Hepatitis C infection is an inflammatory disease of the liver caused by HCV. HCV is most commonly transmitted from person to person through contaminated blood. Hepatitis C is an infection that often goes undetected until it has done significant damage to a patient’s liver. The infection has two phases, acute (the first six months) and chronic (right after the first six months). A minority of sufferers clear the virus from their bodies during the acute phase, but 60-85 percent have a chronic hepatitis C infection.
People may have no signs and symptoms of illness during the acute phase of hepatitis C infection and possibly only a mild flu-like syndrome later. Signs and symptoms of severe liver damage, like nausea, vomiting, collection of fluid in the abdomen, and psychological changes, may not develop for ten or twenty years after the initial infection.
Hepatitis C is triggered by HCV. It's most frequently transmitted from one person to another via infected blood or blood products, but may also be (uncommonly) transmitted from mother to child during childbirth or via sexual intercourse. Before 1992, HCV was sometimes transmitted through blood transfusions, hemodialysis, or transplanted organs from infected donors; these are now uncommon events. In 1992, researchers invented a new test for checking blood products for HCV; as a outcome, new infections annually in the United States declined from 240,000 in the 1980s to about 20,000-30,000 in 2007.
The most common cause of HCV transmission is intravenous drug use; transfusion-related cases of hepatitis C now happen only once in every 2 million transfused units of blood. Hepatitis C infection is occasionally divided into an early phase called the acute stage and a later phase called the chronic stage. The acute stage begins when the virus enters the body; it lasts for about sixmonths.
Antibodies towards the virus can usually be detected between three and twelve weeks after infection. About 15-40 % of individuals who are infected clear the virus from their bodies during this phase, while the other 60-85 % go on to develop chronic hepatitis C infection. It is this second group of patients who run the risk of suffering cirrhosis or other forms of liver or kidney damage years later.
Eighty percent of patients infected by HCV in its early stage do not have any symptoms, or have mild and nonspecific signs and symptoms like fatigue. Other people have a flu-like syndrome marked by poor appetite or nausea, soreness in the region of the liver, or pains in the joints and muscles. Some might notice that their urine is dark and looks like tea or cola. If chronic HCV infection leads to liver illness ten to twenty years later, the patient may have the following signs and symptoms:
Diagnosis of hepatitis C infection is often delayed for years because numerous patients with chronic hepatitis C infection don't have noticeable or troublesome symptoms till liver damage has already occurred. In some cases a person with chronic hepatitis C infection is detected through routine blood testing for abnormal liver function or because they've a history of intravenous drug abuse or HIV infection. Testing for chronic infection begins with blood tests that indicate the presence of antibodies to HCV.
Since antibody tests can't tell whether the person is currently infected, nevertheless, a second blood test that looks for the virus’s characteristic genetic materials is performed. If the results are positive for both tests, the physician will order a third blood test that determines the virus’s specific genotype or genetic makeup. There are six recognized genotypes of HCV as of 2008, and knowing which kind is involved helps to guide the patient’s treatment. To determine the extent of damage towards the patient’s liver, the physician may order a liver biopsy. In this procedure, a needle is inserted into the patient’s liver through the abdomen in order to eliminate a small sample of tissue for analysis.
Not all patients with HCV require therapy, but if treatment is needed, the first line of treatment comprises two medicines recognized as Interferon, a drug that resembles some of the proteins that the physique makes naturally to fight viruses, and Virazole, which is an antiviral drug. The combination of these drugs works better than Interferon alone. Interferon is generally given as a shot once a week and Ribavirin is taken as a pill twice each day. The length of treatment depends on the genotype of HCV; sufferers with genotype 2 or 3 are treated for twenty-four weeks whereas patients with genotype 1 or 4 must undergo forty-eight weeks of treatment.
The cure rates for genotypes 1 and 3 are about 75 percent; the cure rate for genotype 1 is 50 percent; and for genotype 4 it is 65 percent. Regrettably, Interferon and Ribavirin create unpleasant side effects for patients that range from depression and irritability to weight loss, nausea, and muscle pains. In addition to side effects, Ribavirin cannot be given at all to pregnant women simply because it can harm the unborn child. The only treatment for cirrhosis or severe liver disease is liver transplantation.
The issue, nevertheless, is that you will find many more sufferers waiting for donated livers than you will find suitable organs accessible. In addition, liver transplantation does not remedy hepatitis C infection; most people who receive transplanted livers will develop a recurrence of the virus. The effectiveness of medication treatment of hepatitis C following a liver transplant is unclear. Sufferers with chronic hepatitis C should stop drinking alcohol, as it can speed up the rate of liver damage. They ought to also be vaccinated against hepatitis A and hepatitis B.
According to the CDC, between 75 and 85 % of people infected with HCV will develop chronic hepatitis C infection. Twenty percent of these chronically infected persons will develop cirrhosis of the liver within twenty years of infection; 1-5 % of chronically infected people will eventually die of liver disease. Ladies with chronic hepatitis C have better outcomes than males, and sufferers infected at younger ages have better outcomes than these infected in middle age. The cause for these differences is not clear.
There is no vaccine that can prevent HCV. Prevention depends on careful observation of good health practices in hospitals and clinics and on individual lifestyle changes. The CDC recommends the following methods that individuals can lower their risk of getting hepatitis C:
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