Chronic Hepatitis C is caused by the Hepatitis C virus and usually is a “silent” illness until cirrhosis develops with problems associated with end stage liver disease. It is uncommon for Hepatitis C to be diagnosed in the acute stage. The presence of chronic Hepatitis C is usually detected “accidentally” when serving as a blood donor of when having routine laboratory tests, as part of a physical, and abnormal liver function tests are noted.
Who gets it?
Approximately 4 million individuals in the U.S. have been exposed to the Hepatitis C virus and approximately 3 million individuals have chronic infection. Of these 3 million individuals with chronic infection, approximately 20-25% will develop cirrhosis unless they are successfully treated. Worldwide, over 200 million individuals have been exposed to Hepatitis C virus.
The most common way and individual acquires Hepatitis C virus is through blood transfusions prior to 1990 (prior to 1990, the blood banks were unable to screen for Hepatitis C) and intravenous drug use. Other frequent causes for Hepatitis C infection are “snorting” cocaine, the use of non-sterile tattoos and sharing of razors and toothbrushes. It is uncommon for the virus to be transmitted sexually in a monogamous relationship. It is estimated that no more than 1% of the time is the virus transmitted sexually in a monogamous relationship. If there are multiple sexual partners, it is more likely to be transmitted.
Hepatitis C is the leading cause of chronic hepatitis and cirrhosis of the liver in the United States. It is the leading cause for primary liver cancer in the U.S. It is also the leading cause of liver transplants in the U.S.
Regarding symptoms, the symptoms are usually the symptoms associated with cirrhosis. These include:
- fluid on the abdomen (know as ascites)
- upper gastrointestinal bleeding
The diagnosis of chronic Hepatitis C requires blood tests to measure the presence or absence of the Hepatitis C virus. This is done by a test called the Hepatitis C viral RNA. Usually the first screening tests that are done are Hepatitis C antibodies. This would also be the first test that would be done by a physician if an abnormal liver function test was noted. The presence of Hepatitis C antibody does not always mean that an individual has active Hepatitis C virus. They may have had an earlier exposure to the virus and were fortunate enough to clear the virus from their body.If the presence of Hepatitis C virus is confirmed, then it is important to evaluate the severity of liver damage in order to make a recommendation regarding treatment. Liver biopsy is the single most important test because it grades the degree of inflammation and the degree of fibrosis and/or cirrhosis.
It is also important to know what genotype of Hepatitis C virus an individual has. In the U.S., genotype I is the most common genotype. It makes up 75% of the Hepatitis C viral in infections. It is also the least responsive to treatment. Also, females tend to respond better to treatment and individuals below the age of 40 tend to respond better to treatment.
Your physician will determine the best treatment for you. Schedule an appointment.