When the liver becomes inflamed due to infection, disease, drugs, poisons, or excessive alcohol, it is referred to as hepatitis. Infectious hepatitis commonly includes hepatitis A, B, or C. All of these forms are caused by viral infections.
The liver is a two-lobed organ found in the upper-right part of the torso. It is responsible for many functions and substances within the body, including:
- Immune factor
- Producing blood plasma protein
- Storing and releasing glucose
- Storing iron
- Converting ammonia to urea
- Controlling blood clotting
- Processing drugs and poisonous substances
- Removing bacteria from the blood
- Clearing bilirubin from the body
Hepatitis C (HCV) affects thousands of people each year.
Some of those with HCV experience only an acute illness, in which the illness is experienced within 6 months of exposure. However, 75-85 percent of those infected will progress to a chronic, potentially lifelong infection.
What is hepatitis C?
HCV is a tough virus in that it can live for up to 3 weeks on surfaces kept at room temperature. HCV is contagious and spread by blood transmission.
Ways that HCV can spread include:
- Needle or syringe sharing
- Sharing of drug-related equipment used for drug injection
- Healthcare worker-related needle sticks
- Maternal-fetal transmission
- Sharing of razors or toothbrushes
- Having sex with someone who is HCV positive.
- Getting a tattoo or body piercing at a facility using poor infection control practices
The US Centers for Disease Control and Prevention (CDC) report that the risk of getting HCV through sex is increased in those who have many sex partners, have a sexually transmitted disease or HIV, or partake in rough sexual activities
To be clear, the CDC report that while the disease is contagious, it is not spread through the following ways:
- Coughing or sneezing
- Food or water
- Hugging, kissing, or holding hands
Signs and symptoms of hepatitis C
HCV has two phases: acute and chronic. Symptoms vary depending on the phase of the viral infection. While most people with HCV show no symptoms, symptoms can occur as early as 2 weeks after exposure. They can last for up to 6 months.
Acute infections may go away on their own or following treatment with certain antiviral therapies. People with an acute infection may experience symptoms such as:
- Yellowing of the skin and eyes
- Muscle aches
Many of those who progress to a chronic HCV infection will remain without symptoms. When symptoms are experienced, they may include:
- Loss of appetite
- Weight loss
- Stomach pain
- Dark urine
- Clay-colored stool
- Joint pain
- Yellowing of the skin and eyes
- Easy bruising or bleeding
- Skin itching
- Belly fluid
- Leg swelling
- Confusion, drowsiness, and slurred speech
- Spider-like blood vessels in the skin
Other forms of hepatitis, including hepatitis A and B, may present with similar symptoms. If someone is experiencing any of the symptoms of hepatitis, they should speak with their doctor immediately. Testing can then be completed to determine the cause of the symptoms.
Complications of hepatitis C
Complications from an infection with chronic HCV can be serious and life-threatening and include:
- Liver damage
- Liver failure
- Liver cancer
Treatment for hepatitis C
There are several treatments available for both acute and chronic cases of HCV. In both acute and chronic HCV infections, some people will naturally clear the virus without the use of medications. For those with an acute HCV infection, this clearing can occur in nearly 25 percent of people. The risk of chronic infection with HCV is reduced with treatment, however.
Treatment of HCV may include the use of antiviral medications. The medication used depends on the patient’s situation and doctor’s recommendations.
Some people with an HCV infection may require a liver transplant and antiviral therapy to address the liver damage caused by the disease.
In the UK, 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 nowadays they’re often combined with a third medication, such as simeprevir or sofosbuvir. These are newer hepatitis C medications that have been shown to make treatment more effective.
There are also a number of newer medicines that are often used to treat hepatitis C nowadays.
Some of these are taking alongside pegylated interferon and/or ribavirin, while some can be taken on their own or in combination with other new medicines.
These medications include:
- a combination of ledipasvir and sofosbuvir
- a combination of ombitasvir, paritaprevir and ritonavir, taken with or without dasabuvir
These medications are taken as tablets once or twice a day, for between eight and 48 weeks, depending on the exact medicine you’re taking, your hepatitis C genotype and the severity of your condition.
These medicines are generally used to treat people with either genotype 1 or genotype 4 hepatitis C, although sometimes they’re also used to treat people with other genotypes.
In some cases, a combination of these newer medications may be taken without needing to take pegylated interferon and/or ribavirin as well.