European Liver Patients Association

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What is Hepatitis C?

Hepatitis C is a virus that attacks the liver. Liver damage typically occurs slowly over 20-30 years and can lead to liver scarring and potentially, to liver cancer or liver failure. It often remains symptomless for many years. The main symptoms if experienced, are fatigue, pain in the liver area, digestive problems and flu-like symptoms. The presence or absence of symptoms is no indication as to how much damage the virus is causing to the liver. This has led hepatitis C to be termed ‘The Silent Killer’.

How Do You Become Infected?

Unlike hepatitis B, there is no vaccine to prevent people from becoming infected. The hepatitis C virus is spread through direct contact with infected blood. The major ways of coming into contact with infected blood are:

    • blood transfusions before screening was introduced; • receiving blood clotting factors for haemophiliacs before heat treatment was introduced; • sharing equipment for injecting drugs; • medical or dental interventions in countries where equipment is not adequately sterilised; • sharing straws, notes etc. for snorting cocaine (cocaine is particularly alkaline and corrosive); • sharing razors, toothbrushes or other household articles; • tattooing and body piercing if done using unsterile equipment; and

    • a mother infecting a baby at birth.

What are the symptoms of hepatitis C?

Many people who are infected with hepatitis C experience no symptoms at all, making it common that many remain unaware of the disease until they happen to be screened (for example, when donating blood). Others do experience symptoms but mistake them as signs of a cold or flu. The most common symptoms of hepatitis C include:

    • fatigue • anxiety or depression • tenderness on the right side of the abdomen • loss of appetite • jaundice • nausea and vomiting • muscle and joint pain

    • itching

What happens after you become infected? Not everyone who is infected by the hepatitis C virus will have chronic hepatitis C. Some individuals will clear the virus from their bodies within six months. Unfortunately, the majority will remain infected unless they can eliminate the virus using treatment. The damage that chronic hepatitis C does to the body takes time, progressing slowly over many years. Approximately 20% of patients with chronic hepatitis C will develop a condition called cirrhosis (scaring of the liver tissue) resulting in severe damage to the liver over 20-30 years. Individuals with severely damaged livers are at risk for liver cancer or liver failure. This only occurs in a small percentage of patients. The virus can be diagnosed by a simple blood test. Physicians may also perform additional tests to determine the extent of liver damage.

How is hepatitis C treated?

The most effective treatment for hepatitis C is a combined therapy of interferon and ribavirin. Interferon fights the infection and ribavrin makes the interferon more effective. Interferon has recently been modified (pegylated) so that it stays in the body longer, more effectively fighting the virus. Pegylated interferon is given by injection once a week, and ribavirin is a pill taken daily. Depending upon the type of hepatitis C virus (called a genotype), this combination of drugs will be taken for 24 to 48 weeks. The goal of treatment is to achieve a ‘sustained virological response’(SVR), meaning there is no detectable virus in the bloodstream six months after the end of treatment. There are many factors that affect treatment success. The most important factor is the virus genotype. For those infected with the genotype 2 or 3 virus, approximately 80% will be cured. For those infected with genotype 1 virus, approximately 50% will be cured.

There are other factors affecting treatment success including the amount of virus a person has in their body, the extent of liver damage, as well as a person’s gender, race and age.