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Hepatitis C Virus (HCV)
About Hepatitis C
In this section, you or a loved one can find out more about medical treatments, research studies and practical information about hepatitis C. Read on to find answers to some of your questions as well as links to other information. Being informed is an important first step towards becoming an active decision-maker in your care plan.
What Is Hepatitis C?
Hepatitis is an inflammation of the liver – an infectious health condition caused by several types of hepatitis viruses. If a hepatitis C infection is not cleared by the immune system within months after acquiring it, it becomes ‘chronic’, causing inflammation and scarring/cirrhosis, making it harder for the liver to do its job – fighting infection, aiding digestion and filtering toxins from the blood.
Over time, people with hepatitis C virus (HCV) can become very sick and some may eventually need a liver transplant.
However, most people with chronic hepatitis C live very long periods with few to no symptoms. In fact, often only routine medical tests show liver damage – sometimes decades after the initial hepatitis C infection.
What Causes Hepatitis C?
Hepatitis C is spread by HCV-infected blood getting into the bloodstream of another person (blood-to-blood contact). This usually happens through punctures of the skin or scrapes and tears in the delicate tissue lining the nose and mouth.
- Today, most people become infected with HCV by sharing needles or other equipment to inject drugs. This tends to create a stigma for those living with the virus .
- Sharing contaminated needles, spoons, pipes, alcohol swabs, tourniquets and filters to inject drugs: injecting yourself with just one contaminated needle may be enough to become infected.
- Sharing straws to snort drugs, such as cocaine: cocaine can damage the inside of the nose, causing it to bleed. It is then possible to inhale contaminated blood and become infected.
- Getting a blood transfusion or an organ transplant that was not screened for hepatitis C or re-using medical equipment that should only be used once.
- Re-using tools for activities that break the skin, such as tattooing, body piercing, acupuncture and electrolysis.
- Sharing or borrowing personal items that might have blood on them, such as razors, nail clippers and toothbrushes.
- During pregnancy or childbirth, a woman who has hepatitis C can pass the virus to her baby.
- Having unprotected sex where blood could be present: for example, during anal sex, rough sex, sex during a woman’s period or when one person has open sores.
Hepatitis C virus cannot be transmitted through regular daily interactions. You cannot get hepatitis C from:
- Shaking hands or holding hands with an infected person
- Being coughed or sneezed on by an infected person
- Hugging an infected person
- Sharing spoons, forks and other eating utensils
- Mosquitoes or other insects
- Drinking water or eating food
- Toilet seats
- From the breastmilk of a mother with HCV. But if her nipples and/or surrounding areola are cracked and bleeding, she should temporarily stop breastfeeding.
What Are the Effects of Hepatitis C?
The liver is the largest organ in the body and the one most affected by chronic hepatitis C infection. This hard-working organ – roughly the size of a football – rests mainly in the upper abdomen, just to the right of the stomach. It serves as an important processing centre for the entire body.
As blood passes through it, many toxins like ammonia and alcohol are filtered out so they can't damage the body or damage it less than if a larger amount of toxin went into full blood circulation. The liver also manufactures important substances such as bile so food can be digested and absorbed. Last but not least, it stores beneficial substances like vitamins and glucose for later use.
Lifestyle Options
For most people, regardless of having hepatitis C or not, exercise, healthy eating and good sleeping habits are recommended. A healthy lifestyle can lead to an enhanced quality of life for most people. Talk to your doctor before making any lifestyle changes.
The most appropriate diet for you depends on factors such as your age, your weight, the extent of your liver damage (if any) and your symptoms (if any). It is well worth discussing these factors with a dietician. Your doctor should be able to give you a referral. Most people with chronic hepatitis C will be advised to just eat a healthy, balanced diet and protect their liver.
Being overweight can lead to a condition called fatty liver – a build-up of fat in the liver that can lead to cirrhosis. A combination of diet and exercise should help you to get to and/or maintain a healthy weight. Exercise is especially important for HCV, because not only is it an excellent means of weight control, it also increases/maintains body strength.
Stay hydrated. Drink about 8-10 glasses of water a day to give your body all the fluid it needs. Try having a glass along with each meal and drink a few more glasses in between meals.
Everyone has some degree of stress, but living with a chronic disease can increase it. Many patients with hepatitis C tend to be very anxious about their disease and the treatment. The first step in easing stress is identifying the triggers – then developing relaxation and coping skills to improve your overall well-being and give you a greater sense of control over your hepatitis.
