginal fluid, are a concern because they could be carrying small amounts of infected blood.
Some adults with hepatitis C will recover from the disease on their own within 6 months. Until your health care provider confirms your recovery status, you are still contagious and can spread the disease.
After recovery, you are no longer contagious because you will not have the disease anymore. But you can get hepatitis C again.
Unfortunately, most adults with hepatitis C:
- cannot recover on their own
- develop a more serious form of the disease if they are sick for longer than 6 months
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Getting Tested Is The Only Way To Know If You Have Hepatitis C
A blood test called a hepatitis C antibody test can tell if you have been infected with the hepatitis C viruseither recently or in the past. If you have a positive antibody test, another blood test is needed to tell if you are still infected or if you were infected in the past and cleared the virus on your own.
- Are 18 years of age and older
- Are pregnant
- Currently inject drugs
- Have ever injected drugs, even if it was just once or many years ago
- Have HIV
- Have abnormal liver tests or liver disease
- Are on hemodialysis
E1 And E2 Glycoproteins
E1 and E2 are covalently bonded when embedded in the envelope of HCV and are stabilized by disulfide bonds. E2 is globular and seems to protrude 6 nm out from the envelope membrane according to electron microscope images.
These glycoproteins play an important role in the interactions hepatitis C has with the immune system. A hypervariable region, the hypervariable region 1 can be found on the E2 glycoprotein. HVR1 is flexible and quite accessible to surrounding molecules. HVR1 helps E2 shield the virus from the immune system. It prevents CD81 from latching onto its respective receptor on the virus. In addition, E2 can shield E1 from the immune system. Although HVR1 is quite variable in amino acid sequence, this region has similar chemical, physical, and conformational characteristics across many E2 glycoproteins.
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What Is The Treatment For Hepatitis C
Drugs are licensed for treatment of persons with chronic hepatitis C. Combination drug therapy, using pegylated interferon and ribavirin, can get rid of the virus in up to five out of ten of persons with genotype 1, the most common genotype in the U.S. and eight out of ten persons with genotype 2 or 3. It is important to know that not everyone will need treatment. The decision to treat hepatitis C is complex and is best made by a physician experienced in treating the disease.
Effective Treatments Are Available For Hepatitis C
New medication to treat for HCV have been approved in recent years. These treatments are much better than the previously available treatment because they have few side effects and do not need to be injected. There are several direct-acting antiviral HCV treatments that cure more than 95% of people who take them in 8 to 12 weeks. HCV treatment dramatically reduces deaths among people with HCV infection, and people who are cured of HCV are much less likely to develop cirrhosis or liver cancer.
Take Action! CDCs National Prevention Information Network Service Locator helps consumers locate hepatitis B and hepatitis C prevention, care, and treatment services.
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How Is Acute Hepatitis C Treated
Acute hepatitis C is typically monitored and not treated. Treatment during the acute stage doesnt change the risk that the disease will progress to the chronic form. An acute infection may resolve on its own without treatment. The following treatment may be all thats necessary:
- proper rest
- adequate fluids
- a healthy diet
Some people may need treatment with prescription medication. Your doctor will be able to work with you about what treatment options may be best for you.
Those most at risk for acute and chronic hepatitis C are people who use or share contaminated needles. Mothers can transmit HCV to their babies during childbirth, but not through breastfeeding. Other risk factors for transmission of HCV include:
- healthcare work, especially work around needles
- getting a tattoo or body piercing with unsterile equipment
- undergoing hemodialysis
- living in a household with someone with HCV
- sharing personal hygiene products, such as razors or toothbrushes
- engaging in sexual activity with multiple partners without condoms or dental dams
- having a blood transfusion or organ transplant before July 1992 or receiving clotting factors before 1987
The most serious long-term risk of acute hepatitis C is developing chronic hepatitis C, which can lead to cirrhosis and liver cancer. In 75 to 85 percent of those with acute hepatitis C, the disease will progress to the more serious chronic hepatitis C.
Is Chronic Viral Hepatitis C Contagious
Hepatitis C can be passed from person to person. Most people with HCV get it through direct contact with blood containing the virus.
People with hepatitis C can pass on the virus to others by sharing needles and syringes. Hepatitis C is easily transmitted among people who use intravenous drugs.
Its also possible, but much less common, to acquire the HCV by:
- sharing a razor with a person who has the virus
- sharing a toothbrush with a person who has the virus at the same time that you have bleeding gums
- having sexual contact with a person who has the virus
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What Are The Treatment Options For Hcv
Currently, the standard of care for the treatment of HCV is pegylated interferon in combination with ribavirin. This combination therapy is typically a 24-week or 48-week course. Research has shown that combination therapy with pegylated interferon and ribavirin can result in undetectable levels of HCV in 40-50 percent of people with genotype 1 and 70-80 percent of people with genotypes 2 and 3.11,12,13,14
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 Is Hepatitis C Transmitted
Because HCV is primarily spread through contact with infected blood, people who inject drugs are at increased risk for HCV infection. HCV can also be transmitted from an infected mother to child at the time of birth, from unregulated tattoos or body piercings, and from sharing personal items that may be contaminated with infected blood, even in amounts too small to see. Much less often, HCV transmission occurs through sexual contact with an HCV-infected partner, especially among people with multiple sex partners and men who have sex with men. Currently in the United States, health care related transmission of HCV is rare, but people can become infected from accidental needle sticks and from breaches in infection control practices in health care facilities.
