Hepatitis C FAQs
Reviewed By : Dr. Anjali D.
Following are common questions about Hepatitis C:
- What is Hepatitis C?
- What is the function of the liver and how is it related to Hepatitis C?
- How is the virus transmitted?
- Who are the people at risk of infection?
- What symptoms can you find that prove HCV infection?
- How does the virus spread in the body?
- What tests are suggested for diagnosing Hepatitis C?
- What are the lab values of tests required for Hepatitis C?
- What are the test charges of Hepatitis C diagnosis in India?
- What are the different treatment methods for Hepatitis C?
- What are preventive measures to adopt for avoiding Hepatitis C?
- What are the important facts related to the disease?
- What are the facts related to the spread of Hepatitis C in India?
What is Hepatitis C?
- Hepatitis C is a virus which is carried by the blood to the liver
- Hepatitis C(HCV) is a blood-borne virus
- The virus affects the liver and leads to its inflammation
- Hepatitis means inflammation. Normally it refers to the swelling of the liver. If it is inflamed in any way, the liver has a harder time performing its function.
- Besides the liver, it can also affect other parts of the body. For example, the stomach, the brain or the immune system.
- Hepatitis C can be of six types. They are differentiated according to their genotype. It is numbered from 1 to 6 (eg. Genotype 1, Genotype 2... and so on).
- It is essential to know the strain of the virus which the patient has been infected by. Different types of viruses responds to medication, differently. It is possible for a person to be infected by more than one virus at a time.
What is the function of the liver and how is it related to Hepatitis C?
To understand how the Hep C infection occurs, a basic understanding of the liver's function is required. This is because, the liver is mainly affected during the infection. The primary functions of the liver are:
- Converting Sugar to Glycogen. Glycogen is used as a fuel for the body. When energy is required, it is broken down again and released into the blood.
- Synthesizing proteins essential to the blood clotting mechanism
- Process fats and proteins from digested food
- Acts like a filter to remove harmful chemicals, like alcohol, drugs, poisons and toxins
- Secretes a yellowish-green enzyme called as bile, which assists in the breakdown of fats. The bile passes from the liver, down the bile duct, to the stomach. This assists in the absorption of fats in the food.
How is the virus transmitted?
Hepatitis C is commonly transmitted by exposure to the blood or bodily fluids that have already been affected. This can happen:
- By sharing needles, injection and equipment while using drugs
- By birth, a mother can transfer the virus to her child
- In hospitals, where adequate sterilization processes are not being followed (before 1992)
- Organ Transplants (before 1992)
- Getting tattoos and piercings at unlicensed tattoo parlors
- Household contact (sharing razors, toothbrushes)
- Sexual contact. This, however, is not a very common.
Who are the people at risk of infection?
- People who have injected illicit drugs in the past
- Medical workers who have been exposed to infected blood during the course of their job
- People who have received blood donation from a donor who has been identified as HCV positive, after they have already donated blood
- People who have received blood transfusions before 1992
- HIV positive patients
- Children born to HCV patients
- People who get tattoos or piercings at unlicensed parlors
- People engaging in unprotected sex with multiple partners
- People who have worked or been housed in prisons
What symptoms can you find that prove HCV infection?
70 to 80% people, do not show any symptoms after getting infected. A small number of people show symptoms. These are:
- Less appetite
- Stomach pains
- Dark Urine
- Grey-colored feces
- Joint pains
How does the virus spread in the body?
The progression of the virus can be divided into two parts.
- Acute Phase
- First six months is called as acute phase
- No symptoms at first. If at all present, very mild ones.
- Seven to eight weeks later, the first symptoms start to emerge
- Feeling of illness, nausea and vomiting
- Some people might get jaundice at this time. The symptoms of jaundice, like yellowness of the eyes, skin etc. can be observed.
- This occurs due to an excess of the enzyme bilirubin which spreads across the blood stream
- For 1 in 5 cases, the immune system clears the infection within two to six months. Younger people are more prone to fight the virus and then show no long term effects.
- Rest of the cases (4 out of 5) go on to develop a chronic infection and suffer from life long effects
- Chronic Phase
- After six months, the infection enters into the chronic phase
- Even at this stage people might not develop any noticeable symptoms. But when they pass the virus to other people, the infected people may develop problems further on.
- The virus causes different reaction in different people and this makes the treatment more difficult
- The symptoms of Hepatitis C develop for some people. Like intolerance to alcohol, liver pains and depression.
