What is hepatitis C?
Hepatitis C is an infection caused by the hepatitis C virus (HCV). There are different types of hepatitis viruses, including hepatitis A, B, D, and E. Among the different viruses, hepatitis C is the most serious because it can be chronic and cause severe liver damage.
The virus spreads through contact with infected blood, so certain people have a higher risk of infection. This includes healthcare workers exposed to blood and drug users. Getting a tattoo or piercing with unsterilized equipment also increases the risk of infection.
Hepatitis C affects both men and women. As a whole, the symptoms and complications of the disease are the same for both sexes. But the virus can affect women differently.
Symptoms of hepatitis C in women
Many women don’t have symptoms until the disease is in a later stage. Women who have signs of the disease in the earliest stage may brush off symptoms or attribute them to other factors, such as anemia, depression, or menopause.
Early symptoms of hepatitis C in women can include:
- abdominal discomfort
- muscle and joint pain
- poor appetite
Some hepatitis C infections are acute and the infection clears or improves on its own without treatment within a few months. Acute infections are more common in women.
Hepatitis C can also be chronic, meaning the infection doesn’t clear on its own, but rather progresses and damages the liver. Symptoms of chronic hepatitis include:
- bruising or bleeding
- itchy skin
- fluid retention in the stomach
- swollen legs
- unexplained weight loss
- spider veins
The symptoms of chronic hepatitis C occur in both men and women, but the disease can progress slower in women. However, some women experience rapid progression of the disease and liver damage after menopause.
Having these symptoms doesn’t mean you have hepatitis C.
How do women get hepatitis C?
Hepatitis C spreads from person-to-person through contact with infected blood. If you work in an industry where you might come in contact with blood, there’s a slight risk of exposure. This includes personal care such as:
To protect yourself, avoid contact with cuts or open sores on patients and clients. Wear disposable latex or non-latex gloves and sterilize equipment after each use (razors, cuticle scissors, etc.). If you work in the janitorial or housekeeping industry, wear gloves to avoid contact with blood from feminine hygiene products.
Hepatitis C can also be spread to a sexual partner during a menstrual cycle.
Many women with the virus are able to have a healthy baby. However, there is a small risk that the virus will be transmitted to a baby during pregnancy. If you have hepatitis C and give birth, your baby will be tested for the virus at around 18 months.
How is hepatitis C diagnosed?
Some women are unaware of an infection until a doctor discovers high liver enzymes on a routine liver function blood test. A high number of liver enzymes can signify liver inflammation.
Enzymes help the liver function, but they can leak into the bloodstream when there’s damage to liver cells. A liver function test checks the blood for two main enzymes: alanine transaminase (ALT) and aspartate transaminase (AST).
A normal range for AST is 8 to 48 units per liter of serum, and a normal range for ALT is 7 to 55 units per liter of serum. Elevated liver enzymes can indicate a liver problem. If your numbers are elevated and you have risk factors for hepatitis C, your doctor may conduct further testing to determine the cause of inflammation. This includes testing your blood for HCV.
If testing confirms hepatitis C, your doctor may also run a test to check your viral load, which shows the amount of the virus in your blood. Additionally, you may have a liver biopsy to determine the severity of the disease.
Your doctor may not suspect hepatitis C if your liver enzymes are within a normal range, and as a result, never recommend further testing. This is dangerous because according to a report by the HCV Advocate, “some experts feel that the cut-off number for abnormal liver test should actually be lower for women than the number most labs use.”
If your liver function test is normal but your enzyme levels are close to the cut-off number, ask your doctor to check for hepatitis C.
Complications of hepatitis C
Hepatitis C can be a long-term, progressive disease. It can eventually lead to cirrhosis, or scarring of the liver tissue. If this happens, the liver doesn’t function as well. Some people with hepatitis C also develop liver cancer.
A liver transplant may be necessary if the virus has significantly damaged your liver. Even with a new liver, you’ll have to take antiviral medication to avoid infecting the new organ.
Treatment for hepatitis C
The goal of treatment is to clear the virus from the body. If you have acute hepatitis C, you probably won’t have symptoms, and the virus will clear on its own without treatment. In the case of chronic hepatitis, your doctor may treat the virus with antiviral medication for 12 to 24 weeks.
Until 2011, there were only two drugs available to treat hepatitis C: pegylated interferon (Peg-IFN) and ribavirin (RBV). These drugs were often used in combination with each other.
The drugs currently used to treat hepatitis C include:
- simeprevir (Olysio)
- sofosbuvir (Sovaldi)
- daclatasvir (Daklinza)
- elbasvir/grazoprevir (Zepatier)
- Viekira pak
- Ombitasvir/paritaprevir/ritonavir (Technivie)
- ledipasvir-sofosbuvir (Harvoni)
Your doctor will monitor your symptoms throughout the treatment. After the treatment your viral load will be checked again. If the virus is no longer detected in your blood, and remains undetected for at least six months, you may not require further treatment and there’s a lower risk of liver problems. If treatment doesn’t lower your viral load, your doctor may suggest a second round.
Outlook and prevention
According to the Centers for Disease Control and Prevention (CDC), about 75 to 85 percent of those infected with hepatitis C develop a chronic infection. There is no vaccine for the virus, but it is possible to clear the virus from the body with early intervention and the use of antiviral medication.
Since the virus can damage the liver, it’s important to take care of your liver by avoiding alcohol and asking your doctor about safe medications and supplements to take.
Practicing safe sex and avoiding contact with blood can help you prevent the virus. Don’t use illicit drugs and or share personal care items, such as razors, toothbrushes, or cuticle scissors. If you get a piercing or a tattoo, use a reputable establishment and make sure equipment is sterilized.