Overview:
Hepatitis C is a liver disease caused by the hepatitis C virus. Many of the people who get infected with hepatitis C virus experience some symptoms for a short time and then recover. This form of infection is called acute hepatitis C. On the other hand; many patients develop long-term or chronic hepatitis C. According to WHO around 130–150 million people globally have chronic hepatitis C infection. A significant number of patients with chronic condition develops liver cirrhosis or liver cancer. Approximately 700000 people die each year from hepatitis C-related liver diseases.
Modes of Transmission:
Hepatitis C virus transmits from one person to another in the following ways:
- By sharing of infected needles, injections and razors.
- By having penetrative intercourse with an infected person.
- By using inadequately sterilized medical equipment.
- By getting blood or blood product transfusion which were collected from an infected donor.
- From infected pregnant mother to the unborn child.
- Hepatitis C is not spread by sharing food, kissing, hugging, or by breastfeeding.
Symptoms:
The incubation period for hepatitis C is 2 weeks to 6 months. Following initial infection, approximately 80% of people do not exhibit any symptoms. Those who are acutely symptomatic may exhibit fever, fatigue, decreased appetite, nausea, vomiting, abdominal pain, dark urine, grey-coloured feces, joint pain and jaundice (yellowing of the skin and the whites of the eyes).
Management and treatment:
- Regular laboratory monitoring is recommended in the setting of acute hepatitis C virus (HCV) infection. Monitoring is recommended every 4 weeks to 8 weeks and can exceed for 6 months to 12 months to determine whether the treatment is working or not.
- Medical counseling is done for patients with acute HCV infection. The patients are educated about avoiding liver damaging drugs like paracetamol and alcohol and having safe sex practice so that they do not infect their partners.
- An addiction medicine specialist is recommended for patients who are drug addicts and are suffering from acute HCV infection due to sharing injections and syringes.
- Liver biopsy is suggested for the patients with chronic hepatitis to rule out any presence of extensive liver damage or liver cancer. However, a pretreatment liver biopsy is not mandatory.
- Dr. Dilip Wilson, Apollo Family Physician, Apollo clinic Sarjapur, Bengaluru advises that the patients with normal liver enzyme levels in the blood (which is suggestive of normal liver function) and minimal damage noted on liver biopsy can elect to avoid treatment until more effective and less toxic medications become available, whereas patients with more advanced liver injury are recommended to initiate treatment sooner.
- Various medicines are used to treat HCV which includes Pegylated interferon (Peg-IFN), ribavirin, Sovaldi (sofosbuvir), Incivek (telaprevir), Olysio (simeprevir), Victrelis (boceprevir) and Harvoni (ledipasvir/sofosbuvir). Outcomes with the medicine treatment depend on the extend of liver damage and the severity of the infection.