Medical Treatments
There are drug treatments that may get rid of HCV, but they are not for everyone. Assessing the progression of liver disease is critical in first evaluating if a patient will need drug treatment or whether a ‘watch and wait’ approach is better.
The decision to treat with drugs and the drug treatment timing are dependent on a number of factors, such as:
- How much of the virus is in your body (your viral load)
- The genotype(s) or subtype(s) of hepatitis C you have
- The amount of liver damage present, such as cirrhosis
- What other health conditions you have
- The response to any previous treatments for hepatitis C.
Drug treatment is also not always an option as the medications available have serious side effects and do not work for everyone. The only ‘absolute contraindication’ (meaning, never, without exception) to HCV drug therapy treatment is pregnancy.
Doctors specialising in hepatitis C generally do not treat it with drugs unless it becomes chronic. Drug treatment is considered for patients with elevated alanine aminotransferase (ALT) liver enzyme levels (1.5 times the upper-normal limit) for a minimum of 3 months and confirmation from a biopsy that there is inflammation or fibrosis present in the liver, along with other considerations. If your doctor recommends no treatment, you should be monitored for liver problems with follow-up blood tests.
Hepatitis C infection is treated with antiviral drugs intended to clear the virus from your body. Your doctor may recommend a combination of antiviral drugs to be taken over several weeks.
Two antiviral therapies are currently used to treat people with chronic hepatitis C: dual therapy and triple therapy.
Some people may need to change their treatment or take a lower strength of medication. Patient blood tests are monitored throughout the drug treatment to detect side effects you would not be able to feel or see.
At regular follow-up visits after treatment, a liver specialist will check your liver enzyme levels to see whether the virus is still present. If the virus is still present, some patients may be advised to continue antiviral drug treatment, because it may reduce liver inflammation, slow the progression of liver damage or make liver cancer less likely. For those with cirrhosis, antiviral drug therapy may help them live longer.
If the liver has been severely damaged, a liver transplant may be necessary, replacing the damaged liver with a healthy one. Most transplanted livers come from deceased donors, though a small number come from people who donate a portion of their livers. A liver transplant is not a cure, however – treatment with antiviral drugs usually continues afterwards, as hepatitis C infection is likely to affect the new liver as it did the old. A successful transplantation can significantly lengthen the time an HCV-infected person has before liver disease develops again.
When you are living with a chronic disease like hepatitis C, it is normal to want to explore any treatment options to relieve your symptoms and improve your quality of life. Standard hepatitis C treatment has come a long way towards curing the disease. However, the drug treatments do not always work and they can have side effects, so some patients with hepatitis C look into complementary and alternative therapies as well. There is limited research on these therapies – no study so far has proven any alternative remedy to be both safe and effective for treating the condition as a whole (i.e. bringing about disease remission). It is difficult to draw any conclusions from the research because studies on alternative remedies are typically not as rigorous or numerous as those used to test medications.
If you want to try an alternative therapy, talk to your doctor first to make sure it would be safe for you, considering the complexities of your particular medical condition.
Review all your medications with your doctor, including any over-the-counter products you take, and pain relief medication. Depending on the degree of liver damage, your medications or their doses may need to be adjusted.
The single most important substance to avoid is alcohol. Try hard to eliminate or radically minimise your alcohol consumption. It is a very attainable lifestyle change if you make it a personal goal and give yourself a timeline. As alcohol is so ubiquitous in many social situations, make sure that you let friends and family know that you are serious and determined to change your habits.
You must also avoid or limit your exposure to toxic liquids and fumes like solvents (e.g. paint thinner), chemical household cleansers, and gardening pesticides and herbicides. These can further damage your liver. If you must use chemicals, cover your skin, wear gloves and a mask, and keep the area well ventilated.
Disclaimer
Please note that the information on this website is intended for informational purposes only and should not be used as a substitute for seeking medical advice or treatment from a healthcare professional. You should not use this information to diagnose or treat a medical condition or health problem. Speak to a healthcare professional if you have any questions about your health, medical condition, symptoms or treatment options.
References
http://www.nhs.uk/conditions/hepatitis-c
NHS Choices website
http://hepc.liverfoundation.org/
American Liver Foundation
The American Liver Foundation’s dedicated online information resource centre for Hepatitis C (or Hep C for short). Their resource centre was created to provide information and support to those affected by the Hepatitis C virus (HCV).
Hepatitis C Association
The focus of the Hepatitis C Association is to educate the public, both patients and medical providers, about hepatitis C virus. We offer factual information through educational programmes and support materials
