CONDITIONS

What Is Hepatitis C

Hepatitis C is a contagious disease of the liver that can range in severity from a mild illness lasting just a few weeks (acute infection) to a serious, lifelong illness (chronic disease) that attacks the liver.
Hepatitis C results from an infection with the Hepatitis C virus (HCV)-spread primarily via contact with the blood of an infected person.

According to the Centers for Disease Control, viral hepatitis is the leading cause of liver cancer and the most common reason for liver transplantation. The CDC gets case reports electronically from state health departments for the National Notifiable Disease Surveillance System (NNDSS). However, the CDC qualifies the results with this caveat: “Data . . . should be interpreted with the consideration that reported cases of acute or chronic viral hepatitis represent only those relatively few infected persons who were detected, diagnosed, met a stringent case definition, and eventually reported to CDC in 2011”, the most recent year for which statistics are available.

Historically, during the six years the CDC has received data on HCV, about 800 cases have been reported annually. There was, however, a “marked increase of 45% in reported acute HCV infections in 2011 compared with 2010”. The CDC maintains that this change is due to the rising number of HCV infections among adolescents and young adults who inject street drugs. The trend in body piercing may also be a factor. After adjusting for asymptomatic infections and under-reporting, the CDC estimated that 16,600 new HCV infections occurred in 2011.

Chronic HCV infection affects at least 3 million US residents. Since 2007, annual deaths from HCV have exceeded the number of deaths from HIV/AIDS in the United States. The HCV deaths occur most often in patients 45 to 65 years old.

You can learn how to manage your illness by reading about hepatitis C treatment options, prevention methods, and more.

What Causes Hepatitis C

Of the millions of Americans, many of them Boomers, who have hep C, a whopping 80% have no symptoms at all for years and even decades. That’s why testing is so vital in order to get treatment before serious liver damage occurs.

However, certain people do have some or all of the following symptoms:

  • Chronic fatigue in spite of getting enough sleep
  • Not feeling much like eating because of a loss of appetite
  • Jaundice, a yellow discoloration of the skin, mucus membranes (tissue including that which lines the mouth), and whites of the eyes due to liver damage
  • Dark urine
  • Stools that are chalky-colored.
  • Stools that are loose
  • Abdominal pain
  • Generalized aches and pains
  • Rashes that itch (urticaria)
  • Hives
  • Pain in joints
  • A sudden distaste for cigarettes, which is a good development for smokers!
  • Intermittent or fairly constant nausea
  • Bouts of vomiting

Chronic hepatitis C infections may exacerbate some of the above symptoms, including:

  • An overall feeling of weakness
  • Severe fatigue to the point of not being able to carry out normal activities
  • Extreme loss of appetite and with it the danger of losing too much weight and becoming frail.

A chronic hepatitis C infection that is left untreated may advance to serious complications, including:

  • Cirrhosis of the liver, which is scarring of the organ.
  • Progressive liver failure.
  • An increased risk of liver cancer.

Risk Factors For Hepatitis C

To reiterate in digest fashion, these are the factors that raise your risk of a Hepatitis C infection:

  • Having a blood transfusion or organ transplant prior to 1992.
  • Getting blood clotting products prior 1987.
  • Being on long-term kidney dialysis treatment, which may mean contact with contaminated machines.
  • Getting a tattoo at an unlicensed parlor.
  • Having body piercing done at an unlicensed establishment.
  • Sharing needles or straws to inject or inhale illicit drugs.
  • Having sex with partners who have hepatitis C when skin is broken.

Diagnosing Hepatitis C

Your PCP can do the initial testing, but you will probably be referred to a hepatologist – a specialist in liver diseases. Be prepared with a written list of your symptoms, if any, as well as information about your medical history and possible risk factors. Consider bringing a buddy along to help you give information and ask questions in case you get flustered in the presence of a white coat! The physician will do a physical exam, including certain tests:

  • Blood tests to look for hepatitis C antibodies that your body may have made in an attempt to fight HCV, as well as genetic material from the virus that would be a clue to the fact that you harbor HCV.
  • Liver function studies in order to find out how well your liver is functioning. You may need periodic follow-up studies to assess whether more damage is being done.
  • An ultrasound of the liver, which is another way of assessing liver damage.
  • A liver biopsy, which is the excision of small sample of the organ to be sent to a laboratory for testing.

