Hepatitis C | symptoms | diagnosis and treatment

What is Hepatitis C?

Hepatitis C is a condition with liver inflammation, that causes severe damage to the liver. It is a viral disease caused by the Hepatitis C virus. It is primarily spread through contact with the blood of an infected person, such as through sharing needles or other equipment to inject drugs, receiving a blood transfusion or organ transplant before 1992, or being born to a mother with hepatitis C. Symptoms of hepatitis C can include fatigue, abdominal pain, and jaundice. Still, many people do not experience any symptoms. In some cases, hepatitis C can lead to serious liver problems, including cirrhosis and liver cancer. There is a treatment available that can cure the disease in most people. Hepatitis C, symptoms, diagnosis, and treatment

Hepatitis C is typically treated with a combination of antiviral medications called direct-acting antivirals (DAAs). These medications work by targeting specific enzymes essential for the virus to replicate, thereby stopping the virus from spreading. In past, every patient with hepatitis could not take these doses of injections and pills, because of their unacceptable side effects and health issues. But now the problem has been overtaken, and chronic hepatitis can be treated only with oral medications with the least side effects.

In some cases, however, hepatitis may cause no symptoms at all, and the infection is only detected through blood tests. The signs and symptoms may take decades to appear. This is the reason half of the infected people do not know they have hepatitis. U.S. Preventive Services Task Force recommends that all adults ages 18 to 79 years be screened for hepatitis C, even those without symptoms or known liver disease.

Signs and Symptoms of Hepatitis C

Chronic Hepatitis C remains silent for many years. Its signs and symptoms appear at a time when it has severely damaged the liver. 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 15% to 25%. Acute hepatitis C also responds well to antiviral therapy.

These signs include;

1. Fatigue and weakness
2. Nausea and vomiting
3. Loss of appetite
4. Abdominal pain and discomfort
5. Dark urine and clay-colored stool
6. Yellowing of the skin and eyes (jaundice)
7. Itchy skin
8. Bruising or bleeding easily
9. Fever
10. Muscle and joint pain
11. Depression and anxiety
12. Confusion or memory loss
13. Swelling in the legs and ankles
14. Weight loss
15. Changes in skin color or texture.

Causes of Hepatitis C

Hepatitis C is caused by the hepatitis C virus (HCV), which is a blood-borne virus. The most common cause of hepatitis C is through direct contact with infected blood, such as:

1. Sharing needles or other equipment used to inject drugs
2. Receiving a blood transfusion or organ transplant before 1992 (when screening for HCV began)
3. Being a healthcare worker who has been exposed to infected blood
4. Having a history of tattoos or piercings with unsterilized equipment
5. Being born to a mother who has the virus
6. Having unprotected sexual contact with a person who has the virus
7. Being in close contact with someone who has the virus through shared personal items like razors or toothbrushes
8. Being exposed to contaminated blood or body fluids in the workplace.

In some cases, the cause of hepatitis C is unknown and it is considered as an idiopathic form of the disease.

Risk Factors of Hepatitis C

There are some key factors which are responsible for increasing the risk of spreading the virus. You are at high risk in the following situations;

1. IV drug use: Sharing needles or other equipment used for injecting drugs can increase the risk of hepatitis C transmission.
2. Blood transfusions or organ transplants before 1992: Before 1992, blood and organs were not screened for hepatitis C, so people who received blood transfusions or organ transplants before this time may be at increased risk.
3. Long-term kidney dialysis: People who have received long-term kidney dialysis may be at increased risk of hepatitis C infection.
4. Healthcare workers: Healthcare workers who are exposed to infected blood or body fluids may be at increased risk of hepatitis C.
5. Sexual contact: While the risk of hepatitis C transmission through sexual contact is low, people who have multiple sexual partners or engage in high-risk sexual behaviours may be at increased risk.
6. Tattoos and body piercings: People who have tattoos or body piercings that were done with non-sterile equipment may be at increased risk of hepatitis C.
7. Living with an infected person: Living with someone who has hepatitis C increases the risk of infection, particularly if there is sharing of personal items such as razors or toothbrushes.
8. Occupational exposure: People who work in fields such as construction, healthcare, or law enforcement may be at increased risk of hepatitis C due to the potential for exposure to infected blood or body fluids.
9. High-risk sexual practices: Having unprotected sex, having multiple sexual partners and engaging in anal sex with an infected person may also increase the risk of Hepatitis C infection.
10. Smoking: Smoking increases the risk of developing chronic hepatitis C and liver cancer.

