Understanding Chronic Hepatitis C

Health Article
Chronic Hepatitis C

Understanding Chronic Hepatitis C

Chronic hepatitis C is a long-lasting infection caused by the hepatitis C virus (HCV). When HCV enters the body, it primarily targets the liver, leading to inflammation and potential liver damage. Over time, this condition can result in significant scarring, known as fibrosis, which can impair liver function.

According to the Centers for Disease Control and Prevention (CDC), approximately 2.4 million individuals in the United States were living with chronic hepatitis C from 2013 to 2016. Alarmingly, many people are unaware of their infection status. While hepatitis C is a manageable health issue, untreated cases can lead to severe complications, including liver failure or cancer. Currently, vaccines are only available for hepatitis A and B, leaving hepatitis C without an immunization option.

Symptoms of Chronic Hepatitis C

One of the challenges of chronic hepatitis C is its subtle onset. Many individuals show no symptoms in the early stages of the infection. Initial signs may include:

  • Fatigue
  • Muscle aches
  • Decreased appetite

More pronounced symptoms typically emerge as the liver becomes severely scarring (cirrhosis) and begins to fail. These symptoms can involve:

  • Extreme weakness
  • Significant weight loss
  • Issues with blood clotting

In advanced cases, fluid accumulation in the abdomen and jaundice (yellowing of the skin) may also occur.

Transmission of Chronic Hepatitis C

Chronic hepatitis C is contagious and primarily spread through direct contact with infected blood. The most common transmission routes include:

  • Sharing needles and syringes
  • Using personal care items like razors or toothbrushes with someone who has HCV, especially if bleeding occurs
  • Sexual contact with an infected person

While the risk of sexual transmission is lower, it is still a possibility, particularly among individuals with bleeding or open sores.

Treatment Options for Chronic Hepatitis C

The primary treatment for chronic hepatitis C involves direct-acting antivirals (DAAs), which are powerful medications designed to disrupt the virus's lifecycle. Common DAAs include:

  • Elbasvir-grazoprevir (Zepatier)
  • Ledipasvir-sofosbuvir (Harvoni)
  • Sofosbuvir-velpatasvir (Epclusa)
  • Sofosbuvir-velpatasvir-voxilaprevir (Vosevi)
  • Glecaprevir/pibrentasvir (Mavyret)

Treatment duration can vary from 8 to 24 weeks, depending on liver health and previous treatment history. Although side effects are generally rare, they can include:

  • Fatigue
  • Anxiety
  • Anemia
  • Itching
  • Insomnia
  • Rash

Diagnosis of Hepatitis C

To accurately diagnose hepatitis C, a series of blood tests are necessary. The initial test is typically the HCV antibody test. A positive result indicates prior exposure to the virus, but does not confirm an active infection. To verify the presence of the virus, an HCV viral load test is performed. This tests for the genetic material of the virus in your bloodstream.

Additionally, your doctor may perform a genotype test to identify the specific strain of hepatitis C, as there are seven different genotypes, each requiring tailored treatment approaches.

Potential Complications

The most prevalent complication associated with chronic hepatitis C is cirrhosis, a condition characterized by extensive liver scarring. Other serious implications can include liver failure and hepatocellular carcinoma, a type of liver cancer.

A 2017 study revealed that 23.9% of individuals seeking liver transplants had developed hepatocellular carcinoma due to hepatitis C. The necessity for liver transplants among HCV patients has significantly increased over the years.

While undergoing a liver transplant does not cure hepatitis C, advancements in treatment options, such as DAAs, have improved the outlook for those with active infections post-transplant.

Acute vs. Chronic Hepatitis C

Although both acute and chronic hepatitis C stem from the same virus, they differ in duration and presentation. Acute hepatitis C arises from the initial infection and lasts up to six months, often without symptoms. According to the CDC, over half of those with acute hepatitis C will develop chronic hepatitis C.

For approximately 15% to 45% of those with acute hepatitis C, the virus may clear spontaneously within six months. However, for the majority (55% to 85%) who do not clear the virus, chronic infection develops.

Prognosis and Management

Chronic hepatitis C is a serious condition, but with effective management, it can be treated and even cured. According to the CDC, between 5% and 25% of individuals with HCV may progress to cirrhosis within 10 to 20 years. Moreover, every year, 1% to 4% of cirrhotic patients may develop liver cancer.

To safeguard liver health, prompt diagnosis and early initiation of treatment is vital. Individuals diagnosed with chronic hepatitis C should also avoid alcohol, maintain a healthy weight, and limit dietary fats. Post-treatment, ongoing liver function monitoring is essential to ensure continued health.