A Family Doctor's Tale - HEPATITIS C

DOC I HAVE HEPATITIS C
Hepatitis B is a serious  inflammatory liver disease caused by a virus which is called hepatitis C virus (HCV).

Hepatitis C virus infection is one of the most common chronic bloodborne infection.
Persons at risk for infection are:
1. injection-drug users
2. blood transfusions or solid organ transplant recipients before July 1992
3. on long-term dialysis
4. sexual exposure to infected HCV carriers(rare)

Persons who has been newly infected with HCV usually are asymptomatic or have a mild clinical illness:
mild fever and bodyaches
slight jaundice
nausea
enlarged liver


A person exposed to Hepatitis C infection can detect HCV RNA in blood within 1-3 weeks.
The time from exposure to antibody to HCV seroconversion(or Anti-HCV) is 8-9 weeks.
Therefore diagnosis can usually be confirmed by :
1.the presence of Anti-HCV in 98% of infected persons within 6 months of exposure. 
2.Reverse transcriptase polymerase chain reaction to detect HCV RNA

Chronic HCV infection occurs in 70% of HCV-infected persons.
Two thirds of these have evidence of active liver disease but may not be aware of their infection because they are not clinically ill.
Infected HCV carriers can transmit the illness to others and develop chronic liver diseases for years after infection.

There is no cure for HCV infections.
Persons found to be anti-HCV positive should be evaluated for presence of active infection, presence or development of CLD, and for possible treatment.
Combination therapy with interferon and ribavirin may help in treatment of patients with chronic hepatitis C.

No vaccine for hepatitis C is available.

Immune globulin is not effective in preventing HCV infection after exposure.
Primary prevention reduces or eliminates HCV transmission.
Secondary prevention activities reduce liver and other chronic diseases in HCV-infected persons by identifying them and providing appropriate medical management and antiviral therapy.

Persons who test positive for anti-HCV (see Diagnosis and Treatment) should be provided information regarding
1) how to protect their liver from further harm by avoiding alcohol and taking any new medicines (including OTC and herbals)
2) how to prevent transmission to others
a) not donate blood, body organs, other tissue, or semen;
b) not share any personal items that might have blood on them (e.g., toothbrushes and razors);  c) cover cuts and sores on the skin to keep from spreading infectious blood or secretions
3) the need for medical evaluation including assessment of liver function tests, assessment for severity of liver disease and possible treatment, and determination of the need for hepatitis A and B.
HCV-positive women do not need to avoid pregnancy or breastfeeding.