Symptoms of Hepatitis C

Of the millions of Americans, many of them Boomers, who have hep C, nearly 80% have no symptoms at all for years and even decades. That’s why testing is so vital in order to get treatment before serious liver damage occurs.
However, certain people do have some or all of the following symptoms:

  • Chronic fatigue in spite of getting enough sleep
  • Not feeling much like eating because of a loss of appetite
  • Jaundice, a yellow discoloration of the skin, mucus membranes (tissue including that which lines the mouth), and whites of the eyes due to liver damage
  • Dark urine
  • Stools that are chalky-colored.
  • Stools that are loose
  • Abdominal pain
  • Generalized aches and pains
  • Rashes that itch (urticaria)
  • Hives
  • Pain in joints
  • A sudden distaste for cigarettes, which is a good development for smokers!
  • Intermittent or fairly constant nausea
  • Bouts of vomiting

Chronic hepatitis C infections may exacerbate some of the above symptoms, including:

  • An overall feeling of weakness
  • Severe fatigue to the point of not being able to carry out normal activities
  • Extreme loss of appetite and with it the danger of losing too much weight and becoming frail.

A chronic hepatitis C infection that is left untreated may advance to serious complications, including:

  • Cirrhosis of the liver, which is scarring of the organ.
  • Progressive liver failure.
  • An increased risk of liver cancer.

Prognosis

People with hepatitis C can live a normal life span of seventy or eighty years with proper medical care and self care. The main keys to survival are adhering without fail to any medication schedule and avoiding all alcohol because it damages the liver. However, a liver transplant may be necessary if serious damage has already taken place. Even if that is the case, though, taking antivirals and anti-rejection drugs as prescribed can mean a long and relatively healthy life.

MedlinePlus, a service of the National Institutes for Health, reports that hepatitis C patients with genotype 2 or 3 are more likely to respond to treatment than those with genotype 1. A genotype is a virus classification based on material in the RNA (Ribonucleic acid). With proper treatment, increasing numbers of patients are able to live a normal lifespan with no serious liver damage.

According to research done at the University of Dusseldorf in Germany and published in the peer-reviewed journal Hepatology with the title “Prognosis of chronic hepatitis C: results of a large, prospective cohort study”, hepatitis C increased the risk of death mainly when cirrhosis was present and in patients who were younger than 50 at the beginning of the study. The authors wrote: “Patients who acquire the infection early in life have a markedly increased mortality even when cirrhosis is absent at diagnosis. The age at diagnosis therefore should play a major role in therapeutic considerations.”

The World Health Organization (WHO) reports that about 5% of people infected with the hep C virus may die from the consequences of long term infection, such as liver cancer or cirrhosis. As for the course of acute hep C infections, WHO reports that 15%-25% of patients resolve their infection without any residual effects. However, acute infections may also progress to chronic disease, which is why screening is so vital even if no symptoms are present. About 60% to 80% of people who have chronic hepatitis C have no symptoms until liver damage has already occurred.

Living With Hepatitis C

A healthy lifestyle is essential in order to feel your best with hepatitis C.

  • Eat plenty of fruits and veggies, choose lean protein such as fish or chicken, limit red meat, avoid all or most foods high is sugar and fat, and stay away from processed products as well as fast food. This diet should help you maintain a healthy weight.
  • Get plenty of rest.
  • Drink lots of water.
  • Stick with a regular exercise regimen. There’s no need to go to the gym. A simple routine of mall walking with friends three times a week will do the trick!
  • Don’t shy away from the social support and contact you need in order to keep from feeling isolated and perhaps even becoming depressed. You are not putting your family and friends at risk of contracting hep C just by getting together with them for the emotional connections that can boost your mood and help you keep your resolve to do all you can to live well with your hep C.