Can Hepatitis C Be Prevented
There is no vaccine for hepatitis C. But you can help protect yourself from hepatitis C infection by:
- Not sharing drug needles or other drug materials
- Wearing gloves if you have to touch another person’s blood or open sores
- Making sure your tattoo artist or body piercer uses sterile tools and unopened ink
- Not sharing personal items such toothbrushes, razors, or nail clippers
- Using a latex condom during sex. If your or your partner is allergic to latex, you can use polyurethane condoms.
NIH: National Institute of Diabetes and Digestive and Kidney Diseases
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How Is Hepatitis C Diagnosed
Symptoms alone generally dont offer enough information for a doctor to diagnose hepatitis C. Whats more, you might not have symptoms or notice any signs of the condition.
Thats why its so important to connect with a doctor or other healthcare professional and ask about getting tested if youve been exposed to the hepatitis C virus.
The also recommend hepatitis C testing for people who have abnormal liver tests, along with those who are:
- on hemodialysis
A healthcare professional can order a few different tests to help diagnose hepatitis C. These include:
- Blood tests. They may order a series of blood tests to check for the virus, starting with a hepatitis C antibody test. A PCR test can tell your healthcare professional whether the virus is currently active, and viral load testing can measure the amount of virus in your blood.
- Genotype test. This test can reveal which hepatitis C genotype you have. This information will help your healthcare professional find an effective treatment approach.
- Liver function test. If blood test results suggest chronic hepatitis C or your healthcare professional believes you could have liver damage, theyll order a liver function test. This test checks your blood for signs of heightened enzymes from your liver.
- Liver biopsy.This procedure can also help check for liver damage. A biopsy involves taking a small piece of tissue from your liver and testing it for cell abnormalities.
How Is Hepatitis C Treated
Hepatitis C is treated using antiviral drugs.
Treatment in the first 6 months focuses on:
- treating symptoms
- preventing the spread of the disease
- preventing complications, such as liver damage
For someone who has the disease beyond 6 months, treatment includes a combination of medications. However, not everyone with this form of hepatitis C will need treatment.
Whether or not you are getting treatment, you can help lower the risk of damage to your liver by:
- avoiding alcohol
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Finding Help For Hepatitis
If youve been diagnosed with viral hepatitis, there are a variety of resources that are available to help you. Lets explore a few of them below:
- Your doctor. Your doctor is a great first point of contact for questions and concerns. They can help you to better understand the type of hepatitis you have, as well as how it will be treated.
- American Liver Foundation . ALF is dedicated to ending liver disease through education, research, and advocacy. Their site has educational material about viral hepatitis, as well as ways to find doctors, support groups, and clinical trials in your area.
- Patient assistance programs. If you have hepatitis C, the cost of antiviral drugs can be high. The good news is that many drug manufacturers have patient assistance programs that can help you pay for these medications.
The chart below is an at-a-glance summary of some of the key differences between hepatitis A, B, and C.
Blood Donations Before September 1991
Since September 1991, all blood donated in the UK is checked for the hepatitis C virus.
There’s a small chance you may have been infected with hepatitis C if:
- you received a blood transfusion or blood products before September 1991
- you received an organ transplant before 1992
Before 1992 donated organs were not routinely screened for hepatitis C and there is a very small risk a donated organ from someone with hepatitis C could spread the infection.
There are blood tests to check for hepatitis C infection
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What Is The Prognosis For Someone Who Has Hepatitis C
You can continue to lead an active life even if you are diagnosed with hepatitis C. People with the disease can work and continue their regular daily activities. However, it is very important that you see a specialist as soon as you are diagnosed with hepatitis C. There are many treatments available that can cure the virus.
To maintain a healthy lifestyle, patients should:
How Does It Affect The Body
The incubation period for hepatitis B can range from . However, not everyone who has acute hepatitis B will experience symptoms.
About 95 percent of adults completely recover from hepatitis B. However, hepatitis B can also become chronic.
The risk of chronic hepatitis B is greatest in those who were exposed to HBV as young children. Many people with chronic hepatitis B dont have symptoms until significant liver damage has occurred.
In some people whove had hepatitis B, the virus can reactivate later on. When this happens, symptoms and liver damage may occur. People with a weakened immune system and those being treated for hepatitis C are at a higher risk for HBV reactivation.
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