The hepatitis C virus (HCV) is spread by blood-to-blood contact. No vaccine against hepatitis C is available. The symptoms of infection can be medically managed, and a proportion of patients can be cleared of the virus by a long course of anti-viral medicines. Although early medical intervention is helpful, people with HCV infection often experience mild symptoms, and consequently do not seek treatment. An estimated 150-200 million people worldwide are infected with hepatitis C.
About 80% of newly infected patients progress to develop chronic infection. Cirrhosis develops in about 10% to 20% of persons with chronic infection, and liver cancer develops in 1% to 5% of persons with chronic infection over a period of 20 to 30 years. Most patients suffering from liver cancer who do not have hepatitis B virus infection have evidence of HCV infection. The mechanisms by which HCV infection leads to liver cancer are still unclear. Hepatitis C also exacerbates the severity of underlying liver disease when it coexists with other hepatic conditions. In particular, liver disease progresses more rapidly among persons with alcoholic liver disease and HCV infection.
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.Most people who are infected with hepatitis C don't have any symptoms for years. A blood test can tell if you have it. Unlike some other forms of hepatitis, hepatitis C does not get better by itself. The infection can last a lifetime and may lead to liver cancer. Medicines sometimes help, but side effects can be a problem. Serious cases may need a liver transplant.
One of the major problems with hepatitis C virus infections is that 85% of individuals initially infected with this virus will become chronically infected, usually for decades. The other 15% of hepatitis C virus infected individuals simply have an acute infection; that is, one that resolves spontaneously in a few weeks or months. The propensity of hepatitis C virus to cause chronic infection is explained by the extraordinary ability of this virus (in contrast to most other viruses, including hepatitis A) to avoid destruction by the body's immune defense system. (The immune system includes antibodies and specialized white blood cells, called lymphocytes).
With the subsequent development of cirrhosis of the liver (more advanced scarring), hepatitis C virus patients can have muscle wasting, generalized weakness, and easy bruising. Later symptoms, which are due to the complications of cirrhosis, include fluid retention, which leads to edema (swelling of the lower extremities) or ascites (fluid in the abdominal cavity), internal bleeding (usually from dilated esophageal veins called varices), and mental confusion or sleepiness (due to hepatic encephalopathy). Another complication of hepatitis C virus cirrhosis is cancer of the liver (hepatocellular carcinoma or hepatoma), which can cause abdominal pain, weight loss, and fever.
Current medical treatment for HCV is limited to pegylated interferon combination therapy. This therapy is effective in less than 50% of cases of HCV genotype 1 (the most common genotype in North America). Two companies, Roche and Schering, have their own FDA approved versions. Each claims their formulation is superior for treating Hepatitis C. Your doctor will likely recommend one or the other (doctors have no other medicine to offer to treat this disease). You can find more information about each of these drug protocols at this website and elsewhere on the internet.
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