Screening

Health experts’ recommendations for hepatitis C screening differ according to the individual patient. The federal Centers for Disease Control (CDC) recommends routine screening for several groups of people. Here is the agency’s list for routine screening. It includes people who:

  • currently inject drugs
  • ever injected drugs, including those who injected once or a few times many years ago
  • are infected with HIV
  • received clotting factor concentrates produced before 1987
  • were ever on long-term hemodialysis
  • show persistently abnormal alanine aminotransferase levels (ALT). Abormal levels suggest liver damage.
  • were prior recipients of transfusions or organ transplants. These include people who were notified that they got blood from a donor who later tested positive for the hepatitis C virus.
  • who received a transfusion of blood, blood components or an organ transplant before July 1992
  • healthcare, emergency medical, and public safety workers who have had injuries from needle sticks or sharps, or mucosal exposures to HCV-positive blood
  • children born to women with the hepatitis C virus

The CDC also recommends a one-time screening for a much larger group of people: everyone born between 1945 and 1965. More than 75 percent of adults infected are Baby Boomers. The reason for this isn’t exactly known, although it may be that these patients received contaminated blood or blood products before the blood system began to be screened in the 1990s.

According to the CDC, health care providers use several different blood tests in determining whether the hepatitis C virus is present. The federal Department of Veterans Affairs classifies the tests as either “serologic assays” (blood tests) or procedures that analyze HCV RNA in an infected individual. The VA says these procedures are called “hepatitis C viral load” and “hepatitis C genotype” tests. There are six genotypes for the hepatitis C virus.

Usually, a patient will first get a screening test that will show whether he or she has developed antibodies to the Hepatitis C virus. (An antibody is a substance found in the blood that the body produces in response to a virus.) Having a positive antibody test means that a person was exposed to the virus at some time in his or her life. If the antibody test is positive, a doctor will most likely order a second test to confirm whether the virus is still present in the person’s bloodstream.

In the most serious cases, patients will undergo a liver biopsy so physicians can assess the extent of damage to that organ.

Prevention

While there’s no vaccine to guard against hepatitis C, you can protect yourself in a number of ways. The National Institute of Allergy and Infectious Diseases has these suggestions:

  • Don’t share personal care items that might have blood on them, such as razors or toothbrushes
  • Avoid injected drugs or, for drug users, enter a treatment program
  • Never share needles, syringes, water, or “works” (equipment for intravenous drug use) and get vaccinated against hepatitis A and hepatitis B if you are a drug user
  • Consider the risks of getting tattoos or body piercings. You can get infected if the tools have someone else’s blood on them or if the artist or piercer does not follow good health practices.
  • Don’t donate blood, organs, or tissue if you have hepatitis C

Medication And Treatment

According to the American Liver Foundation (ALF), treatment for hepatitis C depends on a number of factors:

  • How much of the virus is in your body (that’s also known as “viral load”)
  • The genotype or variant of Hep C you have
  • Whether you have liver damage, such as cirrhosis
  • Any other health conditions you have
  • Response to any previous hepatitis C treatment

Treatment also varies, the ALF says, depending on the type of hepatitis C you have:

Acute (short-term) Hepatitis C – Most people with an acute (short-term) infection may not be treated at all. Sometimes doctors recommend bed rest, fluids, eating well and avoiding alcohol. But you have to see your doctor regularly for tests to make sure that your body has fully recovered.

Chronic (long-term) Hepatitis C – If you’ve taken blood tests and had a liver biopsy that indicates you have a chronic infection with liver damage, you’ll be treated with antiviral medicines.

But if the blood tests and biopsy show that you have a chronic infection but no damage to your liver, the ALA says immediate treatment may not be necessary.

In the most serious cases of Hepatitis C, the patient may get a liver transplant.

Complementary and Alternative Treatment

While dietary supplements like milk thistle and licorice, have been recommended by alternative – medicine advocates as good treatments for hepatitis C, the consensus among health experts is that there is no supplement or vitamin that will help treat the illness. One so – called remedy, colloidal silver, is even deemed harmful by the FDA. Colloidal silver has been linked to central nervous system problems and is said to cause an irreversible bluish – gray discoloration of the skin if used long enough. Other supplements, such as kombucha and senna, may be harmful as well.

