All You Need to Know About Hepatitis C

Hepatitis is a serious disease that claims the lives of millions of people around the globe. Hepatitis is a medical term used to describe liver inflammation. Hepatitis C is a liver disease that is caused by the hepatitis C virus, a blood borne virus that is extremely infectious. It can result in both short-term (acute) and long-term (chronic) inflammation of the liver, which may be characterized by mild and asymptomatic to severe organ damage and life-threatening symptoms.

According to the data from the World Health Organization (WHO), nearly 70 million people suffer from chronic hepatitis C globally. In Singapore, the prevalence rate of this particular disease is 0.2%. Because of its asymptomatic nature, nearly 50% of those suffering from hepatitis C usually don’t know that they are having the deadly disease.

According to research, more than 70% end up having chronic hepatitis C. Hepatitis C will not only result in chronic liver inflammation, but will eventually lead to liver failure. What’s more, it is a major risk factor for hepatocellular carcinoma or cancer of the liver.

However, despite being a potentially dangerous disease, hepatitis C can easily be treated using antiviral drugs. Of course, both early diagnosis and treatment are key to preventing your hepatitis C from progressing to serious liver conditions as well as other life-threatening complications.

So, what is the difference between hepatitis A, B, and C?

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As you may have guessed, all these are viruses that result in liver inflammation. However, there are some notable differences regarding their modes of transmission as well as how they affect the liver.

• The primary mode of hepatitis A transmission is through the ingestion of contaminated water, food from an infected person. Also, Hepatitis A-associated symptoms usually surface between two and four weeks after the initial infection. These symptoms include diarrhea, fever, nausea, yellowing of the skin or jaundice, and tea-colored urine.

• It is also worth noting that hepatitis A does not always progress to chronic liver inflammation. However, there is a light risk fulminant acute hepatitis, which refers to a severe, possibly life-threatening inflammation of the liver. Regardless, a significant number of patients usually recover from hepatitis A and develop lifelong immunity.

• Hepatitis B, on the other hand, is a bloodborne virus contracted through sexual intercourse, needle sharing, blood transfusions, or from mother to unborn child during birth. Like its hepatitis counterpart, it can progress to both chronic and acute liver inflammation. What’s more, chronic hepatitis B can lead to liver cirrhosis, liver failure as well as liver cancer.

How will I contract hepatitis C?

As we previously mentioned, hepatitis C is a bloodborne virus and can be contracted through:

• The sharing of contaminated syringes, needles, or any other related medical equipment.
• Sharing of personal care items can come into contact with the blood of an infected person such as razor blades.
• Vertical transmission from the mother to the child during birth.
• Body piercings or tattoos in places that proper hygiene and sanitation measures are not adhered to.
• Sexual intercourse with an infected person. However, the risk of transmission via sexual contact is generally fairly lower, but can dramatically increase if one has many sexual partners.

One important point to note is that the hepatitis C virus can survive outside your body for up to six weeks while remaining infectious. What this means is that transmission via contaminated surfaces is a major risk.

So, what are the symptoms of the various stages of hepatitis C?

Acute hepatitis C symptoms:

Hepatitis C-associated symptoms usually begin to manifest between two weeks and several months after infection. Most patients may never experience any visible symptoms. A liver function test usually helps to show the evidence of elevated liver enzymes, confirming liver inflammation. However, for those who develop symptoms, they usually experience nausea, pain in their right part of the abdomen, fatigue, fever, yellowing of the eyes and skin as well as joint pains.

Chronic hepatitis C symptoms:

Between 75 and 85% of the infected people, hepatitis C remains a long-term infection. Just like its acute hepatitis counterpart, a substantial number of chronic hepatitis C patients don’t display any visible symptoms. However, liver function blood test usually reveals the presence of ongoing liver inflammation. Studies have also proven that at least 10-20% of chronic hepatitis C patients usually develop cirrhosis, which is characterized by liver scarring and potentially impaired liver function.

Sadly, those who develop liver cirrhosis may never show any visible symptoms until their cirrhosis is at an advanced stage. What’s more, those who have both hepatitis C and liver cirrhosis are highly likely to develop liver cancer and liver failure. Most people never show any symptoms during acute infection and chronic stages.

So, how will my doctor know that I have hepatitis C?

The diagnostic process of hepatitis C is conducted through blood tests. A screening test usually the first one, which is used to test for antibodies against hepatitis C. And if you are positive for hepatitis C antibodies, you will be taken through a second test such as hepatitis C RNA testing, a confirmatory test. The initial test, hepatitis C antibody test, can identify the presence of hepatitis C infection from one month after the initial infection.

Your doctor may also need to carry out other blood tests such as the liver function test and perhaps the ultrasound scan test to help determine both the severity and any complication caused by hepatitis C.

So, how is hepatitis C treated?

Hepatitis C is only treated during the chronic hepatitis C stage. However, there are some anti-viral treatment options available for the treatment of hepatitis C. Thankfully, these medications have a high success rate of more than 90%.

Even after treatment with anti-viral medications, you will have to undergo routine follow-ups for possible liver inflammation and other complications such as cancer and liver cirrhosis. What’s more, patients will need to refrain from taking anything that might aggravate liver inflammation and damage such as alcohol.

