Hepatitis C

Hepatitis is inflammation of the liver. Several different viruses cause viral hepatitis. They are named the hepatitis A, B, C, D, E and G viruses. All of these viruses cause acute, or short-term, viral hepatitis. The hepatitis B, C, and D viruses can also cause chronic hepatitis, in which the infection is prolonged, sometimes lifelong. Other viruses may also cause hepatitis, but they have yet to be discovered and they are obviously rare causes of the disease.

Symptoms of viral hepatitis:

Jaundice (yellowing of the skin and eyes)

Fatigue

Abdominal pain

Loss of appetite

Nausea

Diarrhea

Vomiting

However, some people do not have symptoms until the disease is advanced.

Hepatitis C infection was discovered in 1989 and is caused by the hepatitis C virus (HCV), which is carried in the blood. The World Health Organization estimates that HCV is responsible for 170 million infections worldwide. Hepatitis C has a slow disease progression. HCV first develops as an acute infection, but patients are often symptom free.

Over 80 per cent of acute HCV infections then develop to chronic hepatitis C. This can lead to liver disease, including scarring of the liver (cirrhosis) in 20 per cent of chronic cases and in a small number of cirrhosis cases primary liver cancer.

Cirrhotic liver damage will occur within 10-20 years of onset, impairing liver function and ultimately leading to liver failure. Until then, infection may go unnoticed. Symptoms of liver damage are fatigue and weakness, nausea and weight loss. Vascular abnormalities may appear on the skin, palms may redden, legs and abdomen swell, and the liver enlarge. The build-up of toxins in the blood can lead to mental changes and eventually coma. 

Causes and Risk Factors

Hepatitis C is carried in the blood, so it can only be acquired by blood to blood contact e.g. after blood transfusion (before 1990), needle sharing or sexual contact. 
 
Diagnosis and Screening
Hepatitis C infection can be diagnosed by a routine blood test performed in hospital or local surgery. Tests are also available to monitor the progression of the disease and the patient's response to therapy.

Management

There is no vaccine for hepatitis C -- the only way to prevent the disease is to reduce the risk of exposure to the virus. This means avoiding behaviors like sharing drug needles or sharing personal items like toothbrushes, razors, and nail clippers with an infected person.

Treatment should be started early, preferably in the acute or chronic stages of hepatitis C infection and before cirrhosis sets in.

Interferon alpha in combination with ribavirin was until recently the standard therapy for the treatment of chronic hepatitis C. Pegylated interferon alpha, a longer acting version of interferon alpha, in combination with ribavirin, is currently the best chance for cure of hepatitis C.