Hepatitis C Defined
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Hepatitis C is a slow-acting liver disease that causes inflammation in the liver. It is caused by the hepatitis C virus and can spread through blood to blood contact. This means that blood from a person infected with hepatitis C must come into direct contact with the blood stream of another person in order for that second person to get the virus. Only a drop of blood from a contaminated needle or toothbrush is needed to spread the virus from one person to the next.
If you just found out that you have hepatitis C you might feel comforted to know that your liver will continue to work hard for you. By adjusting your daily routine and seeking good medical advice and treatment, you will help give your liver an advantage over the disease.
Scientists know that hepatitis C has been around since at least the 1940s because they discovered the virus in some old frozen blood taken then. Until 1989 the hepatitis C virus was known as non-A non-B hepatitis because the virus had characteristics that were different than the two known strains of hepatitis at the time, which were hepatitis A and B.
In recent years scientists have made substantial gains in understanding the virus and are researching new ways of treating the disease. In the United States alone over 4 million people have been exposed to hepatitis C and roughly 3 million have long-term infection. This makes up nearly 2% of the U.S. population. As each year passes, around 30 thousand more Americans become infected with the virus. World-wide around 170 million people have hepatitis C. Because the virus was around for many years before it was recognized it was unknowingly passed from person to person when receiving blood transfusions or other blood products such as platelets or plasma. Since 1992, however, blood donations are tested for the virus, making blood transfusions a very low risk of spreading hepatitis C from person to person.
Today nearly 60% of all new hepatitis C infections are the direct result of sharing needles to inject drugs. Only a drop of blood is needed. So sharing a needle even just one time could spread the virus. If you have ever used injection drugs, it is a good idea to be tested for hepatitis C. There are several other ways in which the virus may be spread through blood to blood contact. Sharing straws or other equipment to snort drugs such as cocaine may be another way to transmit hepatitis C. Blood from the nasal passage can remain on the straw used to snort the drug and then passed to another person. Researchers are not sure just how risky this practice is for spreading hepatitis C.
Work-related blood to blood contact is also a risk factor. Health care workers can become infected when handling needles from infected patients if the needle accidentally injects them. For this reason, medical workers can be at risk if they have been in direct contact with patients' blood such as in military situations where there are injured or wounded personnel. These methods of transmission are kept at low risk due to the safety precautions used by medical personnel such as using latex gloves, properly handling needles, and other infection-control precautions.
Body-piercing, tattooing and acupuncture can be risk-factors as well because they all use needles that can potentially spread blood from one person to another if they are reused inappropriately. Receiving a tattoo or body piercing at a licensed parlor that uses good procedures to clean and sterilize their equipment minimizes this risk. Sharing razors or toothbrushes can also be a risk factor since the virus may be spread by small amounts of blood on the blade or bristles.
There is a 5% chance for a mother who has hepatitis C to give it to her new-born baby during pregnancy and child birth. A father who has hepatitis C is no risk to the unborn baby.
When it comes to sexual activity, hepatitis C is rarely transmitted. The safest way to reduce sexual transmission is to use protection such as latex condoms and to reduce the number of sexual partners. In a long-term monogamous relationship, meaning a relationship of more than five years or so, in which the partners only have sex with each other, the risk of spreading the virus from an infected partner to an uninfected one is very low, less than 5%. People with hepatitis C can maintain relationships with their friends and loved ones because the virus cannot be spread through normal social contact such as hugging, holding hands, or kissing. This social support is important for emotional health when dealing with the stress of a chronic disease. The virus will not spread from person to person through saliva, sweat, tears or from sneezing or coughing. If you have hepatitis C you can eat off the same plate, drink from the same cup, share eating utensils and prepare and handle food for others.
Once the virus has been in the body for many years, the liver may not function as it should and symptoms may increase. These symptoms are the same as the ones that may be experienced early on, such as fatigue, abdominal pain, loss of appetite, lethargy, nausea or becoming sick after eating fatty foods or drinking alcohol.
For every 100 people infected with hepatitis C, 15 will not develop chronic or long-term disease. These people's bodies are able to get rid of the virus on their own. This happens more often in women and children than in men. Most people, however, about 85 out of 100, do get chronic hepatitis C. The immune system's attempts to destroy the virus are actually what cause the damage to the liver. The result of the infected liver cells that are destroyed is scar tissue that forms in the liver. This scarring is referred to as fibrosis in the early stages and cirrhosis at later, more extensive stages of scarring. The combination of alcohol and hepatitis C, especially over the long-term, increases the chance of developing cirrhosis.
Four out of five people with chronic hepatitis C do not develop cirrhosis in their lifetime. Liver cancer affects about 2% of people with hepatitis C. A person with cirrhosis is at an increased risk of getting this cancer.
Testing for the hepatitis C virus in a person's blood stream is initially done through several reliable blood tests. The first test looks for any antibodies that your body may have produced if exposed to the hepatitis C virus. If antibodies are found then a second test called a PCR test is done. The PCR test determines if the hepatitis C virus itself is currently in the body. Another test, called a hepatitis C genotype test determines what strain of hepatitis C exists in the liver. Genotype refers to the genetic make up of a virus or organism. Six genotypes of hepatitis C exist, each one slightly different than the next. In the United States, genotype 1 is the most common and unfortunately the hardest to treat. Another set of tests called liver function tests identify the amount of liver enzymes in a person's blood. High levels of enzymes may suggest damage or inflammation of liver cells. Since a person's enzyme levels may vary, this test will not give a perfect assessment of damage to the liver.
The most accurate test to determine the extent of liver damage is a liver biopsy. This test will reliably determine if the liver is inflamed, how much scar tissue is formed, or if cirrhosis has started. The biopsy is a relatively safe procedure in which a very thin needle is used to remove a small amount of the liver to be examined under a microscope.
Some people have both the hepatitis C virus and the human immunodeficiency virus, also called HIV, the virus that causes AIDS. Like the hepatitis C virus, HIV is spread through blood-to-blood contact. If you have hepatitis C, you should also get tested for HIV because of the similar risk factors of the two viruses.
If you just found out that you have hepatitis C or you are awaiting test results, this may be a difficult time for you. Remember that your individual case will be different from other people's. The more information you can get about hepatitis C and how it is affecting you individually, the better. Having someone to talk to and answer your questions can reduce any fear or anxiety you may be experiencing.