Hepatitis C is a serious and potentially life-threatening condition that affects your liver. Its symptoms can be mild, so it’s possible that you may have the virus for many years before you’re given a diagnosis.
Because of this, it’s important that your doctor checks for any damage done to your liver. By knowing the state of your liver, your doctor can determine an appropriate treatment plan for your hepatitis C.
The Centers for Disease Control and Prevention estimate that more than 3 million Americans live with hepatitis C. Because the symptoms can be mild, many people don’t know that they’ve contracted the virus until much later.
Over time, hepatitis C can lead to chronic liver inflammation and cause liver disease. As more and more damage is done to the liver, scarring can occur. This is called fibrosis. Accumulation of this scaring, in turn, can lead to 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.
A fibrosis score measures the level of scarring to the liver caused by the disease. The greater the fibrosis score, the more likely you are to have severe liver damage.
Damage generally occurs over the course of 10 to 20 years. The Cleveland Clinic estimates that cirrhosis affects approximately 20 percent of those with chronic liver inflammation caused by hepatitis C within 20 years of acquisition.
The major factors associated with worsening fibrosis scores are:
- older age at time of contracting the virus
- male gender
- excessive alcohol use
Other factors, such as obesity and diabetes, may contribute to progressing fibrosis scores.
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 a 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 to test 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.
Fibrosis scores range from 0 to 4, with 0 showing no signs of fibrosis and 4 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 hepatitis C. 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.
You may contract hepatitis C if you come into contact with the blood of a person who has the virus.
You could also be at risk if any of the following apply to you:
- You’ve shared needles.
- You’ve gotten a tattoo or piercing in a nonprofessional 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.
Hepatitis C is diagnosed through blood tests. Your doctor will typically use an antibody test first. Hepatitis C antibodies can typically be detected in 6 to 10 weeks after you’ve contracted the virus. According to Hep, 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 is still in your bloodstream. If the virus hasn’t cleared up on its own, a viral load test can help determine the level of treatment needed.
No matter your fibrosis score, it’s best to talk to your doctor about hepatitis C 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 hepatitis C will vary based on its severity, but the condition may be cured in as little as 12 weeks.
If the condition is undetected in your blood three months after your final treatment, you’re considered cured of the virus.