Hepatitis C | Gastrointestinal Society

Hepatitis C | Gastrointestinal Society


Hepatitis C is a liver disease caused by the
hepatitis C virus. Two of the most important factors in combating
hepatitis C are: identifying those who have the condition, because
many are infected but don’t know it, and providing treatment that will cure the
disease. The liver is our largest solid internal organ, in most adults, it is about the size of a football, and it’s located underneath the ribcage, in the upper right part of the abdomen. The liver has many important functions, it
filters blood, metabolizes substances, such as nutrients and medications, it stores energy,
and makes essential proteins, including those that help the blood to clot when we bleed. Sometimes the liver can repair itself, but
it is susceptible to damage from many different sources, including viruses, toxins, including
alcohol, inherited conditions, and even our body’s own immune system. Hepatitis C, also known as Hep C or HCV, is
one of several viruses that can damage the liver More than 170 million people worldwide are living
with Hep C, including more than 350,000 Canadians Although vaccinations are available for two other forms of hepatitis, hepatitis A and hepatitis B, there is currently no vaccine for hepatitis C.
Hepatitis C begins as an acute infection after exposure to the hepatitis C virus. Some infected individuals will clear the virus
on their own, but most of those infected – about 75% – will go on to develop chronic HCV. Infection with the hepatitis C virus is often
silent; that is, many infected individuals do not have any symptoms. For those who do, symptoms are generally non-specific,
such as mild to severe fatigue or discomfort in the
abdomen. Sometimes health professionals detect hepatitis
C during routine screening or while investigating the cause of other abnormal lab tests. Over many years, inflammation of the liver
caused by the hepatitis C virus usually results in the formation of scar tissue, or fibrosis. The developing fibrosis in the liver can eventually
reach a specific level, which we call cirrhosis. For patients with cirrhosis, ongoing damage
to the liver may eventually result in worsening fatigue, fluid accumulation in the abdomen,
bleeding from veins in the esophagus or stomach, and confusion. Hepatitis C infection with cirrhosis leads to increased risks for liver failure and liver cancer. The goal in identifying and treating hepatitis
C is to cure the disease before cirrhosis develops and its complications occur. Hep C is not spread by sneezing, coughing,
kissing, hugging, or shaking or holding hands. It’s not spread through food or water, or
by sharing food, drinks, or eating utensils with an infected person. However, you can get the virus from activities
involving blood-to-blood contact, injection drug use or sharing of other
contaminated drug paraphernalia, which is responsible for 70-80% of HCV transmissions
in Canada today, sharing personal hygiene items such as
razors and toothbrushes with a person who is infected,
having piercings, tattoos, or acupuncture performed without appropriate sterilization,
having a contaminated needle-stick injury in health care settings,
having received a blood transfusion, organ transplantation, or blood products prior to
1992 is considered a significant risk factor, but with current screening practices for blood
donors, the risk of acquiring hepatitis C from these methods today is exceedingly low,
having surgical or dental procedures, either in Canada or abroad, during which the health
care provider used contaminated equipment. Although possible, sexual transmission
is unlikely, and requires contact with blood. You also could have acquired Hep C by
being born to a woman who had a Hep C infection, but this is very rare.
If you have any of these risk factors, you should discuss them with your doctor and
undergo Hep C testing. However, because many affected individuals
might not recall exposure to any of these risk factors, it is currently recommended
that anyone in Canada born between 1945 and 1975 be screened for hepatitis C. A blood test can identify antibodies to the
hepatitis C virus, which reveal that a person has a current or past infection. Further testing looks for the presence of
the virus itself in the blood, which indicates that a person is currently infected. If in doubt, ask your health care provider
whether testing is a good idea for you. There are several different types of hepatitis C, which
are known as genotypes. It’s important for your physician to identify
the type, so the right treatment can begin. The genotypes currently number from 1 to 6. In North America, the most common genotype
is 1, followed by genotypes 2 and 3. The longer you remain infected, even if you
have no noticeable symptoms, the greater your chance of developing liver damage and of spreading
the virus to others. If you know you have hepatitis C, then stay
in close contact with your health care providers and follow the treatment regimen that they recommend
for you. If there isn’t a therapy available for the
Hep C genotype that has infected you, don’t lose hope Quickly evolving research is bringing faster,
easier-to-tolerate, and more effective treatments all the time. In the meantime, stay as active and healthy
as you can be so that you will be ready when the right therapy becomes available. To protect your liver from further damage,
avoid consuming alcohol and acetaminophen. The good news is that the new treatments cure
hepatitis C and they have an improved side-effect profile and shorter treatment duration than
medications that have been available to treat the disease in the past. There is also great hope that researcher will
discover an effective vaccine, which could lead to worldwide eradication of hepatitis C. I’m Dr. James Gray on behalf of the Medical
Advisory Council of the Gastrointestinal Society; thanks for watching. For more information, go to www.badgut.org.

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