Disease: Hepatitis C

Overview

Hepatitis C is a viral infection that causes liver inflammation, sometimes leading to serious liver damage. The hepatitis C virus (HCV) spreads through contaminated blood.

Until recently, hepatitis C treatment required weekly injections and oral medications that many HCV-infected people couldn't take because of other health problems or unacceptable side effects.

That's changing. Today, chronic HCV is usually curable with oral medications taken every day for two to six months. Still, about half of people with HCV don't know they're infected, mainly because they have no symptoms, which can take decades to appear. For that reason, the U.S. Centers for Disease Control and Prevention recommends a one-time screening blood test for everyone at increased risk of the infection. The largest group at risk includes everyone born between 1945 and 1965 — a population five times more likely to be infected than those born in other years.

Source: http://www.mayoclinic.com

Symptoms

Long-term infection with the hepatitis C virus (HCV) is known as chronic hepatitis C. Chronic hepatitis C is usually a "silent" infection for many years, until the virus damages the liver enough to cause the signs and symptoms of liver disease. Among these signs and symptoms are:

  • Bleeding easily
  • Bruising easily
  • Fatigue
  • Poor appetite
  • Yellow discoloration of the skin and eyes (jaundice)
  • Dark-colored urine
  • Itchy skin
  • Fluid buildup in your abdomen (ascites)
  • Swelling in your legs
  • Weight loss
  • Confusion, drowsiness and slurred speech (hepatic encephalopathy)
  • Spider-like blood vessels on your skin (spider angiomas)

Every chronic hepatitis C infection starts with an acute phase. Acute hepatitis C usually goes undiagnosed because it rarely causes symptoms. When signs and symptoms are present, they may include jaundice, along with fatigue, nausea, fever and muscle aches. Acute symptoms appear one to three months after exposure to the virus and last two weeks to three months.

Acute hepatitis C infection doesn't always become chronic. Some people clear HCV from their bodies after the acute phase, an outcome known as spontaneous viral clearance. In studies of people diagnosed with acute HCV, rates of spontaneous viral clearance have varied from 14 to 50 percent. Acute hepatitis C also responds well to antiviral therapy.

Source: http://www.mayoclinic.com

Causes

Hepatitis C infection is caused by the hepatitis C virus. The infection spreads when blood contaminated with the virus enters the bloodstream of an uninfected person.

Globally, HCV exists in several distinct forms, known as genotypes. The most common HCV genotype in North America and Europe is type 1. Type 2 also occurs in the United States and Europe, but is less common than type 1. Both type 1 and type 2 have also spread through much of the world, although other genotypes cause a majority of infections in the Middle East, Asia and Africa.

Although chronic hepatitis C follows a similar course regardless of the genotype of the infecting virus, treatment recommendations vary depending on viral genotype.

Source: http://www.mayoclinic.com

Diagnosis

Screening for hepatitis C

Health officials recommend that anyone at high risk of exposure to HCV get a blood test to screen for hepatitis C infection. People who may want to talk to their doctors about screening for hepatitis C include:

  • Anyone who has ever injected or inhaled illicit drugs
  • Anyone who has abnormal liver function test results with no identified cause
  • Babies born to mothers with hepatitis C
  • Health care and emergency workers who have been exposed to blood or accidental needle sticks
  • People with hemophilia who were treated with clotting factors before 1987
  • People who have ever undergone long-term hemodialysis treatments
  • People who received blood transfusions or organ transplants before 1992
  • Sexual partners of anyone diagnosed with hepatitis C infection
  • People with HIV infection
  • Anyone born from 1945 to 1965
  • Anyone who has been in prison

Other blood tests

If an initial blood test shows that you have hepatitis C, additional blood tests will:

  • Measure the quantity of the hepatitis C virus in your blood (viral load)
  • Identify the genotype of the virus

Tests for liver damage

Doctors typically use one or more of the following tests to assess liver damage in chronic hepatitis C.

  • Magnetic resonance elastography (MRE). A noninvasive alternative to a liver biopsy (see below), MRE combines magnetic resonance imaging technology with patterns formed by sound waves bouncing off the liver to create a visual map showing gradients of stiffness throughout the liver. Stiff liver tissue indicates the presence of fibrosis, or scarring of the liver, as a result of chronic hepatitis C.
  • Transient elastography. Another noninvasive test, transient elastography is a type of ultrasound that transmits vibrations into the liver and measures the speed of their dispersal through liver tissue to estimate its stiffness.
  • Liver biopsy. Typically done using ultrasound guidance, this test involves inserting a thin needle through the abdominal wall to remove a small sample of liver tissue for laboratory testing.

Source: http://www.mayoclinic.com

Complications

Hepatitis C infection that continues over many years can cause significant complications, such as:

  • Scarring of the liver (cirrhosis). After 20 to 30 years of hepatitis C infection, cirrhosis may occur. Scarring in your liver makes it difficult for your liver to function.
  • Liver cancer. A small number of people with hepatitis C infection may develop liver cancer.
  • Liver failure. Advanced cirrhosis may cause your liver to stop functioning.

Source: http://www.mayoclinic.com

Prevention

Protect yourself from hepatitis C infection by taking the following precautions:

  • Stop using illicit drugs, particularly if you inject them. If you use illicit drugs, seek help.
  • Be cautious about body piercing and tattooing. If you choose to undergo piercing or tattooing, look for a reputable shop. Ask questions beforehand about how the equipment is cleaned. Make sure the employees use sterile needles. If employees won't answer your questions, look for another shop.
  • Practice safer sex. Don't engage in unprotected sex with multiple partners or with any partner whose health status is uncertain. Sexual transmission between monogamous couples may occur, but the risk is low.

Source: http://www.mayoclinic.com

Lifestyle and home remedies

If you receive a diagnosis of hepatitis C, your doctor will likely recommend certain lifestyle changes. These measures will help keep you healthy longer and protect the health of others as well:

  • Stop drinking alcohol. Alcohol speeds the progression of liver disease.
  • Avoid medications that may cause liver damage. Review your medications with your doctor, including over-the-counter medications you take as well as herbal preparations and dietary supplements. Your doctor may recommend avoiding certain medications.
  • Help prevent others from coming in contact with your blood. Cover any wounds you have and don't share razors or toothbrushes. Don't donate blood, body organs or semen, and advise health care workers that you have the virus. Also tell your partner about your infection before you have sex, and always use condoms during intercourse.

Source: http://www.mayoclinic.com

Risk factors

Your risk of hepatitis C infection is increased if you:

  • Are a health care worker who has been exposed to infected blood, which may happen if an infected needle pierces your skin
  • Have ever injected or inhaled illicit drugs
  • Have HIV
  • Received a piercing or tattoo in an unclean environment using unsterile equipment
  • Received a blood transfusion or organ transplant before 1992
  • Received clotting factor concentrates before 1987
  • Received hemodialysis treatments for a long period of time
  • Were born to a woman with a hepatitis C infection
  • Were ever in prison
  • Were born between 1945 and 1965, the age group with the highest incidence of hepatitis C infection

Source: http://www.mayoclinic.com

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