Hepatitis C, if not diagnosed and treated at the right time, can lead to cirrhosis, liver failure and liver cancer. Dr. DHARMESH KAPOOR writes about the killer disease.
Drug addicts sharing needles are a high risk group for Hepatitis C.
ONE hundred and seventy five million people across the world, including 12.5 million Indians, are infected with the hepatitis C virus. The number is about three times the number of HIV infected Indians. But awareness about the disease is low despite the fact that there is no protective vaccine available.
What is Hepatitis C? It is a liver disease caused by the hepatitis C virus (HCV), found only in the blood of those who have the disease. HCV is spread by blood contact with an infected person. A distinct and major characteristic of Hepatitis C is chronic liver disease. At least 75 per cent of patients with acute Hepatitis C ultimately develop chronic infection, and most have accompanying chronic liver disease.
Most people with a chronic infection stay healthy for a long time. Some develop symptoms of liver disease, among them tiredness, lethargy, nausea and discomfort in the upper abdomen area. After many years, some develop liver illness, such as cirrhosis, liver decomposition and liver cancer.
HCV is spread primarily by direct contact with human blood. Some of the ways are:
Receiving blood, blood products, or organs from a donor whose blood contained HCV.
Injections and needles that may have had an infected person's blood
Long-term kidney dialysis during which supplies/equipment that had infected blood on them are shared.
Healthcare worker who may have frequent contact with blood on the job, especially accidental needle sticks, dialysis personnel
From mother to child during childbirth.
Sex with an infected person. The risk of transmission is significant when a patient is also infected with HIV virus.
Sharing razors or toothbrushes that might have blood of an infected person
Tattoo or body piercing needles
A person exposed to these risk factors must get their blood screened for antibodies to HCV using a sensitive and well-validated ELISA.
For a slight majority of patients, the illness begins suddenly like the flu. Except that this "flu" doesn't seem to completely go away. Many other symptoms may also be present; however they will vary among patients. These include: fatigue, low-grade fever, headaches, slight sore throat, loss of appetite, nausea, vomiting, and stiff or aching joints. Many people develop a pain in the right side, over the liver area. The urine may become yellow to dark brown, and the stools may be pale. In severe acute infections, some people may develop jaundice in which the skin and whites of the eyes become yellow.
The major factors promoting progression of chronic hepatitis C include: alcohol consumption, viral load at infection (transfusion acquired), type of virus (genotype), co-existing HBV/HIV infection, body iron stores, age of infection.
Because the virus mutates so frequently, creating slightly different versions every time it replicates, it easily evades the body's immune system. This makes it extremely difficult to develop a vaccine. While the virus is evading the immune system, it is alive and well and uses the liver cell's resources to replicate with high efficiency.
Treatment options for Hepatitis C infection have greatly improved in recent years. By using combination therapy, it is now possible to offer sustained improvement in liver function, as well as viral suppression, in up to 50-60 per cent of people.
In India, Pegylated Interferon Alfa-2a is recommended for treatment of Hepatitis C and cases like cirrhosis and Genotype 1.
The disease must be treated early because research reveals that response to treatment is better at an early age. Needless to say, though, there is no better protection against Hepatitis C or any other disease than awareness of the disease itself.
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