Chronic Hepatitis C: Symptoms, Diagnosis, and Treatment
What Is Chronic Hepatitis C?
Chronic hepatitis C is caused by the hepatitis C virus (HCV). As the virus enters the body, it causes an infection in the liver. Over time, the infection scars the liver and it prevents it from working normally. This condition can be lethal if left untreated.
According to the Centers for Disease Control and Prevention (CDC), more than 3.2 million Americans have hepatitis C. Many of them don’t even know they have it. Although there’s a vaccine against hepatitis A and hepatitis B, there isn’t a vaccine for hepatitis C.
Acute vs. Chronic Hepatitis C
Acute and chronic hepatitis C are actually the same disease. When you are first infected, you develop acute hepatitis C. This stage lasts for about six months. Many people have no symptoms during the acute stage, so they never find out that they are infected.
About 85 percent of people with acute hepatitis C develop chronic hepatitis C, according to the CDC. Of that 85 percent, up to 70 percent will suffer from severe liver damage. An additional 20 percent will develop cirrhosis (scarring of the liver).
Signs and Symptoms
Chronic hepatitis C is often difficult to diagnose because most people have no early symptoms. Only about 25 percent of people experience fatigue, muscle aches, or loss of appetite when they first contract the virus.
Most symptoms of chronic hepatitis C don’t appear until cirrhosis develops and the liver begins to fail. Those symptoms include weakness, weight loss, and blood clotting problems. Fluid can sometimes accumulate in the abdomen. Jaundice (yellowing of the skin) only appears in people with advanced cirrhosis.
Most people who contract hepatitis C get it from infected blood. People who are infected can pass on the virus to others by sharing needles and syringes. Because of this, hepatitis C spreads easily among intravenous drug users.
It’s also possible to be infected by sharing a razor or even a toothbrush if your gums are bleeding. However, the risk of infection in this way is much lower.
Although transmission from sexual contact with an infected person is possible, it’s not very common.
Diagnosing Chronic Hepatitis C
The only way to confirm a hepatitis C infection is through a blood test.
The most common test for hepatitis C is an HCV antibody test. A positive result means you have been exposed to the virus, but not necessarily that you are infected. To confirm infection, you will have to undergo a HCV viral load test, which checks for genetic material (RNA). This can confirm whether you are currently carrying the virus in your body.
Your doctor can also order a third test to check what type of hepatitis C virus you are carrying. There are six different genotypes of hepatitis C and treatment for each kind is slightly different.
The most common treatment for chronic hepatitis C is a combination of interferon and ribavirin. This is known as dual therapy. Interferons boost the immune system so your body can fight the infection. Ribavirin controls and slows down the infection and kills the hepatitis C virus.
You might need to take these drugs for up to a year to eliminate the hepatitis C virus completely.
Side effects of dual therapy include nausea and vomiting, fever and chills, muscle aches, and hair loss. Some people can develop serious depression, high blood sugar, and thyroid problems when taking these medications.
According to a study published in Gastroenterology, 45 percent of all liver transplants in the US are done on people with chronic hepatitis C. Many patients who receive a new liver are reinfected later on, and 25 percent will develop cirrhosis after transplantation.
Interferon, which is commonly used to treat hepatitis C, can cause depression, flu-like symptoms, and a reduced white blood cell count. It can also cause anemia.
Patients who use both interferon and ribavirin for treatment can experience other side effects, including insomnia and shortness of breath.
Protecting Your Liver
The best thing you can do to protect your liver from hepatitis C is to get an early diagnosis. The earlier you start medication, the higher your chances are for preventing liver failure.
People with chronic hepatitis C shouldn’t drink alcohol. They should maintain a healthy weight and avoid excessive fat in their diets.
After you have finished taking medication, you should still have your liver enzymes checked regularly to make sure your liver is healthy.
- Hepatitis C: Definition. (2013, August). Mayo Clinic. Retrieved November 12, 2013, from http://www.mayoclinic.com/health/hepatitis-c/DS00097
- Hepatitis C FAQs for the Public. (2012, October). Centers for Disease Control and Prevention. Retrieved November 12, 2013, from http://www.cdc.gov/hepatitis/c/cfaq.htm#cFAQ22
- Mukherjee, S. & Sorrell, M.F. (2008, May). Controversies in liver transplantation for hepatitis C. Gastroenterology, 134(6), 1777-1788. Retrieved November 12, 2013, from http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3114577/
- Treating Chronic Hepatitis C: A Review of the Research for Adults. (2012, November). Agency for Healthcare Research and Quality. Retrieved November 12, 2013, from http://effectivehealthcare.ahrq.gov/index.cfm/search-for-guides-reviews-and-reports/?pageaction=displayproduct&productid=1288