Saturday, April 14, 2012
The hepatitis C virus, or HCV, is one of the most common causes of chronic liver disease. In some cases it leads to chronic hepatitis, cirrhosis and certain types of liver cancer. Hepatitis means “inflammation of the liver” and the hepatitis A, B and C forms are the most common in Western countries. All three types are associated with acute hepatitis. But only hepatitis B and C are associated with chronic liver disease. Vaccines are currently available to prevent hepatitis A and B, but there is no vaccine for hepatitis C.
HCV is primarily transmitted through contact with infected blood and has already affected an estimated 4 million Americans. Millions more are infected worldwide. Because symptoms often take years, if not decades, to appear, the U.S. Centers for Disease Control and Prevention estimates that 65 percent to 70 percent of those infected are unaware they have the disease.
What Is Hepatitis C?
Individuals react to the hepatitis C virus very differently. Approximately 15 percent of infected individuals will experience a full recovery within six months and will clear the virus from their systems. Most of these people will not even be aware they were ill, though virtually all will have some sort of liver cell injury. Some 85 percent develop chronic hepatitis. That means the virus may progressively damage their livers over time. Of those, most will develop chronic liver disease. The liver disease’s severity is highly variable. At one end of the spectrum are those with mild, stable hepatitis who never develop significant liver disease. At the other end are those with severe hepatitis. Over time, the disease may progress to cirrhosis, which is irreversible scarring and damage to the liver, and ultimately, liver failure.
About a third of those with hepatitis C will eventually develop cirrhosis. But the rate of liver damage varies. In some, serious liver disease can develop in five years. In others, it may take decades. Researchers do not understand why people react so differently to the virus. HCV causes 8,000 to 10,000 deaths each year in the United States and is the leading cause of liver transplants.
Until researchers isolated and cloned the virus in 1989, HCV was referred to as “non-A, non-B” hepatitis and no test was available to detect it. Without a way to screen for HCV, donated blood supplies carried the virus to a large number of unsuspecting recipients. Since 1992, highly accurate blood screenings have nearly eliminated the chance of contracting the virus through donated blood. Currently, the highest rates of new infection are among intravenous drug users. Up to 80 percent of new addicts become infected within the first year of injecting drugs. Intravenous drug use is thought to be responsible for half of all new infections and perhaps greater than half of all chronic HCV cases, according to the National Institutes of Health. If you experimented even once with injecting drugs, you should get tested for hepatitis C.
Range of Symptoms for Hepatitis C
Symptoms of HCV and its progression toward liver disease can vary widely from person to person. Many experience no outward signs of liver disease and their liver enzymes can be completely normal. But they may have mild, nonspecific symptoms such as fatigue, nausea, poor appetite or muscle and joint pain. The majority of cases remain undetected because the people disregard their symptoms or mistake them for the flu. Even those with acute hepatitis C may not have any symptoms in the first six months. A minority may experience fatigue, nausea and jaundice, which is a yellowing of the skin and eyes.
One common symptom is elevated levels of a liver enzyme known as alanine aminotransferase, or ALT. Chronic HCV sufferers may experience periods of elevated ALT levels, followed by periods of normal enzyme activity. For some, levels will fluctuate wildly, while one-third will experience consistently normal ALT levels. It is not clearly understood how ALT levels correlate to the physical symptoms of HCV. ALT levels can be important, however, in diagnosing HCV. By picking up on elevated ALT in a routine physical?s panel of blood tests, a physician may spot the need for an HCV test and therefore diagnose the disease in an earlier stage, when treatment prognoses tend to be better.
Unfortunately for many, symptoms only appear when a person is diagnosed with advanced liver disease. As HCV progresses towards cirrhosis, the fatigue and flu-like symptoms tend to get worse. Muscle weakness, weight loss, itching, jaundice, dark urine, fluid retention and abdominal swelling are common.
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