Complications of Hepatitis C

Acute Hepatitis C may not show any visible symptoms accept diagnosed with a blood test. A chronic infection shows symptoms at a time when it has largely damaged the liver. When the symptoms begin to appear, they appear with a lot of complications. The most common complications associated with Hepatitis C are as under;

1. Cirrhosis: Chronic hepatitis C can lead to scarring of the liver, known as cirrhosis. This can lead to liver failure and the need for a liver transplant.
2. Liver Cancer: People with cirrhosis caused by hepatitis C have a higher risk of developing liver cancer.
3. Portal Hypertension: Cirrhosis can cause high blood pressure in the portal vein, which can lead to bleeding in the esophagus or stomach.
4. Fatigue and Weakness: Chronic hepatitis C can cause fatigue and weakness due to the liver’s inability to function properly.
5. Depression and Anxiety: People with hepatitis C may experience depression and anxiety due to the chronic nature of the disease and the potential for serious complications.
6. Kidney Disease: Chronic hepatitis C can lead to kidney disease, as the liver is responsible for removing waste products from the bloodstream.
7. Autoimmune Diseases: Some people with hepatitis C may develop autoimmune diseases, such as rheumatoid arthritis or lupus.
8. Increased Risk of Infections: People with chronic hepatitis C have a higher risk of developing infections due to their weakened immune system.
9. Sexual Transmission: Hepatitis C can be transmitted through sexual contact, which can increase the risk of infection for partners.
10. Drug Interactions: Certain medications can interact with treatments for hepatitis C and cause serious side effects, such as liver damage.

When to See a Doctor for Hepatitis C

It is important to see a doctor if you have any symptoms of hepatitis C or if you have been exposed to the virus. Symptoms of hepatitis C may include fatigue, jaundice (yellowing of the skin and eyes), abdominal pain, dark urine, and flu-like symptoms.

Additionally, if you have a history of injection drug use, have received a blood transfusion before 1992, have been in contact with someone with hepatitis C, or have a history of liver disease, it is important to get tested for the virus.

It is also recommended for individuals who are at increased risk of hepatitis C infection to get tested on a regular basis. This includes people who have HIV, people who have a history of multiple sexual partners, and people who have a history of injecting drugs.

If you suspect you may have hepatitis C, it is important to see a doctor as soon as possible to get tested and begin treatment if necessary. Early diagnosis and treatment can greatly improve the chances of a successful outcome.

How to prevent Hepatitis C

To prevent hepatitis C, it is recommended to:

Avoid sharing needles:  Hepatitis C is a serious liver infection caused by the hepatitis C virus (HCV). It is primarily spread through the sharing of contaminated needles and other equipment used to inject drugs.

To prevent hepatitis C, it is important to never share needles or other injection equipment. If you do use drugs, it is best to use clean needles and equipment that have been obtained from a needle exchange program or a pharmacy.

Practice safe sex: The virus can also be spread through unprotected sexual contact. To practice safe sex and prevent hepatitis C, it is important to use condoms or other barrier methods during sexual activity. Additionally, individuals should limit the number of sexual partners they have and avoid having sex with anyone who has hepatitis C or other sexually transmitted infections.

It is also important to get tested for hepatitis C if you have engaged in any of the behaviors that could put you at risk for the virus. This includes sharing needles or other equipment for injecting drugs, having unprotected sex, or having a history of other sexually transmitted infections.

By practising safe sex and getting tested, you can help protect yourself from contracting hepatitis C and other sexually transmitted infections.

Avoid contact with the blood of an infected person: One of the most common ways to contract hepatitis C is through contact with the blood of an infected person. This can happen through sharing needles or other equipment used for injecting drugs, or through coming into contact with the blood of an infected person through open wounds or cuts.

Get tested for hepatitis C: The best way to prevent hepatitis C is to get tested for the virus so that you can take steps to protect yourself and others from infection.

Testing for hepatitis C is simple and painless. It involves a blood test that looks for the presence of the hepatitis C virus. If you test positive for the virus, your healthcare provider will work with you to develop a treatment plan that may include medications to help clear the virus from your body.

It is also important to practice safe behaviours to prevent the spread of hepatitis C, such as not sharing needles or other equipment to inject drugs, practising safe sex, and avoiding exposure to other people’s blood.

If you are at risk for hepatitis C, it is important to get tested as soon as possible. Talk to your healthcare provider about getting tested for hepatitis C and taking steps to protect your health.

Get vaccinated for hepatitis A and B: Hepatitis A and B increase the risk of hepatitis C because they can cause chronic liver inflammation, which can lead to cirrhosis and liver cancer. This chronic inflammation can also make the liver more susceptible to other infections, including hepatitis C.

If you are already infected with hepatitis C, avoiding alcohol and not using other drugs can help prevent liver damage.

Diagnosis of Hepatitis C

Screening for Hepatitis C

Screening for hepatitis C is typically done through a blood test called the hepatitis C antibody test. This test looks for antibodies in the blood that are produced by the body in response to a hepatitis C infection. If the test comes back positive, it indicates that the individual has been exposed to the virus at some point in their life.

However, a positive antibody test does not necessarily mean the individual currently has an active infection. To confirm the diagnosis, a follow-up test called the hepatitis C viral load test or the hepatitis C RNA test is done to measure the amount of the virus in the blood. A high viral load indicates an active infection and the need for treatment.

