HEPATITIS C

INTRODUCTION

Hepatitis C in an infection of the liver caused by HCV (hepatitis C virus), which leads to inflammation and infection of the liver. It is the leading cause of liver cirrhosis, and according to WHO estimates, >3% people of the total world population are currently infected with HCV.

Hepatitis C spreads via blood. Hence, it can be acquired from another person through sharing needles in drug abuse, through sexual intercourse, during birth from an infected mother to the child while passing through the birth canal, and through accidental needle stick injury (commonly in healthcare professionals). There is a minimal risk of the disease spreading through saliva, therefore, sharing food with an infected person, kissing etc while are better avoided, still present a very small risk of transferring the virus.

SIGNS AND SYMPTOMS

Initially there may be little to no symptoms in a patient. Early manifestations of Hepatitis C are from outside the liver. They include tingling sensation in limbs, muscle aches and pains, itching, dryness of skin, and loss of nerve function in periphery. Patients may also present with stomach pain, yellowing of skin (which will worsen once the disease progresses), loss of appetite and fatigue.

Symptoms of complicated/advanced disease are the following:

abdominal distension due to ascites

mental status changes

blood in vomiting or stool due to varices ( dilated blood vessels in the oesophagus due to increased pressure within the body)

ankle swelling

As the disease progresses, Hepatitis C can lead to severe liver damage, often resulting in liver cirrhosis.

CAUSES AND RISK FACTORS

The virus is spread from person to person through contact with blood. People who use intravenous (IV) drugs can get hepatitis C when they share needles with someone who has the virus. Health care workers (such as nurses, lab technicians, and doctors) can get these infections if they are accidentally stuck with a needle that was used on an infected patient. You are also at a higher risk if you got a blood transfusion or an organ transplant before 1992 (improvements in blood-screening technology were made in 1992).

Contrary to popular belief, hepatitis C can not be spread through casual contact such as touching, kissing, sneezing or sharing utensils, swimming in the same pool, or touching other items of use by the infected person.

MANAGEMENT

The standard method of treatment for hepatitis C is a combination of antiviral medications. While there is no definitive cure yet, >50% of the people see an improvement in their symptoms after using on market medications for a year. Patients with acute hepatitis C (active infection) respond excellently to 6 months of therapy with Interferon (IFN).

Management of symptoms from long term hepatitis C is a bit different as often times these patients have associated complications of the disease because of late presentation. Priority of treatment is given to patients with fibrosis, compensated liver cirrhosis, and those with severe extra-hepatic signs and symptoms.

Recently, IFN is used in conjuction with Ribavarin, another anitviral drug which has drastically improved morbidity and mortality in hepatitis C patients.

Patients also strongly benefit from liver transplant, more of which can be read about here.

Dr. Annie

Physician, mom and wife

One thought on “HEPATITIS C

  • May 20, 2017 at 1:24 pm
    Permalink

    Learning a ton from these neat arlteics.

    Reply

Leave a Reply

Your email address will not be published. Required fields are marked *