Is there any vaccine against hepatitis C currently available?

Unfortunately, no vaccine has been developed against this particular disease. However, both hepatitis A and B have vaccines.

Am I at risk of developing hepatitis C?

The following people may be at risk of getting hepatitis C:

• HIV patients.
• Those with hepatitis C positive sexual partners.
• Drug abusers.
• Those who engage in risky sexual behaviors such as anal sex.
• Kids of mothers with hepatitis C.

What type of relationship is there between HIV and hepatitis C?

If you have been diagnosed with hepatitis C, your doctor should also screen you for HIV. And the same should apply if you have been diagnosed with HIV (you should get tested for hepatitis C). Research has proven that those having both HIV and hepatitis C are three times more likely to develop liver-related health complications. And the aggressive anti-retroviral medications used to treat HIV may only increase this risk even further.

Also, the outcomes for those having HIV and hepatitis C co-infection are generally poorer in comparison to those with either HIV or hepatitis C alone. The treatment of HIV/hepatitis C co-infection patients is usually very complex and overly challenging. This is because co-infection treatment options are chosen taking into account medication interaction concerns.

Despite being highly overlooked, hepatitis C is a serious health condition that affects millions of unsuspecting individuals not only in Singapore, but globally. 

You now know that hepatitis C-related complications can easily arise when your hepatitis C is left undetected!

Frequently Asked Questions:

So, what causes hepatitis C?

Hepatitis C is an inflammation of the liver that occurs as a result of a viral infection. The virus responsible for the infection is known as HCV or hepatitis C virus. You can potentially contract this particular virus through contact with infectious fluids as well as secretions from those who are already infected with the virus.

It takes how long for symptoms to show after initial infection by the virus?

Among those who develop symptoms from acute infection, they usually exhibit those symptoms after between two and twelve weeks after initial exposure. But, the majority of patients never show any visible symptoms.

Can you transmit hepatitis C without showing any signs or symptoms?

Yes, asymptomatic hepatitis C patients can spread to other people.

Can you have hepatitis C and don’t know about it?

Bearing in mind that most hepatitis C patients are usually asymptomatic, you might have the virus and remain completely healthy. In this regard, without proper testing, you may never know you are hepatitis C positive.

Is it curable?

Unfortunately, we don’t have a cure for hepatitis C just yet. Thankfully, vaccines are being developed to help prevent it.

What vaccine is currently used to prevent hepatitis C?

Even though there are lots of research in regards to hepatitis C vaccines, we currently don’t have a designated vaccine for hepatitis C. However, there are vaccines for both hepatitis A and B.

Is sexual contact a mode of transmission for hepatitis C?

It is possible to contract hepatitis C via sexual intercourse. However, the transmission risk is fairly lower. It is important to note that the risk may increase for those who:

• Have many sexual partners.
• Have sexually transmitted infections or diseases.
• Are HIV positive.
• Engage in risky sexual contact, especially unprotected anal sex.

Will I be able to completely clear the hepatitis C virus from my body?

Nearly half of people infected with the virus usually clear it from their systems naturally without the help of any treatment. However, how this happens remains a misery among medical experts.

Can you contract hepatitis C by getting a piercing or a tattoo?

As at now, no research shows you can contract the virus by either getting a piercing or tattoo in a licensed tattooing commercial facility. However, you can potentially contract hepatitis C when sub-standard infection-control techniques are employed during piercing or tattooing.

How will hepatitis C affect my normal life?

Generally, the prognosis of chronic hepatitis C is amazing and we can only hope it improves with time. And a significant number of chronic HCV patients can lead a normal life, provided their healthcare providers can diagnose it early enough before complications such as liver damage occur. This only signifies the importance of early diagnosis and prevention!

As a hepatitis C patient, what can I do to protect my liver?

If you have chronic hepatitis C, you need to inform your doctor about your previous treatments. And if you have liver cirrhosis, you may be at risk of developing cancer of the liver even after your hepatitis C virus infection is fully cured. Those with cirrhosis as well as those with chronic hepatitis C should always undergo routine screening and monitoring. What’s more, they should be vaccinated against both hepatitis A and B.

Hepatitis C patients should not take alcohol because it can lead to increased liver damage. What’s more, they need to consult their doctor before taking any prescription supplements, pills, herbs, or OTC drugs, since any of these can cause liver damage.

References

1. Smith, D. B., Becher, P., Bukh, J., Gould, E. A., Meyers, G., Monath, T., Muerhoff, A. S., Pletnev, A., Rico-Hesse, R., Stapleton, J. T., & Simmonds, P. (2016). Proposed update to the taxonomy of the genera Hepacivirus and Pegivirus within the Flaviviridae family. The Journal of general virology, 97(11), 2894–2907. https://doi.org/10.1099/jgv.0.000612
2. Scheel, T. K., Simmonds, P., & Kapoor, A. (2015). Surveying the global virome: identification and characterization of HCV-related animal hepaciviruses. Antiviral research, 115, 83–93. https://doi.org/10.1016/j.antiviral.2014.12.014

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