Hepatitis C virus (HCV) is a serious and potentially life-threatening condition that targets your liver. Its symptoms can be mild, so it’s possible that you may have this condition for many years before you’re given a diagnosis. Because of this, it’s important that your doctor determines any damage done to your liver. By knowing the state of your liver, your doctor can determine an appropriate treatment plan for your HCV.
What Is Hepatitis C?
Hepatitis C is a virus that attacks the liver. More than 4 million Americans are afflicted with HCV. Because the symptoms can be mild, many people don’t know that they’ve been infected with the virus until much later.
Over time, HCV can lead to chronic inflammation and cause liver disease. As more and more damage is done to the liver, scarring can occur. This is called cirrhosis. Cirrhosis and liver disease can cause the liver to shut down. Aggressive treatment is required to treat cirrhosis. A liver transplant may also be necessary.
How Are the Risk Factors for Hepatitis C?
You may contract HCV if you come into contact with an infected person’s blood.
You could be at risk if any of the following apply to you:
- You share improperly sanitized needles during illegal drug use.
- You’ve gotten a tattoo or piercing in an unclean environment.
- You have HIV.
- You received a blood transfusion before 1992 or a clotting factor concentrate before 1987.
- You were born to a mother who has hepatitis C.
- You’re a healthcare worker who has been exposed to infected blood.
Diagnosis and Treatment
HCV is diagnosed through blood tests. Diagnosing typically starts with an antibody test. HCV antibodies can typically be detected in six to 10 weeks after you have contracted the virus. Approximately 15 to 25 percent of people can clear the virus from their bodies within six months of exposure.
Viral load testing may be done to see if the virus has spread into your bloodstream. If the virus hasn’t cleared up on its own, a viral load test can help determine the level of treatment needed.
Liver Damage and Hepatitis C
A fibrosis score measures the level of scarring to the liver, or cirrhosis, caused by disease. The greater your fibrosis score, the more likely you are to have severe liver damage. Damage generally occurs over the course of 10 to 20 years. Cirrhosis affects approximately 20 percent of those with chronic inflammation caused by hepatitis C.
The major factors associated with worsening fibrosis scores are older age at infection, male gender, and excessive alcohol consumption. Other factors, such as obesity and diabetes, may contribute to progressing fibrosis scores.
Testing for Fibrosis
Your doctor will determine whether your liver should be tested for fibrosis. Fibrosis is the first stage of liver scarring. The gold standard for testing for fibrosis is the liver biopsy. This procedure can be invasive and carry risks, such as bleeding, so your doctor may recommend other methods to determine your fibrosis score.
Alternative methods of testing for fibrosis include:
- laboratory tests in combination with abdominal imaging studies
- noninvasive serum markers
- radiologic imaging
One type of noninvasive procedure to determine a fibrosis score is FibroScan. This is a vibration-controlled transient elastography (VCTE) that measures the level of fibrosis in the liver.
Understanding Your Fibrosis Score
Fibrosis scores range from 0 to 5, with 0 showing no signs of fibrosis to 5 showing the presence of cirrhosis. Middle scores, such as 3, show that fibrosis has spread and has connected to other areas on the liver that contain fibrosis.
Your fibrosis score may determine the level of treatment you wish to seek for HCV. High fibrosis scores indicate a risk of cirrhosis, liver disease, or both. If you do receive a high score, your doctor will likely pursue an aggressive form of treatment. If you have a low score, you may choose to forego therapy in the short term.
Speaking with Your Doctor
No matter your fibrosis score, it’s best to talk to your doctor about HCV treatment options. Treatments are rapidly changing. What was once a long, difficult process is now becoming much more straightforward through oral treatments. Your treatment for HCV will vary based on its severity, but the condition may be cured in as little as 12 weeks. If the disease goes undetected in your blood three months after your final treatment, you’re considered cured of the virus.