Hepatitis C is the liver disease caused by the hepatitis C virus (HCV) which was first identified in 1989. HCV is spread by direct contact with the blood or body fluids of an infected person. Previously known as "non-A or non-B hepatitis," hepatitis C differs from hepatitis A which is spread through eating or drinking contaminated food or water and hepatitis B is caused by an entirely different virus, which is also spread through blood contact with blood or body fluids of an infected person.
Some people are more likely to contract hepatitis C than others. People at risk for hepatitis C include the following:
The most common means of transmission is through injection drug use, even if drug use was many years ago or happened only once. Sharing needles or any drug-related equipment is enough to spread hepatitis C. The only way to avoid being exposed to HCV in this way is by not sharing needles!
Another way of getting hepatitis C is through a blood transfusion from a donor who has hepatitis C - especially for those people who received a blood transfusion prior to 1990. In 1998, the risk of getting HCV infection in this way is virtually zero (less than 1 in 200,000), because of precautions taken in screening donors and blood units.
Activities such as tattooing and body piercing, which may be performed without sterile precautions, or sharing toothbrushes or razors with an infected person can also spread the hepatitis C virus. The risk of getting HCV infection through ordinary household or workplace interactions is extremely low.
At this time, it is believed that transmission of HCV by sexual means - either heterosexual or homosexual - is rare (approximately 1% to 3%). In spite of the low risk, long-term monogamous couples must decide for themselves about routine condom use. They should avoid unprotected intercourse during menstrual periods if the woman is HCV - positive. People with multiple sexual partners should always practise safe sex, not only to decrease the small risk of hepatitis C virus transmission, but to minimize the risk of acquiring other infections.
The limited evidence to date suggests that it is possible for pregnant women with hepatitis C to transmit the infection to the baby in the womb or at the time of birth (approximately a 5% to 10% risk). Current evidence suggests that breastfeeding does not appear to transmit HCV and may be permitted.
Many people with hepatitis C experience no symptoms at all and may feel quite healthy. Others may develop fatigue, jaundice - or yellowing - of the eyes and skin, and loss of appetite.
Most people infected with HCV are unaware they have it and can carry it unknowingly for decades. Only a blood test can detect hepatitis C virus infection. If you think you may have been exposed to HCV through high-risk behaviour, major surgery, a blood transfusion or blood products and are concerned, you should see your physician and discuss whether or not you should be tested.
If you test positive for antibodies to HCV, then your physician should do a follow-up blood test to see whether actual viral material can be found in your blood, along with blood tests to check the state of your liver. Some people with HCV infection have a mild, brief disease and get rid of the virus completely. In this case, the antibodies to HCV usually remain detectable in the blood but the actual viral material does not. It is currently believed, however, that most people who get hepatitis C will have HCV infection for a long time, and possibly for the rest of their lives.
It is important for people living with hepatitis C to implement lifestyle changes, including:
A second infection by either hepatitis A virus or hepatitis B virus can cause your liver disease to become worse. All hepatitis C infected individuals should be immunized against both hepatitis A and B. Various hepatitis vaccines are available to make immunization fit the needs of the individual patient.
For those whose hepatitis C is more advanced, drug treatment may be appropriate and must be administered after careful assessment by your physician. Currently only one drug - interferon - alpha - is licensed for the treatment of hepatitis C. Various types of interferon - alpha are available. The best treatment strategy may be to use two anti-viral drugs together. Recent studies indicate that a combination of anti-viral drugs (interferon-alpha 2b plus ribavirin) is more effective than interferon-alpha 2b alone. New drugs are being developed. No herbal remedies have been shown to be useful.
Most people with chronic hepatitis C feel well for many years. However, chronic hepatitis C can lead to cirrhosis, which is scarring of the liver. This occurs in approximately 20% of patients and usually takes years to develop. In severe cases, however, hepatitis C may lead to liver cancer or death. For these patients liver transplantation may be the best treatment.
People who have been diagnosed with hepatitis C need not become socially isolated, but the following are common-sense precautions that should be taken to prevent spreading the virus:
For further information please use the links at the top of the page.
Steph
ZuniZoni@aol.com
Feb. 9, 1999
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