- Extreme fatigue, memory loss, poor concentration, joint aches and pains are also common.
- The severity of the symptoms does not indicate heavy liver damage. People with no outward indication of the disease might suffer from inflammation.
- One-third of those infected might develop liver cirrhosis, over a duration of 20 to 30 years. Cirrhosis means scarring of the liver and causes severe damage. Finally liver failure can occur and even cancer.
What tests are suggested for diagnosing Hepatitis C?
The virus can be diagnosed in two steps
- Serological Test which identifies people who have been infected by the virus by screening for antibodies of HCV
- A Nucleic acid test for people who have tested positive for the previous test. This is only for confirmation, as sometimes people who have tested positive for antibodies, might fight the infection and clear it. Thus, they test negative for the nucleic acid test.
- Biopsy of the liver for evaluation of damage (Cirrhosis or fibroids). Many non-invasive tests can also be performed.
What are the lab values of tests required for Hepatitis C?
For Serological Test:
Alanine aminotransferase (ALT) levels
- Minimum: 3.0 mg per dL(51 μmol per L)
- Average: 4.1 mg per dL(70 μmol per L)
- Minimum: 600 U per L (10,000 nkat per L)
- Average: 1,410 U per L (23,500 nkat per L)
What are the test charges of Hepatitis C diagnosis in India?
The expenses for performing Hepatitis tests might differ between cities, type of hospitals and diagnostic centers chosen. To get an extensive list, with the charges offered in your city, click here.
What are the different treatment methods for Hepatitis C?
Hepatitis C sometimes does not require treatment as the immune response is enough to clear the infection. Some people who suffer from chronic infection might not develop liver damage. The cure rate depends on the strain of the virus and the treatment being prescribed.
- Weekly injections of interferon and ribavirin for 48 weeks cured half of the people tested with this drug. Frequently, the other half of the people tested did not respond well to this treatment.
- Recently, a new antiviral drug has been introduced in the market. This drug is called as Direct Antiviral Agents.
- The treatment is safer and shorter
- Though the production costs of this is quite low, the initial cost is quite high. This makes the drugs very expensive.
- Finally, if the liver has been damaged severely, then a liver transplant may be required
- Liver transplant may not be a permanent cure for HCV. The virus might recur and fibroids and cirrhosis might occur again.
- People might choose to opt for the alternative therapy route by keeping the liver and immunity system healthy. Ayurvedic medicine, milk thistle, massage, acupuncture therapy are methods that are sometimes used to good results. As Hepatitis C cannot be completely cured, a balance of the two methods of treatment might be used for optimum health.
What are preventive measures to adopt for avoiding Hepatitis C?
- Needles should not be shared. Prevention of drug abuse can reduce the risk of infection.
- Health care workers should take care to avoid exposure to infected blood. A strict sterilization process should be followed.
- Personal items like toothbrushes and razors should never be shared among members of a household.
- Tattoo and piercing parlors should be selected with great care
- Practice of safe sex should be followed
What are the important facts related to the disease?
- Chronic HCV infection can lead to complications, like liver cancer and cirrhosis. It may finally lead to death.
- There is no vaccine for the disease
- It was discovered in the 1980s and so it's a relatively new disease
- There are 180 million HCV patients throughout the world
- Majority of infected people may not know about it, as symptoms are very few; however, 15-45% of people may clear the infection on their own, without any medication, within six months of being infected
- Approximately 90% of people can get cured by taking anti-viral medicines
- The primary problem is getting access to diagnosis and treatment
- Hep C virus can survive outside the human body for up to 3 weeks
- Hepatitis C is not spread through
- Breast Milk
- Sharing food or water with an infected person
- Mosquito bites
What are the facts related to the spread of Hepatitis C in India?
- 1 to 1.5% population of India is infected by the virus
- Despite the low percentage, due to the large population of India, there are 12 to 18 million HCV affected people
- This accounts for a 80% percentage of the disease infected people worldwide
- Two drugs, sofosbuvir and simeprevir, which help in fighting HCV, have been approved by the FDA. Many more drugs are present in the pipeline, waiting for approval and then entry into the Indian markets.
- These new drugs are of a lower cost and need to be consumed for shorter duration (12 weeks), with lesser side effects
- In the near future, there will be an easy access to affordable drugs for all those who are in need