According to the National Center for Complementary and Alternative Medicine (NCCAM), part of the National Institutes of Health, milk thistle, a popular supplement, has been shown in studies to have no greater effect than a placebo. “Other supplements have been studied for hepatitis C,” the NCCAM said in a statement, “but overall, no benefits have been clearly demonstrated.” These supplements include the following:

  • Probiotics
  • Zinc
  • Licorice
  • SAM – e

But there are some steps outside of conventional medicine that can help patients feel better by improving their quality of life. Experts on hepatitis C suggest that you eat a healthy diet, maintain a normal weight and avoid alcohol, since it damages the liver. Be sure to stay hydrated, drinking from six to eight glasses of water per day. Additionally, you can de – stress via yoga, meditation or exercise such as walking. Ask your doctor what kind of exercise is right for you. Finally, connect with others via patient support groups where others will understand what you’re going through.

Care Guide

There’s no doubt that hepatitis C is a discouraging and difficult condition. But it is possible to have a good quality of life by following these expert suggestions from the U.S. Department of Veterans’ Affairs (VA):

Eat well. Your diet should be rich in whole grains as well as fresh fruits and vegetables. Make sure you get enough protein from low-fat dairy products, lean meat, soy nuts, or eggs. And stay hydrated.

Maintain a good weight. It’s especially important to avoid being overweight, since that condition can add fatty tissue to your liver.

Manage your pain. Patients may experience joint pain due to proteins in the blood. Antiviral treatment may alleviate this. It’s important to remember, though, that increased pain doesn’t mean your condition is getting worse. And some of your pain may be related to side effects from your medication, not from the illness itself. Talk with your doctor about the best method of pain relief for you.

Don’t ignore your mental health. Strong emotions such as fear or anger are natural after being diagnosed with hepatitis C. You may also become depressed. Don’t ignore these feelings, since they may make you more inclined to ignore your physical health as well. Talk with your doctor about the best way to handle these issues, including antidepressant therapy and attending support groups.
Know your sexual risks. If you have been in a long-time monogamous relationship, and your partner doesn’t have hepatitis C, there’s no need to change your sex life, the VA says. If you are worried nonetheless, use latex condoms. People who have more than one sex partner should reduce the number of their partners and use latex condoms as part of a safer-sex practice.

There’s no definitive finding on whether the virus can be spread through oral or anal sex, though it’s likely than anal sex is the riskier of the two. There’s no risk of spreading the virus via hugging or kissing.

When To Contact A Doctor

Unfortunately, it’s possible to have hepatitis C without knowing it. But there are symptoms that can reveal its presence. The federal Centers for Disease Control (CDC) lists these:

  • Fever
  • Fatigue
  • Loss of appetite
  • Nausea
  • Vomiting
  • Abdominal pain
  • Dark urine
  • Clay-colored bowel movements
  • Joint pain
  • Jaundice (yellow color in the skin or eyes)

These symptoms, for acute hepatitis C, usually appear within six to seven weeks after exposure. People with chronic (long-term) hepatitis C may also show signs of liver problems before they are diagnosed.

If you have these symptoms, contact your healthcare practitioner immediately so you can get tested.

Questions For A Doctor

Even the bravest people can get nervous when health is at stake! Consider bringing your spouse or a close friend else with you when you go to the doctor. You can rely on the person who’s with to help you get all the information you need. Also, be sure to write down your questions ahead of time and print them out or carry your tablet with you, and take notes while the doctors is answering your questions, or have your friend od that so you can maintain eye contact with the doctor.

Some questions you may want to ask about hepatitis C:

  • How could I have become infected with HCV?
  • Are there any medications or over-the-counter products I should avoid because my HCV?
  • Is there a chance I could spread the virus to other people?
  • What are some symptoms I might notice?
  • What treatments do you recommend?
  • Is it safe for me to get pregnant?
  • Do I need protection for my sexual partner?
  • Do I need to avoid alcohol?
  • Can I exercise?
  • Can my hepatitis be cured?
  • Will it become a chronic problem?
  • How much damage is there to my liver?
  • Do I need a liver transplant?

Resources

American Liver Foundation
This nonprofit group is dedicated to the prevention, treatment and cure of liver diseases. Their website has crucial information for patients as well as a directory of hepatitis clinical trials.

HCV Advocate
An organization that focuses on education, advocacy, and support.

Hepatitis C Association
This group aims to provide emotional support for patients. It has a toll-free support line.

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