In addition to these tests, a liver function test and a liver ultrasound may also be performed to assess the extent of liver damage caused by the infection.

The U.S. Preventive Services Task Force recommends that all adults ages 18 to 79 years be screened for hepatitis C, even those without symptoms or known liver disease. Screening for HCV is especially important if you’re at high risk of exposure, including:

• • 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 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 to diagnose Hepatitis C

After a positive result of Hepatitis is shown by an initial blood test, further blood tests will further clarify the presence of virus in the bloodstream.

01. Viral Load:

A viral load test is used to measure the amount of hepatitis C virus (HCV) in the blood. A high viral load indicates an active infection and a higher risk of progression to chronic hepatitis C. A low viral load may indicate that the infection is in the early stages or that treatment is working to reduce the viral load. It is important to note that a viral load test should be used in combination with other diagnostic tests, such as an HCV antibody test, to confirm a diagnosis of hepatitis C.

02. Identification of Genotype of Virus: 

The genotype of the hepatitis C virus (HCV) can be determined through genetic testing of the viral RNA. There are currently six known genotypes of HCV (genotypes 1-6), each with subtypes. The genotype is important in determining the appropriate course of treatment and the likelihood of response to therapy.

Tests for Liver Damage

1. 1. Blood tests – These tests measure the levels of liver enzymes, bilirubin, and other substances in the blood that can indicate liver damage or dysfunction.
   2. Imaging tests – Ultrasound, CT scan or MRI can help identify any structural abnormalities or tumors in the liver.
   3. Liver biopsy – This is a procedure where a small sample of liver tissue is removed for examination under a microscope.
   4. Fibroscan – A non-invasive test that uses ultrasound waves to measure the stiffness of the liver, which can indicate the presence of fibrosis or cirrhosis.
   5. Autoimmune markers – Blood tests that can detect antibodies associated with autoimmune liver disease.
   6. Viral hepatitis tests – Blood tests that can detect the presence of hepatitis A, B, and C viruses, which can cause liver damage.
   7. Alpha-fetoprotein (AFP) – A blood test that can detect the presence of a certain protein that is often elevated in liver cancer.
   8. Alpha-1-antitrypsin deficiency – A blood test that can detect a genetic condition that can lead to liver damage.

Treatment of Hepatitis C

Anti-viral Medication

Antiviral medications are the primary treatment for hepatitis C and can help to clear the virus from the body.

The most common antiviral medications used to treat hepatitis C are called direct-acting antiviral (DAA) drugs. These drugs target specific proteins in the hepatitis C virus and prevent it from reproducing. Some examples of DAA drugs include sofosbuvir, ledipasvir, and daclatasvir.

These medications are usually taken in combination with one another, and treatment typically lasts for 8-12 weeks. The specific combination of drugs and length of treatment will depend on the genotype of the virus, as well as the patient’s overall health and medical history.

During treatment, patients will need to have regular blood tests to monitor the virus levels and ensure that the medications are working effectively. If the virus is successfully cleared from the body, the patient will be considered “cured” of hepatitis C.

It’s important to note that not everyone will respond to antiviral medications, and some patients may experience side effects from the drugs. However, with appropriate treatment and monitoring, most patients with hepatitis C can achieve a cure and prevent serious liver damage.

Liver Transplantation

Hepatitis C is a viral infection that causes inflammation and damage to the liver. It can lead to serious complications such as cirrhosis and liver cancer. In some cases, the damage caused by hepatitis C can be severe enough to require a liver transplant.

A liver transplant is a surgical procedure in which a healthy liver is transplanted into a patient with a diseased liver. The goal of the transplant is to replace the damaged liver with a healthy one, allowing the patient to live a normal life without the complications of liver disease.

Before a liver transplant can be performed, a patient must first be evaluated to determine if they are a good candidate for the procedure. This includes a thorough medical evaluation, as well as testing to confirm the diagnosis of hepatitis C and the extent of liver damage.

If a patient is deemed a suitable candidate, they will be placed on the transplant waiting list. The wait for a liver transplant can vary, depending on a number of factors such as the availability of donors and the patient’s medical condition.

Once a suitable liver is found, the transplant surgery is performed. The surgery typically takes several hours, and the patient will need to stay in the hospital for several weeks to recover.

After a liver transplant, the patient will need to take immunosuppressant medications to prevent rejection of the new liver. They will also need to undergo regular follow-up appointments and testing to monitor their recovery and ensure that the transplant is successful.

Overall, liver transplantation is a highly effective treatment for hepatitis C, with a high success rate. It can provide patients with a new lease on life and the opportunity to live without the complications of liver disease.

Vaccinations to cure Hepatitis C

There is currently no vaccine available to cure hepatitis C. However, vaccinating against the hepatitis A and B viruses can be helpful to cure complications caused by HAV, and HBV. These are separate viruses that also can cause liver damage and complicate the course of chronic hepatitis C.

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