hepatitis c

Hepatitis C is one of several viruses that can attack and infect the liver making patients progressively sicker over time. HCV, like all virus, cannot reproduce on its own and so must hijack your cells to replicate its genetic material. The infected cells burst and this allows for further spread of the infection. Most of the time, the immune system is able to mount a response to viruses but in the case of hepatitis C, about 80% of people infected develop a chronic infection. It is the body’s inflammatory response in trying to eradicate the virus that leads to liver scarring over decades.

In general terms, any inflammation of the liver (whether due to alcohol, drugs, lack of blood flow, or virus) is termed “Hepatitis”. After a brief period of muscle aches and fever, most people live with the virus for many years without symptoms. It can be decades before other symptoms develop. During this period, the only alert you might have to the disease are some elevations in your liver panel/bloodwork (ALT and AST, enzymes on the surface of the liver cells) or perhaps a letter from the Red Cross after to attempting to donate blood.

About 2.4 million people in the US (1% of the population) are estimated to have this infection and 71 million people worldwide. Because it can act silently, most people have no symptoms for many years after the initial flu like presentation. Late complications of the chronic infection can produce:

• Confusion and brain fog (hepatic encephalopathy)
• Yellow eyes and skin (icterus/jaundice)
• Sleep disturbance/insomnia
• Breath changes (hepatic fetor)
• Weight gain and fluid around the intestines/ankle swelling
• Easy bruising or bleeding (from lack of clotting factors and low platelets)
• Weight loss and malnutrition with swelling in the intestine and less absorption of nutrients.
• Changes in the color of your stool-- turning pale or even silver.

About 20% of patients infected with Hepatitis C will develop cirrhosis. Cirrhosis is another term for severe, end-stage scarring of the liver. The damage can produce a fertile environment for the development of liver cancer. If you have cirrhosis, your physician may want to check periodically for the growth of masses in the liver. The scarring also makes the HCV harder to treat. Longer duration therapy may be required.

Most infections are secondary to “risky behaviors” in peoples lives in their 20’s-40’s—the “sow your oats” decades, but in some patients we can find NO risk factors. Those at high risk include individuals who identify with one of the following:

• Injected drugs or shared needles with other individuals
• Shared apparatus for snorting cocaine (blood exposure from nosebleeds)
• Unprotected sex with multiple partners
• Have HIV or AIDS
• Sharing hygiene or grooming items like razors, toothbrushes, nail files or clippers with infected individuals
• Obtaining tattoos or body piercings in a non-sterile environment
• Accidental needle sticks for health workers
• Received a blood transfusion before 1990
• On hemodialysis for kidney failure
• If your mother had active Hepatitis C

All individuals over the age of 18. Individuals who have elevated liver function results from a blood test should also be tested for HCV.

Most insurances will pay for a screening test for individuals who meet any (or all) of the above categories.

The screening test is for the Hepatitis C antibody. If this is positive, another test will be done to check the HCV viral load (to see if you’re part of the 20% of people who were able to defeat the virus) and check for the subtype of hepatitis or genotype.

Call Anderson Digestive Health Center at 601-553-6515 to schedule an appointment if you need to be evaluated/treated for a positive test.

If you are concerned and cannot pay for the test, Anderson Region Medical Center may be able to provide you financial assistance.

Immediate changes you can make to help this condition include weight loss, since fat infiltration in the liver can accelerate damage caused by the virus.

Discontinuation of any alcoholic beverage will also benefit the liver. Alcohol accelerates the damage to the liver caused by this virus. The antiviral agents also seem to be less effective when alcohol exposure continues during treatment.

Get plenty of rest and hydrate aggressively.

Older drugs have been largely replaced by the direct acting antiviral agents, boosting the cure rate in the vast majority of individuals from 50% to greater than 95%, provided the patient completes their course.

Side effects from the newer medication have improved as well with less anemia, fatigue, depression, and immunosuppression.

If the cirrhosis becomes very advanced, also described as decompensated, the patient may be referred to a transplant center for evaluation. Hepatitis C is the most common indication for transplant in the United States.

Click the following links:

• The Hepatitis Foundation
• AASLD/American Liver foundation website
• Center for Disease Control Website
• National Prevention Information Network – the Hepatitis C Connection