Viral Hepatitis C

What is hepatitis C?

Hepatitis C is a viral infection brought on by the hepatitis C virus which leads to the liver becoming inflamed. The hepatitis C virus is one that is blood-borne and the infection can be spread through sexual contact (this is rare), when you share needles with an infected person or when using equipment that has been close to the virus and not undergone proper sterilisation. Hepatitis C mainly affects the liver but it can also damage other body areas, such as the digestive, brain and immune system.

There are 6 different forms of hepatitis C virus. They are numbered one to six and known as different genotypes.

It is believed that around 400,000 individuals in the United Kingdom have hepatitis C, but the infection is more prevalent in other areas of the world, including China, Egypt and Indonesia.

What causes hepatitis C?

Hepatitis is a term that is used to describe swelling of the liver. There are different causes of hepatitis, including heavy or prolonged drinking and exposure to viruses. Hepatitis C is often spread by sharing needles; people who insert drugs have a high risk of developing hepatitis C. Other potential causes of hepatitis C include sharing toothbrushes and razors, body piercing and blood transfusions; although the risk is now extremely low as all blood donations in the United Kingdom are tested for infections before they are used. People who received a blood donation before September 1991 may have an augmented risk of hepatitis C as blood was not screened before this date (the risk is still low).

It is also likely for mothers to pass hepatitis C on to their newborn baby, though there is only a minute risk of this occurring. 

Symptoms of hepatitis C

Hepatitis C has an impact on people in different ways. In many cases the symptoms are very mild and some people are not even aware of the presence of symptoms. It is not uncommon for individuals with hepatitis C to be diagnosed with chronic fatigue syndrome or ME due to the similarities between the symptoms.

There are four stages of hepatitis C and these cause different symptoms. These stages include:

• Acute stage (1-6 months after infection): symptoms may include generally feeling unwell, tiredness, high temperature, nausea, tummy ache and vomiting.
• Chronic stage (after 6 months): symptoms include fatigue, depression, memory loss, mood swings, a lack of concentration and confusion.
• Compensated cirrhosis: cirrhosis is blemishes of the liver tissue, which is more prevalent in people who consume a lot of alcohol and affects around 20% of individuals with hepatitis C. Compensated cirrhosis indicates that the liver is still functioning well.
• Decompensated cirrhosis: this means that the liver cannot function properly and will eventually stop working altogether (known as liver failure).

Complications of hepatitis C

Possible complications of hepatitis C include:

• Liver cancer.
• Underactive (hypothyroidism) or overactive thyroid gland (hyperthyroidism).
• Dry mouth and eyes.
• Patches of itchy, irritated skin (known as lichen planus).
• Increased sensitivity to light, which can cause ulcers and blisters.
• Inflammation inside the kidneys (known as glomerulonephritis).

How is hepatitis C diagnosed?

Hepatitis C can be diagnosed by a blood test with the blood sample analysed for the incidence of antibodies to the hepatitis C viral infection. If the examination is positive this signifies that the virus has affected you at some point in your life. It will remain positive even if an individual is no longer contaminated with the virus. If the blood test result is positive another test (known as a PCR) will be carried out to find out if the illness is active, and further tests may be conducted to see what category of hepatitis C virus is present. If you are given a diagnosis of hepatitis C your doctor may order additional tests (including liver function tests, a biopsy and an ultrasound examination of the liver) to determine the extent of injury to your liver and examine how well the liver is functioning.

Treating hepatitis C

Prompt treatment of hepatitis C is able to clear the illness and prevent extra harm to the liver. If you are diagnosed with hepatitis C you will be referred to a liver specialist and your treatment plan will be drawn up. Treatment for hepatitis C usually involves taking two types of medication:

• Interferon: interferon is a drug used to fortify the immune system and works in the same way as the substance interferon, which is a natural construct of the body (interferon is usually injected).
• Ribavirin: this is an anti-viral drug which is taken twice a day and helps to stop the virus from reproducing inside the body.

Medication is usually taken for between 6 and 12 months and blood tests are repeated to determine whether the virus is still at hand. The length of treatment may vary according to the type of hepatitis C.

Preventing hepatitis C

There is at present no vaccination for hepatitis C, though there are ways of reducing the risk of developing the infection. These include:

• Avoid sharing needles or other drug-related equipment.
• Ensure all medical and dental equipment is sterile.
• Use a condom.
• Do not share anything that could be contaminated, such as a razor or toothbrush.

If you are diagnosed with hepatitis C you can lessen the threat of passing the infection on by following these steps:

• Avoid sharing needles, toothbrushes, scissors or razors with others.
• Use a condom (if you are in a long-standing relationship and want to consider other contraception options you should arrange to see your GP).
• Cover wounds and cuts with sterile waterproof dressings.
• Keep surfaces clean in the home.
• Avoid giving blood.