What is hepatitis?
Hepatitis is an inflammation of the liver caused by certain viruses and other factors, such as alcohol abuse, some medications and trauma. Its various forms affect millions of Americans. Although many cases of hepatitis are not a serious threat to health, infection with certain hepatitis viruses can become chronic (long-lasting) and can sometimes lead to liver failure and death.
How many kinds of viral hepatitis are there?
There are four major types of viral hepatitis, all caused by different viruses: hepatitis A, hepatitis B, hepatitis C and delta hepatitis. This "HealthBeat" focuses on hepatitis C.
What is hepatitis C and how is it transmitted?
This type of hepatitis is caused by the hepatitis C virus (HCV), which infects approximately 36,000 persons each year in the United States. Although generally a mild condition, hepatitis C is much more likely than hepatitis B to lead to chronic liver disease. People infected with HCV can become chronic carriers of the virus, although they may have no symptoms. It is estimated that there are approximately 4 million HCV chronic carriers. Around 70 percent of all HCV carriers will develop chronic liver disease, regardless of whether they have symptoms.
HCV is spread primarily by exposure to human blood. Approximately 80 percent of persons who share needles to inject drugs are infected with HCV. Persons who receive blood transfusions face some risk, although it is very low since testing of donated blood for HCV began in 1990. Hepatitis C has been transmitted between sex partners and among household members, but the degree of risk is believed to be low. HCV is not spread by food or water or casual contact, such as shaking hands or sharing a work space or bathroom facility.
What are the symptoms of hepatitis C?
Many people infected with hepatitis C have no symptoms. When symptoms are present, they can range from mild to severe. The most common early symptoms are mild fever, headache, muscle aches, fatigue, loss of appetite, nausea, vomiting and diarrhea. Later symptoms may include dark coffee-colored rather than dark yellow urine, clay-colored stools, abdominal pain, and yellowing of the skin and/or whites of the eyes (jaundice).
Who should be tested for hepatitis C?
It is recommended that the following persons be routinely tested for hepatitis C:
Can people with no symptoms pass hepatitis C to others?
Yes. Infected persons, regardless of whether they have symptoms or not, can transmit their infection to others.
How is hepatitis C diagnosed?
A test is now available to identify antibody (proteins produced by the immune system in response to the virus) to HCV, which is present in approximately 50 percent of persons with early hepatitis C infections and in almost all with chronic hepatitis C infections. There are other tests that can confirm a positive antibody test result and tell the physician if the infection is causing damage to the liver. A liver biopsy sometimes is needed to enable the physician to determine the degree of damage to the liver.
How is hepatitis C treated?
There are no specific treatments for the symptoms of acute hepatitis C. Doctors recommend bed rest, preventing dehydration, a healthy diet and avoidance of alcoholic beverages. Most patients with mild to severe hepatitis C begin to feel better in two to three weeks and recover completely from their symptoms within four to eight weeks.
Synthetic forms of the protein interferon are used to treat some people with chronic hepatitis C. This can improve liver function in some people with hepatitis and diminishes symptoms, although it may cause side effects such as headache, fever and other flu-like symptoms. Sometimes this drug is used in combination with another drug, ribavirin. Treatment is effective in 10 percent to 40 percent of patients.
Many chronic carriers remain symptom free or develop only a mild condition, chronic persistent hepatitis. However, approximately 50 percent go on to develop the most serious complications of viral hepatitis: cirrhosis of the liver and liver cancer.
How can hepatitis C be prevented?
The most effective means of preventing hepatitis C is to avoid contact with human blood. Do not inject illegal drugs and do not share toothbrushes, razors or other items that might have blood on them.
No vaccines yet exist for HCV.
What do I do if I test positive for HCV?
You should have a medical evaluation to help determine that the HCV test result is not a false positive. Your physician may repeat the test or may see you regularly for a few months to test blood samples for liver enzymes and do a follow-up test again in six months. Persons who have hepatitis C should be considered potentially infectious. They should not donate blood, body organs, other tissue, or semen. Toothbrushes, razors or other items that could become contaminated with blood should not be shared. Cuts, open sores or other breaks in the skin should be covered to prevent the risk of blood exposures to others. When seeking medical or dental care, persons with HCV infections should inform those responsible for their care of their HCV status so that they can be appropriately evaluated.
Do not use alcohol, see your physician, do not take new over-the-counter drugs without first talking to your physician, and get vaccinated against hepatitis A and hepatitis B.
Although sexual transmission has occurred, presently there is little reported evidence that chronically infected persons infect long-term sex partners in mutually monogamous relationships. Current information suggests there is no need in changing current sexual practices for a person with a steady sexual partner. Persons with HCV infection who have multiple sexual partners should reduce their number of sexual partners and inform prospective sexual partners so that appropriate precautions (latex condoms) can be used.
Approximately 5 percent of HCV-positive women transmit their infection to their infants (this rate is higher if the mother is also infected with HIV). HCV-positive mothers can breastfeed their babies as long as their nipples are not cracked or bleeding.
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