What is Hepatitis C?                                                                         

                                                      

Virus

Hepatitis C is a disease that primarily infects the liver and is caused by the hepatitis C virus (HCV). It is predominantly blood borne and is spread through blood-blood contact. It is also contained in the bodily fluids of an infected person, though to a much lesser extent.

   

Worldwide Prevelance 

It is estimated that 170 million people worldwide are infected with hepatitis C and 4 million are newly infected each year; in the UK alone, estimates suggest that over 250, 000 people are infected and 80% of those don’t realise they are affected. 


History

Currently there are five known  hepatitis viruses: A, B, C, D and E. Hepatitis C was first discovered in the 1980s when an unknown virus was found to cause liver damage and was neither due to hepatitis A or B. This new strain was called non-A, non-B hepatitis (NANBH) and it wasn’t until 1989 that the virus responsible was identified, cloned and named the hepatitis C virus.

  

Infection and Symptoms 

The hepatitis C infection is mainly asymptomatic, but a minority show symptoms that are vague and non-specific to the disease (or flu-like). These include fatigue, weight loss, headaches, fever, joint pains etc.

 

The onset and severity of symptoms can vary depending on the level of infection. Acute hepatitis C refers to the first six months after infection where 60-70% of people show no symptoms. Around 20% of patients will clear the virus from their bodies during the acute stage. For the remaining 80-85%, the virus will persist and if undetected for beyond six months, the infection will develop into chronic hepatitis.

 

Over a period of years symptoms become more apparent, as chronic hepatitis can cause liver inflammation and fibrosis. It can also lead to liver cirrhosis, and eventually liver failure or cancer (hepatocellular carcinoma (HCC)). It must be noted that the rate of hepatitis progression is affected by other factors such as lifestyle and diet.

Stages of liver damage in HCV

Figure 1.2

Different stages of liver damage caused by hepatitis C.

Treatment

There is currently no vaccine for the hepatitis C virus though persistent infection and symptoms can be treated. Before any treatment can be administered, patients should consult a doctor or liver specialist to establish the extent and strain of the viral infection. Diagnosis usually involves blood tests and liver biopsies.

 

The most common form of treatment is a combination of pegylated interferon alpha and ribavirin, which gives patients the best chance to clear the virus and reduce liver scarring and inflammation; it has shown to be effective in 55% of cases. If the infection and liver damage is severe, transplantation is recommended, however, there is a high chance of relapse.

 

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