CONDITIONS
Hepatitis C infection
Hepatitis C infection
Viral Hepatitis has become increasingly widespread across the world making it a global public health issue. The death rate from viral Hepatitis has been steadily climbing over time with lakhs of deaths per year. These infections directly affect the liver.
Viral Hepatitis is mostly caused by any of the known five viruses, namely Hepatitis A Virus (HAV), Hepatitis B Virus (HBV), Hepatitis C Virus (HCV), Hepatitis D Virus (HDV), and Hepatitis E Virus (HEV). Chronic HCV affects 13 to 15 crore persons worldwide. Chronic infections often last a long time and take some time to be completely cured. In India, the overall percentage of people suffering from HCV are from 0.19% to 53.7%.
The hepatitis C virus affects people in different ways:
Acute hepatitis C: A short-term illness lasting for the first 6 months post virus entering the body. Some people clear the virus on their own post infection.
Chronic hepatitis C: Eighty five percent of the cases with Hepatitis C result into a long-lasting stage (longer than 6 months) called a chronic hepatitis C infection and may lead to serious health problems like liver cancer or cirrhosis.
How is Hepatitis C transmitted?
What are the symptoms of Hepatitis C?
Acute hepatitis C is difficult to diagnose because it rarely causes symptoms. Between 2 weeks to 6 months of the entry of the virus, following symptoms may be noticeable:
- Jaundice (yellowing of eyes and skin)
- Pain in upper tummy
- Dark urine
- Pale-yellow pale grey coloured poop
- Loss of hunger
- An upset stomach
- Vomiting
- Itching
- High temperature (Fever)
- Flu-like symptoms such as fatigue, muscle pain, headache
- Diarrhea or constipation
- Joint pain
Chronic hepatitis C also does not show any symptoms for many years before the virus damages the liver enough to cause them. In addition to the above symptoms, following may be seen:
- Bleeding and bruising easily
- Weight loss.
- Swelling in the legs.
- Fluid buildup in the stomach area, called ascites.
- Confusion, drowsiness and slurred speech, called hepatic encephalopathy
- Spiderlike blood vessels on the skin, called spider angiomas.
What are the causes and risk factors of Hepatitis C?
Hepatitis C is caused by the hepatitis C virus (HCV). The virus enters the bloodstream of a person not affected by it. The infection spreads when the blood, semen is transmitted to another healthy person. This exposure could happen from:
- Sharing injection drugs and needles
- Having sex with infected person or partner
- Accidentally stuck by infected needle (might happen to people who work constantly with needles, etc. like nurses, doctors.)
- Pregnancy – a mother can pass it to a child
- Sharing personal care items like toothbrushes, razor blades, and nail clippers
- Getting a tattoo or piercing with unclean, unsterilized equipment
Hepatitis C does not spread through:
- Breastfeeding (nipples should not be cracked and bleeding)
- Casual contact
- Coughing
- Hugging
- Holding hands
- Kissing
- Mosquito bites
- Sharing eating utensils
- Sharing food or drink
- Sneezing
How is Hepatitis C diagnosed?
Doctor generally checks the blood for:
- Anti-HCV antibodies: These are present if there is hep C virus in the blood. In case if the test is positive, then doctor conducts a HCV RNA test.
It usually takes a few days to a week to get results, though a rapid test is available in some places. The doctor may also advise some Liver function tests to assess liver damage or the presence of liver enzymes in the blood.
How will I tell if I need to undergo Hepatitis Ctest?
Often, the doctors may ask healthy people to undergo these tests because the virus can damage the liver before showing signs and symptoms. People might be advised testing in cases of:
- Pregnancy
- Babies born to hepatitis C infected mothers
- Living with hepatitis B infected person
- Multiple sexual partners
- Indulged in sex with someone with hepatitis B
- Man having sex with a man
- Living with a history of sexually transmitted illness
- Having HIV or hepatitis C or sexually active people about to start taking medicine to prevent HIV
- Having a liver tests with unexplained abnormal results
- Receiving kidney dialysis
- Anyone injecting, snorting or inhaling an illegal drug.
- Are/were in prison
- Health care and emergency workers in contact with blood or been stuck by a needle.
What are the treatment options for Hepatitis C?
There is no recommended treatment for acute hepatitis C. However, if hepatitis C turns into a chronic hepatitis C infection, there are several medications available.
Antiviral medicines: Help in clearing the virus from the body. Treatment goal is to have no hepatitis C virus found in the body post treatment for at least 12 weeks. Depending on the choice of Hepatitis C virus, extent of liver damage, the treatment may be recommended. Interferon, peginterferon, and ribavirin are few drugs used to treat hepatitis C.
Liver transplantation: In case of serious liver damage from chronic hepatitis C infection, the doctor may suggest having a liver transplant as an option. In liver transplant, the surgeon removes the damaged liver and replaces it with a healthy liver.
However, even with the liver transplant, in most cases the hepatitis C infection is not cured, and the infection is likely to return. This means more treatment with antiviral medicines to prevent damage to the new liver.
How can Hepatitis C be prevented?
There’s no vaccine for hepatitis C. But the health care provider will likely recommend vaccines against the hepatitis A and B viruses. These are viruses that also can cause liver damage and make hepatitis C worse.
Remember the following to avoid getting the virus:
- Use a latex condom every time while having sex.
- Don’t share personal items like razors.
- Don’t share needles, syringes, or other equipment when injecting drugs.
- Check if the equipment are sterilized while getting a tattoo, body piercing, or manicure.
Are there any government programs to help with diagnosis and treatment of Hepatitis C?
References
- Kumar D, Peter RM, Joseph A, Kosalram K, Kaur H. Prevalence of viral hepatitis infection in India: A systematic review and meta-analysis. J Educ Health Promot. 2023 Mar 31;12:103.
- Hepatitis C. Mayo Clinic. February 2024. https://www.mayoclinic.org/diseases-conditions/hepatitis-c/symptoms-causes/syc-20354278
- Hepatitis C. WebMD. February 2024. https://www.webmd.com/hepatitis/digestive-diseases-hepatitis-c
- Satsangi S, Dhiman RK. Combating the wrath of viral hepatitis in India. Indian J Med Res. 2016 Jul;144(1):1-5.
