Hepatitis C symptoms, signs and other features of the disease are different from other forms of hepatitis. Just symptoms and signs are not obvious clues of the disease. Therefore, insight is required to suspect it and seek help.
What is hepatitis C?
Hepatitis C is chronic inflammation and infection of liver cells caused by the hepatitis C virus. Unlike hepatitis A and B the immune system oftentimes does not eradicate the hepatitis C pathogen. Thus, it takes up permanent residence within the body. Hep C is a shortened term for the virus itself or the chronic liver disease it causes. HCV is an abbreviation for the hepatitis C virus.
Even though the primary pathology is liver inflammation, the remote effects of long-standing infection are most dire. They are the increased risks of cirrhosis and hepatocellular carcinoma (a form of liver cancer). To date, cirrhosis due to HCV is the leading cause of liver transplants in the United States. It accounts for almost 40% of all liver transplants in adults. Recent studies show that there is a threefold increase in the incidence of liver cancer in individuals who have had the infection for two to four decades.
Signs and symptoms of hepatitis C
Early on, some individuals with hepatitis C infection may have flulike symptoms, but most don’t report any hepatitis C symptoms or signs in the early stage of the disease. The most common chronic symptom that individuals with HCV report is fatigue. Other symptoms that might occur in the later stages of the disease include mild fever, loss of appetite, abdominal pain, nausea, vomiting, muscle aches, and joint aches. Unlike hepatitis A and B, it usually does not cause the classic sign of jaundice. Later on as liver scarring occurs and cirrhosis develops it might cause varying degrees of jaundice, light-colored stools, dark urine, alteration of mental status, or other signs of cirrhosis.
How do you get hep C?
Commonly asked questions are – how is hep C transmitted, and is it contagious. To answer both questions, transmission occurs for the most part by the blood of an infected individual coming in contact with the flowing blood of an uninfected one. Hence the most common means of transmission and risk factors for obtaining it are the following:
- Intravenous drug use using a shared needle
- Getting an unregulated tattoo
- Body piercing with unsterilized instruments
- Long-term hemodialysis
- Childbirth by an infected mother
- Other exposures of broken skin to someone else’s blood
Except during sexual intercourse, exposure to other body fluids does not appear to be a means of contracting hep C. Despite evidence of sexual spread one study showed that transmission of the virus occurs in one out of every 190,000 instances of sexual contact. The number of sexual partners and types of sexual practices of course, influence the incidence of sexual transmission though.
Prior to 1992 the receipt of a blood transfusion was a very common way of getting hepatitis C. The reason is prior to that time there was no blood test for making the diagnosis. Thus, there was no knowledge of the existence of the virus. Because screening procedures for donated blood now exist blood transfusion is no longer an important source of HCV infection. Because blood transfusion was a prior common source of transmission, hepatitis C infection is currently most prevalent in persons born between 1945 and 1965. According to data from 1999 to 2008 about 75% of patients in the United States with hep C were born during that time frame. For this reason, The US Preventive Services Task Force recommends that all baby boomers with prior or current risks factors undergo HCV screening.
New hep C treatment
Many have posed the question – is hepatitis C curable? Prior to 2011 the answer was sometimes, depending on the genotype (genetic makeup) of the infecting virus. But that has changed. To date there are six different groupings that are based on the genetic strains of the hepatitis C virus. They are genotypes 1, 2, 3, 4, 5 and 6. Since 2011 with the arrival of new medications which continue to evolve, more genotypes are curable and the cure rates are higher. Because of the variable strains of HCV due to mutations (changes in the genetic makeup) a vaccine for hep C is difficult to develop and does not exist at this time. Therefore, research has focused on developing drugs to treat the disease.
The standard treatment prior to the arrival of these new drugs consisted of a combination of a weekly injection and a daily oral tablet. The problem with that regimen though is it cannot cure many of the genotypes and has significant side effects. With the development of newer medications there are now treatment options that don’t require an injection and side effects from the drugs are not as serious. Additionally, more genotypes are curable and the cure rates are higher. As more drugs are emerging the treatment and cure of hep C looks very promising. The biggest obstacle at this point though is cost.