Hepatitis C is an infectious disease caused by the Hepatitis C Virus (HCV), it is a silent disease but leaves very serious consequences. Every year in the world there are about 3% of people chronically infected with Hepatitis C and there are about 170 million carriers of Hepatitis C.

Symptoms are vague, mild and easily overlooked

Hepatitis C is a disease transmitted from person to person by 3 modes: blood contact, sexual contact and from mother to child through the placenta at birth. However, the risk of sexually transmitted infection is lower as compared to Hepatitis B. Mother to child transmission of hepatitis C have been recorded, but the rate is low. Thus, the risk of infection of Hepatitis C Virus mainly via blood-transfusion (recipient of blood or blood products infected with C virus; sharing needles with HCV infected person, health personnel exposed to HCV-contaminated specimens, a number of other causes, such as acupuncture, ear piercing, tattooing, where the tools are not absolutely sterile). In addition, amongst 30-40% population of HCV infection, cause is unknown.

Diagnosis of Hepatitis

After HCV enters into the body, there is a long incubation period (ranging from 7-8 weeks), followed by onset. Most cases of acute Hepatitis C have no specific symptoms, person feels tired, has headache and some flu-like symptoms. Some cases may manifest gastrointestinal disorders such as abdominal pain, anorexia, right upper quadrant pain, i.e. (the liver). If you put pressure on intercostal space of costal rib 11-12, on right side, person will feel pain, or discomfort. The reason is the liver is inflamed, and swollen liver causes the outer membrane to be overstretched. Accompanying pain, may present with jaundice, yellow eyes, dark urine, fever due to hepatic inflammation which also affect bile ducts in liver causing stasis of bile pigment.

Besides, pain and jaundice, yellowing of eyes is so mild that patient doesn’t pay attention, even though the liver is still suffering with severe inflammation. The period of this disease can last a long time (about 6 to 8 weeks) and the disease itself does not need any treatment. However, the number of patients healing on their own are only around 15-30% of the cases (while for Hepatitis B is 90%). The rest of them either will have chronic Hepatitis C or become carriers Hepatitis C (i.e. after about 6 months, the body doesn’t clear HCV from the body).

Rate of becoming chronically infected with HCV is much higher than that with Hepatitis B (55–85% of persons will develop chronic HCV infection, whereas in Hepatitis B, only 10% will develop chronic HBV infection). The prominent feature of chronic Hepatitis C is that the progression is very quiet over 10-30 years, so the disease is often not diagnosed and treated promptly. The most worrisome is chronic Hepatitis C, which can lead to Cirrhosis (about 10-20%) or more dangerous i.e. Liver Cancer (about 5%). The rate of complications of Cirrhosis, Liver Cancer compared with Hepatitis B is also much higher. Person carrying the Hepatitis C Virus has little effect on himself, but a dangerous source of infection to others. Therefore, the current Hepatitis C virus remains a major threat to humans. Many people have no or few symptoms during the acute phase of HCV infection. Most people with chronic Hepatitis C have no symptoms and still almost live a normal life, and when Cirrhosis or Liver Cancer occur, symptoms are exhibited.

When should be hepatitis C treated?

When Hepatitis is suspected, seek medical attention immediately. Doctor will prescribe all kinds of tests from basic to specific. The tests for Hepatitis C at the baseline level can be performed by a blood tests with HCV antibody rapid test, serum bilirubin, liver enzymes (SGOT and SGPT), and liver ultrasound to evaluate the condition of the liver if it has become inflamed or shrunken. At higher levels, in addition to the basic testing, test to quantify the Hepatitis C virus (HCV-RNA) in the blood and genotyping done to determine the course of treatment, specific test i.e. fibroscan to determine extent of liver fibrosis. Liver biopsy is seldom needed.

Until relatively recently, treatment for chronic hepatitis C usually involved taking two main medicines: pegylated interferon – a medication that encourages the immune system to attack the virus ribavirin – an antiviral medication that stops the virus reproducing.

These medications were frequently just taken together, but now there are new Directly Acting Antivirals (DAAs) medications that have been shown to make the treatment more effective. Currently used FDA approved treatment involve Ledipasvir/sofosbuvir, velpatasvir/sofosbuvir, elbasvir/grazoprevir, sofosbuvir/daclatasvir, ombitasvir/paritaprevir/ritonavir, simeprevir/sofosbuvir for 12-48 weeks.

Prevention of Hepatitis C

Primary prevention activities can reduce or eliminate potential risk for HCV transmission from a) blood, blood components, and plasma derivatives; b) such high-risk activities as injecting-drug use and sex with multiple partners; and c) percutaneous exposures to blood in health care and other (i.e., tattooing and body piercing) settings. Immunization against HCV is not available; therefore, identifying persons at risk but not infected with HCV provides opportunity for counseling on how to reduce their risk of becoming infected.

To prevent infection with Hepatitis C virus by contact with the blood, health personnel must use absolutely sterile medical instruments relating to patients in their daily work. Proper and strict screening test of blood donors before receiving blood is essential.

In daily professional work, the physician must take precautions while doing the procedure or (injections, communications, surgery, or other procedures guidelines in contact with blood) as patient may be infected with Hepatitis C. Strictly not to share needles and syringes, use absolutely sterile equipment. For men, don’t share razors. And barbers should use a new razor blade for each person.

To avoid unsafe sexual practices with unknown/suspected person with infection i.e. during sexual intercourse, it is necessary to use a condom. When we know the transmission routes of hepatitis C virus, in the daily life we need not to be afraid to live together, to shake hands, embrace or not to be afraid to sit with them.

People with chronic Hepatitis C or Hepatitis C carriers, should get periodic medical examinations as directed by your doctor. In people with chronic Hepatitis C, alpha-FP should be checked in your blood (alpha feto-protein) in order to detect early Liver Cancer. This is a type of protein found in the blood of people with liver cancer.