What Causes Hepatitis C?
Hepatitis C Well-Being
What is Hepatitis C?
HCV (Hepatitis C Virus) is an inflammation of the liver causing
soreness and swelling. It is the most common chronic blood borne infection
in the United States. The hepatitis C virus usually is transmitted through
contact with infected blood, most commonly by sharing needles during intravenous
drug use, or getting a blood transfusion before 1992. Hepatitis C also
may be spread through unprotected sexual intercourse, but this is uncommon.
Most people don't feel sick when they are first infected with hepatitis
C. Instead, the virus stays in their liver and causes chronic liver inflammation.
- HCV is one of the most common causes of chronic liver disease in the
- If the inflammation is not reversed, it becomes chronic (ongoing,
long term) and can cause chronic liver disease, which can be serious
or even fatal.
- At least 75% of people infected with hepatitis C develop chronic hepatitis
- If the disease progresses to the point at which the liver begins to
fail (end stage liver disease), the only treatment is liver transplantation.
- About 4 million people in the United States have antibodies to HCV,
meaning they have been infected with the virus at some point; as many
as half of them do not know they have the infection.
Symptoms of hepatitis B or C include headache, nausea, vomiting, abdominal
pain, jaundice (the skin turns yellow), weakness and fatigue. Bowel movements
may be gray in color. The urine may be dark and look like tea. Sometimes,
though, hepatitis is a mild illness. If you have a mild case of hepatitis,
you may not even realize that you have it. It may not cause symptoms or
may only cause symptoms similar to the stomach flu. You might think you
have the flu, and not know you have hepatitis.
- Chronic hepatitis C can lead to Cirrhosis of the liver
in many people, a condition traditionally associated with alcoholism.
Symptoms of cirrhosis include the following:
- Fluid retention causing swelling of the belly (ascites), legs, or
- Persistent jaundice
- Disturbances in sleeping
- Itchy skin
- Loss of appetite, weight loss, wasting
- Vomiting with blood in the vomit
- Mental disturbances such as confusion, lethargy, extreme sleepiness,
or hallucinations (hepatic encephalopathy)
Hepatitis C is mainly transmitted by contact with blood or blood products.
Many times, the cause of hepatitis C is never found.
- Sharing of contaminated needles among intravenous (IV) drug users
is the most common mode of transmission. Using a needle to inject drugs,
even just once many years ago, is a risk factor for hepatitis C.
- Many people contracted hepatitis C through blood transfusions. Since
1992, however, screening tests to check for hepatitis C in donated blood
have decreased the chance of getting the virus.
- Extremely rare transmission modes include from mother to child during
birth, sexual intercourse (particularly if sexually active with more
than 1 partner), and accidental needle sticks from a needle used by
someone infected with HCV. Other possible modes include manicures, haircuts,
razors, toothbrush, and tattoos, but these are unlikely.
- Received blood, blood products, or solid organs from a donor who has
- Have been on long-term kidney dialysis
- Have had frequent workplace contact with blood (for instance, as
a healthcare worker)
Combination therapy with Interferon and Ribavirin is the treatment of
choice resulting in sustained response rates of 40%-80%. (up to 50% for
patients infected with the most common genotype found in the U.S. [genotype
1] and up to 80% for patients infected with genotypes 2 or 3). Interferon
monotherapy is generally reserved for patients in whom Ribavirin is contraindicated.
Ribavirin, when used alone, does not work. Combination therapy using interferon
and ribavirin is now FDA approved for the use in children aged 3-17 years.
What are the side effects of interferon therapy?
Most persons have flu-like symptoms (fever, chills, headache, muscle
and joint aches, fast heart rate) early in treatment, but these lessen
with continued treatment. Later side effects may include tiredness, hair
loss, low blood count, trouble with thinking, moodiness, and depression.
Severe side effects are rare (seen in less than 2 out of 100 persons).
These include thyroid disease, depression with suicidal thoughts, seizures,
acute heart or kidney failure, eye and lung problems, hearing loss, and
blood infection. Although rare, deaths have occurred due to liver failure
or blood infection, mostly in persons with cirrhosis. An important side
effect of interferon is worsening of liver disease with treatment, which
can be severe and even fatal. Interferon dosage must be reduced in up
to 40 out of 100 persons because of severity of side effects, and treatment
must be stopped in up to 15 out of 100 persons. Pregnant women should
not be treated with interferon.
What are the side effects of combination (ribavirin + interferon)
In addition to the side effects due to interferon described above, ribavirin
can cause serious anemia (low red blood cell count) and can be a serious
problem for persons with conditions that cause anemia, such as kidney
failure. In these persons, combination therapy should be avoided or attempts
should be made to correct the anemia. Anemia caused by ribavirin can be
life-threatening for persons with certain types of heart or blood vessel
disease. Ribavirin causes birth defects and pregnancy should be avoided
during treatment. Patients and their healthcare providers should carefully
review the product manufacturer information prior to treatment.
- For end-stage liver disease, the only treatment that will cure the
problem is liver transplantation.
Hepatitis C Well-Being
Follow all instructions that your health care provider gives you. A healthy
lifestyle is more important than ever.
- Eat a varied, healthy diet, take it easy, and get plenty of rest.
- Drink plenty of fluids to prevent dehydration.
- Do not drink alcohol of any kind, including beer, wine, and hard
- Avoid medicines and substances that can cause harm to the liver such
as acetaminophen (Advil, Aleve, Ibuprofen, Tylenol) and other preparations
that contain acetaminophen.
- Avoid prolonged, vigorous exercise until symptoms start to improve.
The better you take care of yourself, the more likely you will be one
of the many individuals who do well for many years.
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