what is hepatitis C?

[salimswati]

Hepatitis C is a serious disease caused by a virus that attacks the liver. The virus, which is called hepatitis C virus (HCV). An estimated 3 percent of the world's population — more than 170 million people — carry a mysterious virus that silently attacks their livers, often without their knowledge. That's because up to 80 percent of those infected with the hepatitis C virus (HCV) have no symptoms at all. In fact, most people don't know they have the disease until decades later when liver damage shows up during routine medical tests.

Hepatitis C is one of six identified hepatitis viruses — the others are A, B, D, E and G. All cause the liver to become inflamed, which interferes with its ability to function. Hepatitis C is generally considered to be among the most serious of these viruses.

Over time, HCV infection can lead to liver cancer, liver failure or cirrhosis — irreversible and potentially fatal scarring of the liver. It ranks second only to alcoholism as a cause of liver disease and is the leading reason for liver transplants in the United States. Unlike HIV, the virus that causes AIDS, HCV usually isn't transmitted through sexual contact. Instead, its primary mode of transmission is contaminated blood — through needles shared by drug users or through blood transfusions. Nearly 4 million Americans have been infected at one time with HCV and close to 3 million are chronically infected.

The encouraging news is that new cases of HCV have declined 80 percent since blood banks began screening for the virus in 1992. At the same time, because standard drug treatments are effective in only about half the people treated, the annual death toll from the disease is expected to triple in the next 10 years.

Although vaccines exist for hepatitis A and B, no vaccine for hepatitis C has been developed, primarily because the virus has many subtypes that change rapidly. Researchers hope to find a medication that will inhibit the growth of the virus and prevent long-term complications, such as cirrhosis and cancer, from developing.

Alternative names

Non-A or non-B hepatitis
Definition

Hepatitis C is an inflammation of the liver caused by infection with the hepatitis C virus.
Causes, incidence, and risk factors

Hepatitis C infection is caused by hepatitis C virus (HCV). Persons who may be at risk for hepatitis C are those who:

Received a blood transfusion prior to July 1992
Received blood, blood products, or solid organs from a donor who has hepatitis C
Injected street drugs or shared a needle with someone who has hepatitis C
Have been on long-term kidney dialysis
Have had frequent workplace contact with blood (for instance, as a healthcare worker)
Have had sex with multiple partners
Have had sex with a person who has hepatitis C
Shared personal items, such as toothbrushes and razors, with someone who has hepatitis C
Were born to hepatitis C infected mother
Other hepatitis virus infections include hepatitis A and hepatitis B.

Symptoms

Many people who are infected with the hepatitis C do not have symptoms. Hepatitis C is often detected during blood tests for a routine physical or other medical procedure. If the infection has been present for many years, the liver may be permanently scarred -- a condition called cirrhosis. In many cases, there may be no symptoms of the disease until cirrhosis has developed.
The following symptoms could occur:

Jaundice
Abdominal pain (right upper abdomen)
Fatigue
Loss of appetite
Nausea and vomiting
Low-grade fever
Pale or clay-colored stools
Dark urine
Generalized itching
Ascites
Bleeding varices (dilated veins in the esophagus)
Signs and tests

Hepatitis virus serology
ELISA assay to detect hepatitis C antibody
Hepatitis C PCR test
Elevated liver enzymes
Liver biopsy shows chronic inflammation
Hepatitis C genotype. Six genotypes are present around the world. Most Americans have genotype 1 infection, which has lower response rates to treatment.
Treatment

Some patients with hepatitis C benefit from treatment with interferon alpha or a combination of interferon alpha and ribavirin.

Interferon alpha is given by injection just under the skin and has a number of side effects, including flu-like symptoms, headaches, fever, fatigue, loss of appetite, nausea, vomiting, depression, and thinning of hair. Treatment with interferon alpha may also interfere with the production of white blood cells and platelets.

Ribavirin is a capsule taken twice daily, and the major side effect is severe anemia (low red blood cells). Ribavirin also causes birth defects. Women should therefore avoid pregnancy during and for 6 months following treatment.

Recently, a version of interferon alpha with a longer half-life (pegylated interferon alpha) was introduced, and the longer half-life means the injections are taken weekly instead of the three times a week with standard interferon alpha. Pegylated interferon alpha and ribavirin lead to a sustained response in approximately 50% of patients.

A sustained response means that the patient remains free of hepatitis C virus 6 months after stopping therapy. Approximately 40% of patients with genotype 1 infection will respond.

Rest may be recommended during the acute phase of the disease when the symptoms are most severe. All patients with hepatitis C should be immunized against hepatitis A and B.

People with hepatitis C should also be careful not to take vitamins, nutritional supplements, or new over-the-counter medications without first discussing it with a doctor. People with hepatitis C should avoid any substances toxic to the liver (hepatotoxic), including alcohol. Even moderate amounts of alcohol speed up the progression of hepatitis C, and alcohol reduces the effectiveness of treatment.

Expectations (prognosis)

Hepatitis C is one of the most common causes of chronic liver disease today. At least 80% of patients with acute hepatitis C ultimately develop chronic liver infection, and 20% to 30% develop cirrhosis. Between 1% and 5% of patients may develop liver cancer.

Complications

Chronic hepatitis
Cirrhosis
Calling your health care provider

Call your provider if symptoms of hepatitis develop, or if you believe you have been exposed to the hepatitis C virus.

Prevention

Avoid contact with blood or blood products whenever possible. Health care workers should practice universal precautions when handling blood and bodily fluids.

Do not inject drugs of abuse, and especially do not share needles with anyone. Be cautious when getting tattoos and body piercings.

Sexual transmission is low among stable, monogamous couples. A partner should be screened for hepatitis C. If the partner is negative, the current recommendations are to make no changes in sexual practices. Individuals having sex outside of a monogamous relationship should practice safer sex behaviors to avoid hepatitis C as well as sexually transmitted diseases, including HIV and hepatitis B.

Currently there is no vaccine for hepatitis C.

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Jazakhallah khair bro - lotsa useful info!