Hepatitis C is a liver disease caused by the hepatitis C virus.
Two of the most important factors in combating hepatitis C are:
identifying those who have the condition, because many are infected but don’t know it,
and providing treatment that will cure the disease.
The liver is our largest solid internal organ, in most adults, it is about the size of a football,
and it’s located underneath the ribcage, in the upper right part of the abdomen.
The liver has many important functions, it filters blood, metabolizes substances, such
as nutrients and medications, it stores energy, and makes essential proteins, including those
that help the blood to clot when we bleed.
Sometimes the liver can repair itself, but it is susceptible to damage from many different
sources, including viruses, toxins, including alcohol, inherited conditions, and even our
body’s own immune system.
Hepatitis C, also known as Hep C or HCV, is one of several viruses that can damage the liver
More than 170 million people worldwide are living with Hep C, including more than 350,000 Canadians
Although vaccinations are available for two other forms of hepatitis, hepatitis A and hepatitis B, there is
currently no vaccine for hepatitis C. Hepatitis C begins as an acute infection after
exposure to the hepatitis C virus.
Some infected individuals will clear the virus on their own, but most of those infected – about
75% – will go on to develop chronic HCV.
Infection with the hepatitis C virus is often silent; that is, many infected individuals
do not have any symptoms.
For those who do, symptoms are generally non-specific, such as
mild to severe fatigue or discomfort in the abdomen.
Sometimes health professionals detect hepatitis C during routine screening or while investigating
the cause of other abnormal lab tests.
Over many years, inflammation of the liver caused by the hepatitis C virus usually results
in the formation of scar tissue, or fibrosis.
The developing fibrosis in the liver can eventually reach a specific level, which we call cirrhosis.
For patients with cirrhosis, ongoing damage to the liver may eventually result in worsening
fatigue, fluid accumulation in the abdomen, bleeding from veins in the esophagus or stomach,
and confusion.
Hepatitis C infection with cirrhosis leads to increased risks for liver failure and liver cancer.
The goal in identifying and treating hepatitis C is to cure the disease before cirrhosis develops
and its complications occur.
Hep C is not spread by sneezing, coughing, kissing, hugging, or shaking or holding hands.
It’s not spread through food or water, or by sharing food, drinks, or eating utensils
with an infected person.
However, you can get the virus from activities involving blood-to-blood contact,
injection drug use or sharing of other contaminated drug paraphernalia, which is
responsible for 70-80% of HCV transmissions in Canada today,
sharing personal hygiene items such as razors and toothbrushes with a person who
is infected, having piercings, tattoos, or acupuncture
performed without appropriate sterilization, having a contaminated needle-stick injury
in health care settings, having received a blood transfusion, organ
transplantation, or blood products prior to 1992 is considered a significant risk factor,
but with current screening practices for blood donors, the risk of acquiring hepatitis C
from these methods today is exceedingly low, having surgical or dental procedures, either
in Canada or abroad, during which the health care provider used contaminated equipment.
Although possible, sexual transmission is unlikely, and requires contact with blood.
You also could have acquired Hep C by being born to a woman who had a Hep C infection,
but this is very rare. If you have any of these risk factors, you
should discuss them with your doctor and undergo Hep C testing.
However, because many affected individuals might not recall exposure to any of these
risk factors, it is currently recommended that anyone in Canada born between 1945 and
1975 be screened for hepatitis C.
A blood test can identify antibodies to the hepatitis C virus, which reveal that a person
has a current or past infection.
Further testing looks for the presence of the virus itself in the blood, which indicates
that a person is currently infected.
If in doubt, ask your health care provider whether testing is a good idea for you.
There are several different types of hepatitis C, which are known as genotypes.
It’s important for your physician to identify the type, so the right treatment can begin.
The genotypes currently number from 1 to 6.
In North America, the most common genotype is 1, followed by genotypes 2 and 3.
The longer you remain infected, even if you have no noticeable symptoms, the greater your
chance of developing liver damage and of spreading the virus to others.
If you know you have hepatitis C, then stay in close contact with your health care providers
and follow the treatment regimen that they recommend for you.
If there isn’t a therapy available for the Hep C genotype that has infected you, don’t lose hope
Quickly evolving research is bringing faster, easier-to-tolerate, and more effective treatments
all the time.
In the meantime, stay as active and healthy as you can be so that you will be ready when
the right therapy becomes available.
To protect your liver from further damage, avoid consuming alcohol and acetaminophen.
The good news is that the new treatments cure hepatitis C and they have an improved side-effect
profile and shorter treatment duration than medications that have been available to treat
the disease in the past.
There is also great hope that researcher will discover an effective vaccine, which could
lead to worldwide eradication of hepatitis C.
I’m Dr. James Gray on behalf of the Medical Advisory Council of the Gastrointestinal Society;
thanks for watching.
For more information, go to www.badgut.org.