Diagnosis and treatment of hepatitis C have seen great improvements
Hepatitis C is a virus that affects the liver and can lead to acute hepatitis, chronic hepatitis C as well as cirrhosis of the liver and liver cancer. It is estimated that about 3.5 million people in the United States are living with hepatitis C. About 50% of all infected people are unaware of the fact that they have the hepatitis C virus.
Risk factors for acquiring hepatitis C
- Current or past injection drug users (accounts for about 50 to 60 percent)
- Blood transfusion or solid organ transplantation prior to July 1992 (prior to better testing protocol). Risks of blood transfusion now is less than one per two million units transfused
- Chronic hemodialysis patients
- Health care workers after needle stick injury from patients infected with the virus
- Children born to mothers with hepatitis C
- Unregulated tattoo
- Sexual relationship with people with hepatitis C
- Sharing contaminated items like toothbrushes and razors
Clinical presentation
15 percent to 25 percent of people who get exposed to this virus will clear the virus on their own without any treatment while 75 percent to 85 percent of patients develop chronic hepatitis C. Weakness, fatigue and jaundice may develop in the acute phase. Patients with chronic hepatitis C may have no symptoms. However, when patients develop cirrhosis then symptoms include swelling of the legs and abdomen, vomiting blood and confusion. Liver cancer may develop in the presence of liver cirrhosis and these patients may also have pain in the right upper abdomen
Who should be tested?
- Those who have any of the risk factors noted above
- The U.S. Preventive Services and Task Force (USPSTF) also recommends testing in anybody born between 1945 and 1965
- Presence of hepatitis C antibody requires confirmation with a more specialized test
Treatment
Prior treatment included use of interferon, which was administered as a subcutaneous injection with too many side effects and minimal effectiveness. Treatment lasted for about a year. Interferon-based treatment was poorly tolerated and many patients discontinued treatment.
Current treatment now involves pills taken by mouth without any more injections. Current antiviral treatments have little or no side effects and are well tolerated. Depending on genotype and presence or absence of cirrhosis virus, the eradication rate now could be as high as 94 percent to 100 percent. Duration of treatment now could be as short as eight weeks.
We have come a long way from the days of interferon therapy to new well-tolerated, highly effective treatment options administered by mouth, so we encourage people to get tested for their own sake and for the sake of others.
Information provided by Bolarinwa F. Olusola, MD, gastroenterologist at UT Health North Campus Tyler.