Navigating Your Health: 5 Things to know about Hepatitis C
Recently, we have been seeing a sudden increase in patients with Hepatitis C, especially among childbearing age females. Often these women are diagnosed during their prenatal care and had no idea prior that they were infected. According to the CDC, there was a 21% increase in reported cases of Hepatitis C between 2015 and 2016. It is believed the Opioid epidemic and the increase in IV drug use is to blame for the sudden rise.
When I have spoken to these women with a new diagnosis of Hepatitis C, they seem extremely surprised and confused. Many people are not aware of what Hepatitis C is, how it is transmitted, or the long-term effects of the disease.
Here are 5 things you should know about Hepatitis C:
- There are 3 types of Hepatitis infection: A, B, C. They are all caused by viruses and can lead to acute inflammation of the liver, but have many differences when it comes to transmission and long-term effects. Here is a short summary of Hepatitis A and B to help understand the differences:
Hepatitis A: Hepatitis A virus is found in the feces (poop) of people with Hepatitis A. It is transmitted primarily through the fecal-oral route (patients become infected through eating food handled by an infected person, or being in extreme close contact with someone that has been infected). Things that can increase your risk for Hepatitis A include traveling to areas where Hepatitis A is common, living with an infected person, or having sex or very close contact with infected person. Hepatitis A infections last around 15-50 days and will go away on its own without treatment. The symptoms are typically GI-related, such as nausea, vomiting, diarrhea, or abdominal pain. Most infections do not have any long-term effects on the liver and are rarely fatal.
Hepatitis B: Hepatitis B is spread through bodily fluids by an infected person. This includes blood and semen. It can be passed through sexual contact with an infected person, sharing of contaminated needles or syringes, or from an infected mother to her baby. Having multiple sexual partners, having sex with an infected person, and IV drug use can increase your risk of contracting Hep B. Healthcare and public safety workers can also be at an increased risk due to exposure to bodily fluids. Symptoms include fever, fatigue, loss of appetite, nausea, vomiting, abdominal pain, joint pain, and jaundice. Only 30-50% of people over five years old develop acute symptoms. There is no treatment for acute infection. There is a vaccine available. For an unimmunized person, chronic infection occurs in 90% of infants, 25-50% of children aged 1-5 years, and 6-10% of older children and adults. Chronic infection is managed with regular monitoring of signs of liver disease and some can be prescribed antiviral drugs. Most people with acute disease will recover with no long-term damage to the liver. However, about 15-25% of chronically infected people will develop chronic liver disease, including cirrhosis, liver failure, or cancer.
- Hepatitis C is spread through transmission of blood from an infected person, by sharing needles or syringes to inject drugs, needle-stick injuries in healthcare settings, or from an infected mother to her unborn baby. Before 1992, Hepatitis C was commonly spread through blood transfusions and organ transplants. Now, with widespread screening of the blood supply in the U.S. that does not occur. Less common ways of transmission include sharing personal care items such as razors and toothbrushes with an infected person, having sexual contact with an infected person, or getting a tattoo or body piercing in an unsanitary setting. Hepatitis C is NOT spread through breastfeeding, hugging, kissing, toilet seats, mosquito bites, sharing utensils or food.
- Approximately 15-25% of people who are infected with Hepatitis C will develop chronic infection. Most people with chronic infection do not have any symptoms except for fatigue or depression. Many will eventually develop liver disease, although this typically occurs slowly over many decades. Chronic Hep C infection is often not realized because people do not have symptoms for many years. Chronic Hepatitis C is the major cause of cirrhosis and liver cancer in the U.S. It is also the most common reason for liver transplantation. There is no treatment for acute Hepatitis C infection. People who are diagnosed with acute infection should be monitored by their doctors for signs and symptoms of chronic infection. There are treatments available for chronic Hepatitis C infection. The medications have improved over the years. Currently, the recommended treatment involves 8-12 weeks or oral therapy and has a cure rate of 90%.
- Transmission of Hepatitis C from mother to baby affects approximately 6 in 100 infants. This risk becomes even higher is the mother is also HIV positive. Even if the baby is infected with Hepatitis C, there is no reason the mother cannot breastfeed her baby. Breastfeeding can be encouraged, although precautions may be considered for mothers with cracked and bleeding nipples.
- Hepatitis C is diagnosed via a blood test called a Hepatitis C antibody test. This test can tell if you have ever been infected with the Hepatitis C virus. Additional testing, called Hepatitis C virus RNA test can tell if you have a current or chronic infection. According to the CDC, the following people should be tested:
- Current or former injection drug users
- Everyone born from 1945-1965
- Anyone who received clotting factor concentrates before 1987
- Recipients of blood transfusions or solid organ transplants prior to July 1992
- Long-term hemodialysis patients
- People with known exposures to Hepatitis C such as healthcare workers with needle-sticks injuries
- People with HIV infection
- Children born to mothers with Hepatitis C.
- Other high-risk groups include people in jail, people who snort drugs through their nose, and people who get unregulated tattoos.