Nothing catches my attention more than when the CDC makes a sweeping recommendation for screening as it recently did for Hepatitis C, a serious and often silent infection caused by a virus that attacks the liver. The acute form—when someone is first infected– of hepatitis C infection tends to be short and rarely causes liver damage; however, chronic hepatitis C infection can follow a progressive course over many years ultimately resulting in cirrhosis — scarring of the liver — or a form of liver cancer known as hepatocellular carcinoma, or even the need for liver transplantation.
Consider that the CDC estimates that there were 17,000 new cases of Hepatitis C in 2010 yet only 2800 patients (16 percent) had any symptoms of the acute infection; most people don’t know they had the infection until the liver damage showed up decades later during routine medical tests. Thus, of the hepatitis viruses (hepatitis A and B are the other types), the C virus is considered to be the most serious. The following are important things you may not know about Hepatitis C.
1. Hepatitis C infection produces no signs and symptoms during the early stages and when they do occur they are generally mild and flu-like and may include fatigue, fever, nausea or poor appetite, muscle and joint pains, and even tenderness in the area of your liver. This typically happens 2- 26 weeks after exposure and lasts between 2- 12 weeks.
2. Hepatitis C is spread only when you come in contact with contaminated blood. Therefore screening of Hepatitis C logically includes groups or situations where one may have been exposed to infected blood. Testing for hepatitis C infection may help doctors begin treatment or recommend lifestyle changes that may slow liver damage. In 2012, the CDC recommended screening for all of the following individuals:
- born in the United States between 1945 and 1965 – that means everyone in this group
- ever injected with illegal drugs
- received clotting factors made before 1987
- received blood and organs before July 1992
- ever on chronic hemodialysis
- had evidence of liver disease including elevations of liver enzymes, a blood test, ALT specifically, or are infected with HIV
- were healthcare, emergency and public safety workers after a needle stick or exposure to hepatitis C virus
- were children born to hepatitis-C-infected women
3. Chronic hepatitis C infection can cause significant complications such as scarring of the liver, otherwise known as cirrhosis, which makes it difficult for the liver to function, a process that may take up to 20-30 years. In some cases, liver cancer and other cases of liver failure may occur. For Latinos, the course of Hepatitis C is more aggressive, with a higher risk to develop cirrhosis.
4. In many cases, a diagnosis of hepatitis C doesn’t necessarily mean you will need treatment.
5. For others, however, antiviral medication is needed to clear the virus from the body and a doctor may recommend a combination of medications depending on the individual– typically interferon and ribavirin. Sadly for Latinos, emerging evidence suggests that we have decreased response to these treatment regimens because Latinos often have a more resistant form of the virus.
6. There are side effects of antiviral treatments in the majority of individuals who take interferon and ribavirin combination therapy. Side effects include flu-like symptoms, anemia, lowered white blood cells, rash, hair loss, thyroid problems, depression, fatigue, irritability, cough, dyspnea and many other symptoms.
7. If your liver has been severely damaged, a liver transplant may be the only option. During liver transplant the surgeon will remove the damaged liver and replace it with a healthy liver but getting a liver is easier said than done, as there is a severe organ shortage throughout the world.
8. According to the Mayo Clinic, some lifestyle tips if one receives a diagnosis of hepatitis C include
- stop drinking alcohol; alcohol speeds the progression of the disease
- avoid over the counter medications that are processed by the liver
- staying healthy through diet, exercise and sleep
- help prevent others from coming in contact with your blood; never share razors, toothbrushes, don’t donate blood or body organs or semen
- advise healthcare workers that you have the virus
9. To prevent Hepatitis C, it is important to
- avoid or stop using illicit drugs and never share needles
- be cautious about body piercing and tattooing; if you undergo piercing or tattooing look for a reputable shop, make sure the equipment is clean and that there are sterile needles
- don’t engage in unprotected sex with multiple partners
Because Hepatitis C is so common, silent, and dangerous, understanding how to prevent and spreading hepatitis C is essential to avoiding becoming one of its victims.
Dr. Joseph Sirven is a first-generation Cuban-American. He is Professor and Chairman of the Department of Neurology and was past Director of Education for Mayo Clinic Arizona. He is editor-in-chief of epilepsy.com and has served U.S. and global governmental agencies including the Institute of Medicine, NASA, FAA, NIH and CDC.