What is hepatitis and HCV?
Hepatitis is a general term for inflammation of the liver. Any number of conditions can cause hepatitis, but one of the more common causes is a viral infection from the hepatitis virus, of which there are three types: A, B, and C. Type A is a short-term infection often caused by consumption of a contaminated food or water source. Type B is also short-term, though chronic hepatitis can evolve from an HBV infection in some cases. This type is spread by blood, semen, or saliva from an infected organism entering the body of an uninfected one – IV drug use, sexual contact, and animal bites can all lead to an infection of Hepatitis B. Vaccinations for both Type A and Type B hepatitis exist.
Hepatitis C is of particular concern because the virus can remain dormant for decades, often failing to manifest symptoms until an infected person’s immune system is compromised by age or a separate medical condition. Untreated, Hep C can lead to cirrhosis, liver cancer, and death. It’s also a factor in the fastest growing cause of cancer-related deaths in America presently, hepatocellular carcinoma (HCC). In fact, HCV is the leading cause of HCC in the western world. There is no vaccine for Hepatitis C.
How is HCV spread?
Hep C isn’t spread by casual contact with a carrier or through a vector (mosquitoes, animals, or contaminated food products). Needle-sharing is presently the most common cause of an HCV infection. Prior to 1992 HCV was spread through blood transfusions, but rigorous screening of blood products has eliminated that concern. In some cases, sexual contact, sharing of contaminated razors, and contact with unsterilized tattoo needles has led to an HCV infection, though these are much less common causes of the disease. Finally, a baby born to a mother with HCV will also carry the HCV virus.
What are the symptoms of hepatitis?
An acute infection of hepatitis C manifests with fever, fatigue, abdominal pain often accompanied by nausea and vomiting, jaundice (a yellow discoloration of the skin and eyes), joint pain, clay-colored stools, and dark urine. Bear in mind, however, that an acute infection from HCV is less likely than a chronic infection, which typically manifests no symptoms and takes years or even decades to cause damage to the liver (in the form of scarring or cancer). Many carriers of HCV will have no reason to suspect they’re infected (and as carriers they can still infect another person with it).
Who should be screened for Hep B and why?
Anyone who’s ever been an IV drug user or shared needles should strongly consider HCV screening. Currently, there’s also a huge push for baby boomers (anyone born between 1945 – 1965) to receive HCV screening because of the risk from contaminated blood products. Moreover, because of the time required for HCV to cause liver damage, baby boomers entering middle age are now at the greatest risk for complications. In fact, baby boomers are five times more likely to have an HCV infection than the general population and may not even know it. Health care workers who’ve been exposed to HCV by needle-stick injury or handling blood products should be screened. Some experts also suggest that incarcerated individuals living in close contact with others should also be screened.
Getting an HCV screen promptly will help anyone with an HCV infection receive care to prevent the potentially serious side-effects of hepatitis.
What’s the procedure for HCV screening?
The first step in HCV screening is a routine blood test ordered by your primary care provider (PCP). This test is used to determine the presence or absence of an antibody for HCV. However, a reactive antibody test (meaning the antibody is present) only indicates that the person is a carrier. To determine if an active HCV infection is present, a second test for HCV ribonucleic acid (RNA) is done (See: “Screening and Management of Hepatitis C,” American Nurses Association). Both tests are required for a positive diagnosis of HCV, however, because (for reasons we don’t fully understand), 1 in 4 people eliminate the hepatitis C virus on their own – meaning they will have the HCV antibody, but not the active infection. Baby Boomers take note: Medicare covers the cost of the PCP-ordered blood test for anyone born between 1945-1965.
How is an HCV infection treated?
HCV used to be treated with interferons with limited success. However, since the introduction of a new class of drugs called direct acting antivirals (DAAs) in 2012, the success rate for eliminating HCV is now an impressive 90-95%. DAAs are given as an oral medication with very few side-effects. Unfortunately, they’re also very expensive and this is a major barrier to treatment.
Hepatitis C is a viral infection of the liver, sometimes leading to an acute set of symptoms but most often developing over decades with little or no obvious symptoms in the carrier. However, this chronic form of hepatitis can lead to serious outcomes later in life – scarring of the liver (cirrhosis), liver or blood cancers (HCC), and death.
Anyone with a history of needle sharing/IV drugs use, Baby Boomers (individuals born between 1945 – 1965), and anyone who received blood clotting products or an organ transplant prior to 1992 should consider being screening for HCV through a routine blood test ordered by their provider.
Remember, no one can diagnosis or treat an illness except a qualified, licensed medical professional like your primary care provider. If you’re concerned about HCV, contact your doctor or APRN and schedule an appointment to discuss your concerns.
Legal disclaimer: Advice offered on this website is for educational purposes only. The information herein is not intended for use to diagnose, treat, or manage any health conditions or offered as an intent to treat any individuals. ALWAYS consult your primary care provider with questions regarding your health.