Hepatitis C
What is hepatitis?
Hepatitis is an inflammation of
the liver. Inflammation causes soreness and swelling.
Hepatitis can be caused by many things. Drinking too much
alcohol, abusing drugs and taking some medicines can cause
hepatitis. Many viruses can cause hepatitis, too.
There are 2 main kinds of
hepatitis, acute hepatitis and chronic hepatitis. When a
person has hepatitis, the liver may become inflamed very
suddenly. This is called acute hepatitis. If you have acute
hepatitis, you might have nausea, vomiting, fever and body
aches. Or you may not have any symptoms. Most people get over
the acute inflammation in a few days or a few weeks.
Sometimes, however, the inflammation doesn't go away. When the
inflammation doesn't go away, the person has chronic
hepatitis.
How does hepatitis affect the
liver?
The liver breaks
down waste products in your blood. When the liver is inflamed,
it doesn't do a good job of getting rid of waste products. One
waste product in the blood, called bilirubin (say
"billy-roo-bin"), begins to build up in the blood and tissues
when the liver isn't working right. The bilirubin makes the
skin of a person with hepatitis turn a yellow-orange color.
This is called jaundice (say "john-dis"). Bilirubin and other
waste products may also cause itching, nausea, fever and body
aches.
What is hepatitis C?
Several viruses can infect the
liver. Each hepatitis virus is named with a letter of the
alphabet. There are 3 main types: hepatitis A, hepatitis B and
hepatitis C. Hepatitis C is usually spread through contact
with blood products, like accidentally being stuck with a
dirty (used) needle, using IV drugs and sharing needles, or
getting a blood transfusion before 1992. Most people don't
feel sick when they are first infected with hepatitis C.
Instead, the virus stays in their liver and causes chronic
liver inflammation.
Most people who are infected with
hepatitis C don't have any symptoms for years. However,
hepatitis C is a chronic illness (it doesn't go away). If you
have hepatitis C, you need to be watched carefully by a doctor
because it can lead to cirrhosis (a liver disease) and liver
cancer.
I've never used IV drugs or been stuck
with a dirty needle. How did I get hepatitis
C?
Many times, the cause
of hepatitis C is never found. This virus can be
transmitted through sex. It can also be passed from one
person to another by living in the same house with someone who
has hepatitis C. Sharing razors or toothbrushes can
transmit the hepatitis C virus. It can be transmitted by
tattoo needles. It can even be passed from a mother to her
unborn baby. All of these ways of catching hepatitis C are
uncommon, but they do occur.
Could I give hepatitis C to someone
else?
Yes, as far as we know, once you
have hepatitis C, you can always give it to someone else. If
you have hepatitis C, you can't donate blood. You should avoid
sharing personal items like razors and toothbrushes. Always
use a condom when you have sex. If you have hepatitis C, your
sex partners should be tested to see if they also have
it.
Talk to your doctor first if you
want to have children. The virus isn't spread easily by sexual
contact or from a mother to her unborn baby. If you're trying
to have a baby, don't have sex during the menstrual cycle,
because the hepatitis C virus spreads more easily in menstrual
blood.
How should I take care of myself if I have
hepatitis C?
You should
eat a healthy diet and start exercising regularly. A dietitian
can help you plan a diet that is healthy and practical. Talk
to your doctor about medications that you are taking,
including over-the-counter medications. Many medicines,
including acetaminophen (brand name: Tylenol) are broken down
by the liver and may increase the speed of liver damage. It is
very important that you drink only a minimal amount of
alcohol. An occasional alcoholic drink is probably OK, but
check with your doctor first.
Is there a vaccine for hepatitis
C?
No, not for hepatitis
C. There are vaccines for hepatitis A and hepatitis B. If you
have hepatitis C, your doctor may want you to take the vaccine
for hepatitis B (and maybe the vaccine for hepatitis A), if
you don't already have these viruses. If you have hepatitis C,
you are more likely to catch hepatitis A or hepatitis B, and
that would cause more damage to your liver.
Is there a treatment for hepatitis
C?
Medicines available
for hepatitis C include interferon alfa-2a (brand name:
oferon-A), interferon alfa-2b (brand names: Intron-A),
interferon alfacon-1 (brand name: Infergen), interferon
alfa-2b plus ribavirin (brand name: Rebetron), and interferon
alfa-n1 (brand name: Wellferon). These medicines are given as
an injection (a "shot") every day, every other day, or 3 times
a week for several months, and sometimes longer. About 1/4 of
the people who take interferon for hepatitis C feel better.
These medicines don't cure hepatitis C, but they do make
people feel better and may prevent future liver problems.
What should I know about
interferon?
Before you can start taking
interferon, you will have a liver biopsy. A tiny bit of your
liver will be taken out in a surgical operation. The doctor
will check this sample of your liver to see how much damage
there is. Younger patients with mild liver disease and fewer
virus particles in the liver have a better response to
interferon.
Interferon is expensive. It costs
about $6,000 a year. You should check with your health
insurance provider to see if your medical insurance will cover
the cost.
What side effects will I have from taking
interferon?
The most
common side effect feels like having the flu. Some people
taking interferon have fevers, body aches, headaches, fatigue,
irritability, nausea, vomiting, loss of sleep, sleep
disturbance or changes in their blood. If you take interferon,
your doctor will want to examine you regularly to keep track
of the side effects. If they get too bad, you may have to stop
taking interferon.
Do I have to take interferon?
The choice is up to you and your
doctor. Some people with hepatitis C don't have any symptoms.
They only have a little inflammation of their liver. If you
have hepatitis C but no symptoms, your doctor will want to
keep a close watch on you. This is done by checking your blood
at least once a year, and maybe 3 times a year. Your doctor
will check the level of 2 enzymes that are made in your liver.
Your doctor might decide to give you medicine for hepatitis C
only if these enzymes reach a certain level.
The decision to use interferon
therapy can be hard to make because of the expense and the
side effects. Your doctor will pay attention to the type of
the virus and the amount of the virus in your body. Your
overall health and the results of your blood tests and the
liver biopsy are also important to know about before your
doctor gives you interferon treatment.
Other Organizations
American Liver
Foundation
http://www.liverfoundation.org
75 Maiden Lane, Suite 603
New
York, NY 10038-4810
800-GO-LIVER
Source
Hepatitis C: Part II.
Prevention Counseling and Medical Evaluation (American Family
Physician January 15, 1999, http://www.aafp.org/afp/990115ap/349.html)
