Hepatitis C

Diagnosis

Hepatitis C is a viral infection that affects the liver and often has no symptoms, but it can still cause chronic liver disease over time. Hepatitis C often exists without symptoms. Only about 5% of people who have hepatitis C are aware that they have it, and therefore they continue to infect others. When symptoms of acute hepatitis do exist, they are generally mild and flu-like, and may not require treatment. Even if your symptoms go away, you may still be infected with hepatitis C if you don't get treated. In fact, hepatitis C can last for decades, and can progress to chronic infection or liver disease.

You can get hepatitis C if you come in contact with blood carrying the hepatitis C virus (HCV). Hepatitis C results when the hepatitis C virus (HCV) enters your bloodstream and infects your liver. You can get the virus from needles, syringes, or other tools used for injections, as well as from razor blades, toothbrushes, or tattooing or body piercing equipment. Sexual transmission or transmission from mother to infant can occur, but is relatively rare. In the past, many people were infected with hepatitis C through blood transfusions. Now donated blood is routinely checked for hepatitis C so the risk of acquiring the infection through a transfusion is very small.

Acute hepatitis C usually starts with flu-like symptoms Table 01. Symptoms of hepatitis C occur in three phases that, in acute cases, resolve within one month. The first phase is characterized by flu-like symptoms. Within 3 to 10 days, your urine may become dark, and your eyes and skin may turn yellow (jaundice). Jaundice fades within the two-to-four-week recovery phase that follows.

Table 1.   Symptoms of Hepatitis C

You may experience liver damage if hepatitis C symptoms progress and become chronic. Chronic HCV can cause cirrhosis two or three decades after the initial infection.

Injecting illegal drugs puts you at great risk for acquiring hepatitis C. More than 60% of new HCV infections result from high-risk drug behaviors Table 02.

Table 2.  Risk Factors for Acquiring Hepatitis C

a
Prior to 1992, testing for viruses in blood transfusions was inefficient.

Your clinician will ask questions about your health to help make a diagnosis of HCV. Since early-stage HCV mimics various flu-like illnesses, it is difficult to diagnose. Therefore, your doctor will need to know if you have any risk factors—such as using illegal injection drugs or drinking heavily-that would increase the likelihood that you have HCV.

Your clinician will run blood tests to confirm a diagnosis of HCV.

It can take four to eight weeks for your body to launch an immune response large enough to be recognized by a blood test for HCV. Therefore, early blood tests may come back falsely negative. After you have been infected for 5 to 12 weeks, your doctor can detect HCV from a blood test called a polymerase chain reaction (PCR) test. Another test that detects antibodies to HCV is not accurate until another two months after that.
If you test positive for HCV, your clinician will run periodic blood tests to determine if your infection is chronic, and whether or not your liver is functioning properly.

Avoid high-risk situations and take special precautions when you come in contact with a person who has hepatitis C Table 02. Avoid reusing or sharing syringes, water, or drug paraphernalia. Do not share toothbrushes, razors, or other personal-care articles. Healthcare workers should follow routine barrier precautions, and safely handle needles and other sharps. Use latex condoms if you are having sex with multiple partners. Avoid tattoos and body piercing.

If you have HCV you should take precautions to protect yourself from liver damage. Avoid consuming alcohol, and visit your physician regularly. Avoid starting any new medicines or over-the-counter herbal remedies without a physician's approval.

If you are an HCV-infected healthcare worker, follow strict aseptic technique and standard precautions, including appropriate handwashing, protective barrier techniques, and care, use, and disposal of needles and other sharp instruments.

Take precautions to avoid spreading the virus to others. Wear disposable gloves, and wipe up blood spills carefully with household bleach and disposable paper towels. Completely cover an open cut or wound with a wound dressing. Put blood-stained articles (e.g., tissues, sanitary napkins, or dressings) in a plastic bag before throwing them away. If you are in a monogamous long-term relationship, discuss your sexual practices with your healthcare provider before adopting any changes. If you have multiple sexual partners, practice safe sex by using condoms. In addition, discuss your condition with your health care provider when undergoing a medical or dental procedure.