All You Need To Know About Hepatitis C

All You Need To Know About Hepatitis C

Medical science has witnessed some of the fearsome diseases to date. Hepatitis C, the most dreaded form of hepatitis viral infection is one of those terrible diseases which the world is still grappling with. Let’s learn everything about this disease.

Highlights

  • Hepatitis C is an inflammatory condition of the liver which is highly contagious in nature
  • The condition spread through unsafe injection practice, sharing needles and razors, and unsafe blood transfusion
  • Hepatitis causes improper functioning of the liver and can take severe form resulting in liver cancer and liver failure

Hepatitis C

Hepatitis C is a medical condition in which the liver gets inflamed. The disease is caused by hepatitis C virus (HCV) and can be either acute or chronic, depending on how the immune system responds to the virus. 

Hepatitis C is contagious in nature and the fact could be seen in the high number of people being affected worldwide. But it does not mean one can get the virus from casual contact.

Hepatitis C Factsheet

  1. According to World Health Organization (WHO), there are currently over 71 million people living with chronic hepatitis C. Out of this, around 8-12 million cases are estimated to be in India alone
  2. An estimated 4 lakh people die every year due to hepatitis C globally
  3. In India, the HCV infection was responsible for approximately 59,000 deaths in the year 2015
  4. The treatment is expensive and limited globally
  5. Recently, there has been a breakthrough in this respect. A research institute in India named Sanjay Gandhi Post Graduate Institute of Medical Sciences, Lucknow, has developed Directly Acting Anti-Virals (DAAs) to treat the disease and the good news is that the cost is relatively cheap. Many other countries have also developed generic versions, resulting in a dramatic reduction of price
  6. Over 95 percent of the cases of hepatitis C infection can be cured effectively but the dark side is that access to treatment is unfortunately limited

Types of Hepatitis C Virus

Scientists have been able to find out at least 11 different strains of HCV known as genotypes. Out of these 11, 6 are major genotypes that are widespread. These 6 genotypes have 50 sub-types. Different genotypes respond to treatment differently.

In India, genotype 3 is the most prevalent accounting for over 63 percent of cases while genotype 1 accounts for over 25 percent of all the hepatitis C infection cases. Genotype 4 and 6 are less common having a geographical restriction.

How hepatitis C virus spread?

The hepatitis C virus typically spreads through the contaminated blood of an infected person. The virus can also be transmitted via sexual contact or infected mother to a baby, but these cases are less common.

Here are some of the risk factors or modes through which a person can get this virus:

  • Unsafe injection practice
  • Unsafe or unscreened blood transfusion
  • Organ transplants
  • Sharing razors, needles, and toothbrushes
  • Inhaled or injected illicit drugs
  • HCV infected sex partner
  • People practicing tattoos or piercing in unhygienic environment
  • Blood transfusion before 1992 (this year blood screening was introduced)
  • One who has been on kidney dialysis for a long time

Symptoms of hepatitis C

Jaundice is the classic symptom of hepatitis C. Other symptoms include:

  • Poor appetite
  • Nausea
  • Dark urine
  • Fever
  • Fatigue
  • Swelling in the legs

Complications of hepatitis C

If the infection becomes chronic, it can lead to serious complications including:

  • Scarring of the liver (cirrhosis) making it difficult for the liver to perform normal functioning
  • Liver cancer
  • Liver failure

Stages of hepatitis C

The progression or development of HCV infection is highly unpredictable since the virus can be cleared in some people without the need for any treatment. Apart from this, the stages are also highly variable but are typically referred to as acute, chronic and end stage.

Acute

It is characterized by rapid onset of symptoms. These symptoms are experienced by a few of the individuals, usually within 2 weeks of the exposure. In this stage, HCV will principally target liver cells known as hepatocytes.

During this stage, the virus can replicate a trillion copies of itself. It can directly kill hepatocytes, triggering the immune system to produce lymphocytes (white blood cell), the virus-fighting agents that come to rescue. 

In 20-25 percent of cases, virus can clear off within the timeframe of 6 months, but in people in which the virus persists, these people advance to the chronic stage.

Chronic

During the course of chronic infection, the immune system of the body produces collagen and other substances to strengthen the defensive wall of the liver. 

Over the time, this development causes accumulation of scar tissue, which eventually leads to cirrhosis of the liver. This increases the chances of liver failure. About 10-15 percent of the people with chronic stage infection will progress to end-stage infection.

End Stage

The end stage can be roughly defined as the stage where mortality risk becomes high. This is due to decreased liver functionality that gives room to liver cancer, kidney and liver failure. 

People suffering liver cancer and cirrhosis usually have 5-year survival rate. Liver transplant remains the last option; however, HCV can recur in 80 percent of the cases.

Diagnostic procedures of Hepatitis C  

A simple blood test is a method to detect defensive protein known as antibodies. The antibodies are specifically programmed to fight foreign substances. If someone is infected with hepatitis C virus, his body will produce hepatitis C antibodies and the blood test will confirm that.

The blood test will determine:

  • Quantity of virus in the blood
  • Genotype of the virus

Test for liver damage may include:

MRE (Magnetic resonance elastography)

This non-invasive imaging technology determines stiffness in the liver. Stiffness indicates fibrosis or scarring of the liver as a result of chronic hepatitis C

Transient elastography

This too is a non-invasive test that sends ultrasound vibrations to the liver and evaluates the stiffness.

Liver biopsy

The doctor will insert a needle into the abdominal wall and take a sample of the liver tissue for lab testing

Treatment of hepatitis C

Treatment will depend on individual to individual. Not everyone would need treatment as their immune system can clear off the virus from the body automatically. But for the people who are unable to remove the virus on their own, they don’t have to panic as there still remain some options for them.

The medications to treat hepatitis C are known as interferons and antivirals. But there are several HCV genotypes and not all the medications are foolproof. So once your doctor identifies the genotype, he will get to know a better idea which medication to give.

Today, medical science has certainly made progress in developing effective anti-virals (DAA) which not only falls under short treatment plan, but are also less toxic with high success rates.

Sources

1. Ghany MG,et al.(2009). Diagnosis, management, and treatment of hepatitis C: an update.DOI: 10.1002/hep.22759 read more
2. Hepatitis C(2016, January 28). read more
3. Testing for the Hepatitis C Virus(2013, september 13).
read more