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Hepatitis

Background / Definition

Hepatitis means inflammation of the liver and also refers to a group of viral infections that affect the liver.  there are several types of viral hepatitis infections. The most common types are Hepatitis A, Hepatitis B, and Hepatitis C.

Hepatitis C is a blood born virus and is transmitted by blood to blood. It is a contagious liver disease that results from infection with the hepatitis C virus. It can range in severity from a mild illness that last a few weeks to a serious life long illness.

Acute Hepatitis C is a short-term illness that occurs within the first 6 months after someone is exposed to the Hepatitis C virus. For reasons that are not known, 15 to 25 percent of people clear the virus without treatment, however, approximately 75 to 85 percent of people who become infected with the Hepatitis C virus develop chronic or lifelong infection.

Chronic Hepatitis C is a long term illness that occurs with the Hepatitis C virus remains in a person’s body. Over time it can lead to serious liver problems, including liver damage cirrhosis, liver failure, or liver cancer.

The incubation period varies from 2 to 26 weeks.  The virus is in the blood and may be causing liver cell damage, and the infected person can transmit the disease to others. About 3.2 million people are chronically infected with the hepatitis C virus.

Diagnosis

Doctors can diagnose hepatitis C using specific blood tests. Typically, a person first gets a screening test that looks for antibodies to the hepatitis C virus. For diagnosis of acute or chronic hepatitis C infection a specific blood test for hepatitis C virus is required. Follow up tests should be done to confirm the hepatitis C infection status and the presence of biochemical markers of liver injury. HCV testing is recommended for anyone at increased risk for HCV infection, including:

  • Persons who have ever injected illegal drugs, including those who injected only once many years ago
  • Recipients of blood transfusions or solid organ transplants before July 1992
  • Persons with known exposures to HCV, such as health care workers after needlesticks involving HCV-positive blood recipients of blood or organs from a donor who later tested HCV-positive
  • All persons with HIV infection
  • Patients with signs or symptoms of liver disease (e.g., abnormal liver enzyme tests)
  • Children born to HCV-positive mothers (to avoid detecting maternal antibody, these children should not be tested before age 18 months)

Treatment

Since acute hepatitis C rarely causes symptoms it often goes under diagnosed and therefore untreated. When it is diagnosed, doctors recommend rest, adequate nutrition, fluids, and antiviral medications.  People with chronic hepatitis C should be monitored regularly for signs of liver disease. Even though a person may not have symptoms or feel sick, damage to the liver can still occur. Antiviral medication can be used to treat some people with chronic hepatitis C, but not everyone needs or can benefit from treatment. Many peoples treatments can be a success and result in the virus no longer being detected.

Side Effects

The antiviral medications can have side effects that include fatigue, fever, chills, depression, weight loss, rash and anemia.  It is important that the treatment is never changed or stopped without speaking to their doctor or pharmacist.

Symptoms

Many people with Hepatitis C do not have symptoms and do not know they are infected. Even though a person has no symptoms, the virus can still be detected in the blood.
Some people have symptoms that appear while they have acute hepatitis C and will see symptoms from 2 to 6 months after exposer. While other people have symptoms that appear after they have chronic hepatitis C and can take up to 30 years to develop.  When symptoms do appear they are often signs of advanced liver disease.

Symptoms for both acute and chronic hepatitis C can include fever, fatigue, loss of appetite, nausea, vomiting, abdominal pain, dark urine, grey-colored stools, joint pain, and jaundice.

Causes

Hepatitis C is usually spread when blood from a person infected with hepatitis c virus enters the body of someone who is not infected. Today, most people become infected with hepatitis c by sharing needles or other equipment to inject drugs. Before widespread screening of the blood supply began in 1992, Hepatitis C was also commonly spread through blood transfusions and organ transplants.

People most likely to be exposed to the hepatitis C virus include: injection drug users, people with tattoos or piercings done with unsterile instruments or in unsanitary conditions, people who have sex with an infected person, people who share personal items like toothbrushes, razors, and nail clippers with an infected person, and health care workers that are exposed to blood.

Sources

American Liver Foundation
Hepatitis Foundation International
Hepatitis C Association
Centers for Disease Control