Hepatitis C

What is hepatitis C ?
Hepatitis C is a liver disease caused by the hepatitis C virus (HCV). HCV causes the liver to swell and prevents it from working well. HCV usually causes long-term or chronic infection of the liver and unless successfully treated with medications, can lead to cirrhosis (scarring) of the liver, liver cancer, and liver failure.

Who is at risk of having hepatitis C ?
HCV is spread by blood to blood contact. You may be at risk if you have:
Used intravenous drugs in the past and shared needles for injecting these drugs
Received blood transfusion in the past especially from unregulated blood banks
Chronic kidney disease on hemodialysis
Contact with infected needles or blood
Unprotected sex with multiple partners
Persons who have tattoos

The commonest cause of HCV infection in India is through improperly sterilized medical equipment and the re-use of injection needles in hospitals and clinics.

What does not cause Hepatitis C ?
HCV is not spread by sneezing, hugging, or coughing or casual contact
HCV is not spread by food or water, sharing utensils or drinking glasses

What are the long term consequences of hepatitis C ?
HCV damages the liver slowly over a period of 20-30 years. More than 50 percent of patients with untreated hepatitis C progress to liver cirrhosis which is scarring of the liver. Once cirrhosis develops patients are at a risk of developing liver failure. Five to 10 percent of these patients develop liver cancer.

What are symptoms of hepatitis C ?
Patients during the early phase of infection have no symptoms and feel absolutely healthy. When the disease progresses and patient develops liver cirrhosis, symptoms occur such as tiredness, nausea, loss of appetite, skin itching, dark urine, and jaundice (yellowing of the skin and eyes). Once liver failure develops, patients develop swelling of the legs (edema), fluid in the abdomen (ascites), vomiting of blood, and mental confusion.

How is hepatitis C diagnosed ?
Hepatitis C is diagnosed by simple blood tests. Specialized tests can also tell you about the amount of virus in your blood. A liver function test and an ultrasound scan of the liver will assess whether you may have developed early cirrhosis. Your doctor may advise you to undergo a liver biopsy to check how much of the liver is damaged. During a biopsy, a small piece of liver tissue is removed with a needle passed into the liver. This tissue is then studied in the laboratory.

What should you do if you are diagnosed to have hepatitis C ?
Eat healthy meals
Exercise and try to lose weight if you are overweight
See a liver doctor regularly
Take only the medications recommended by your doctor
Avoid alcohol completely
Talk to your doctor about treatments for Hepatitis C
Talk to your doctor about hepatitis A and hepatitis B vaccines
Ask your spouse to get tested for Hepatitis C

How is hepatitis C treated ?
There is effective treatment for HCV infection. Treatment usually consists of weekly injections of Interferon along with oral drugs (Ribavirin). Treatment is usually given for 6 to 12 months. Two out of three patients respond well to treatment. Newer drugs such as Boceprevir and Telaprevir help in improving the response to treatment. Treatment is more effective if patients are treated when they are young and do not have advanced liver disease.

How can patients with Hepatitis C and liver failure be treated ?
Once patients with HCV develop cirrhosis and liver failure, they cannot be treated with medicines. The only option in such patients is to undergo liver transplantation. Overall about 10 percent of patients with Hepatitis C require liver transplantation. The success rate of transplantation 90 percent, but the new liver may get re-infected with hepatitis C which may require treatment after transplant.

What is the best way to stop the spread of hepatitis C ?
There is no vaccine to prevent HCV. The only way to stop the spread of HCV is to avoid direct contact with infected blood.
Make sure your healthcare providers use clean and sterile equipment for your care and are not reusing injection needles
Make sure that blood being transfused is from an authorized and government blood bank.
Practice safe sex
Use clean needles and equipment for tattoos, ear and nose piercings
Do not share razors, toothbrushes, or other personal items with others

Hepatitis C : Facts at a Glance
Hepatitis C is a liver disease caused by the hepatitis C virus (HCV).
HCV is spread by direct contact with infected blood.
1-2 percent of the Indian population is HCV positive
Most people with HCV have no symptoms.
HCV can be diagnosed by simple blood tests.
There is no vaccine to prevent Hepatitis C.
HCV causes slowly progressive liver disease and leads to liver cirrhosis and liver failure.