https://ift.tt/2uK5N66 And Warning Signs Of Hepatitis C: A Reality Check. Hepatitis C is a liver disease caused by the hepatitis C virus (HCV): the virus can cause both acute and chronic hepatitis, ranging in severity from a mild illness lasting a few weeks to a serious, lifelong illness. Hepatitis C is a major cause of liver cancer.
Complications Associated with Hepatitis C.
Hepatitis C infection that continues over many years can cause significant complications, such as:
- Scarring of the liver (cirrhosis). After decades of hepatitis C infection, cirrhosis may occur. Scarring in your liver makes it difficult for your liver to function.
- Liver cancer. A small number of people with hepatitis C infection may develop liver cancer.
- Liver failure. Advanced cirrhosis may cause your liver to stop functioning.
- The hepatitis C virus is a bloodborne virus: the most common modes of infection are through exposure to small quantities of blood. This may happen through injection drug use, unsafe injection practices, unsafe health care, transfusion of unscreened blood and blood products, and sexual practices that lead to exposure to blood.
- Globally, an estimated 71 million people have chronic hepatitis C virus infection.
- A significant number of those who are chronically infected will develop cirrhosis or liver cancer.
- WHO estimated that in 2016, approximately 399 000 people died from hepatitis C, mostly from cirrhosis and hepatocellular carcinoma (primary liver cancer).
- Antiviral medicines can cure more than 95% of persons with hepatitis C infection, thereby reducing the risk of death from cirrhosis and liver cancer, but access to diagnosis and treatment is low.
- There is currently no effective vaccine against hepatitis C; however, research in this area is ongoing.
Hepatitis C is a viral infection that causes liver inflammation, sometimes leading to serious liver damage. The hepatitis C virus (HCV) spreads through contaminated blood.
Until recently, hepatitis C treatment required weekly injections and oral medications that many HCV-infected people couldn’t take because of other health problems or unacceptable side effects.
That’s changing. Today, chronic HCV is usually curable with oral medications taken every day for two to six months.
Still, about half of people with HCV don’t know they’re infected, mainly because they have no symptoms, which can take decades to appear. For that reason, the Centers for Disease Control and Prevention recommends a one-time screening blood test for everyone at increased risk of the infection. The largest group at risk includes everyone born between 1945 and 1965 — a population five times more likely to be infected than those born in other years.
- Hepatitis C is a liver disease caused by the hepatitis C virus (HCV): the virus can cause both acute and chronic hepatitis, ranging in severity from a mild illness lasting a few weeks to a serious, lifelong illness.
- Hepatitis C is a major cause of liver cancer.
- The hepatitis C virus is a bloodborne virus: the most common modes of infection are through exposure to small quantities of blood. This may happen through injection drug use, unsafe injection practices, unsafe health care, transfusion of unscreened blood and blood products, and sexual practices that lead to exposure to blood.
- Globally, an estimated 71 million people have chronic hepatitis C virus infection.
- A significant number of those who are chronically infected will develop cirrhosis or liver cancer.
- WHO estimated that in 2016, approximately 399 000 people died from hepatitis C, mostly from cirrhosis and hepatocellular carcinoma (primary liver cancer).
- Antiviral medicines can cure more than 95% of persons with hepatitis C infection, thereby reducing the risk of death from cirrhosis and liver cancer, but access to diagnosis and treatment is low.
- There is currently no effective vaccine against hepatitis C; however, research in this area is ongoing.
Transmission
The hepatitis C virus is a bloodborne virus. It is most commonly transmitted through:
- injecting drug use through the sharing of injection equipment;
- the reuse or inadequate sterilization of medical equipment, especially syringes and needles in healthcare settings;
- the transfusion of unscreened blood and blood products;
- sexual practices that lead to exposure to blood (for example, among men who have sex with men, particularly those with HIV infection or those taking pre-exposure prophylaxis against HIV infection).
HCV can also be transmitted sexually and can be passed from an infected mother to her baby; however, these modes of transmission are less common.
Hepatitis C is not spread through breast milk, food, water or casual contact such as hugging, kissing and sharing food or drinks with an infected person.
WHO estimates that in 2015, there were 1.75 million new HCV infections in the world (23.7 new HCV infections per 100 000 people).
Symptoms of hepatitis C
Long-term infection with the hepatitis C virus is known as chronic hepatitis C. Chronic hepatitis C is usually a “silent” infection for many years, until the virus damages the liver enough to cause the signs and symptoms of liver disease.
Signs and symptoms include:
- Bleeding easily
- Bruising easily
- Fatigue
- Poor appetite
- Yellow discoloration of the skin and eyes (jaundice)
- Dark-colored urine
- Itchy skin
- Fluid buildup in your abdomen (ascites)
- Swelling in your legs
- Weight loss
- Confusion, drowsiness and slurred speech (hepatic encephalopathy)
- Spiderlike blood vessels on your skin (spider angiomas)
Every chronic hepatitis C infection starts with an acute phase. Acute hepatitis C usually goes undiagnosed because it rarely causes symptoms. When signs and symptoms are present, they may include jaundice, along with fatigue, nausea, fever and muscle aches. Acute symptoms appear one to three months after exposure to the virus and the last two weeks to three months.
Acute hepatitis C infection doesn’t always become chronic. Some people clear HCV from their bodies after the acute phase, an outcome is known as spontaneous viral clearance. In studies of people diagnosed with acute HCV, rates of spontaneous viral clearance have varied from 15% to 25%. Acute hepatitis C also responds well to antiviral therapy.
The incubation period for hepatitis C ranges from 2 weeks to 6 months. Following initial infection, approximately 80% of people do not exhibit any symptoms. Those who are acutely symptomatic may exhibit fever, fatigue, decreased appetite, nausea, vomiting, abdominal pain, dark urine, grey-colored feces, joint pain and jaundice (yellowing of the skin and the whites of the eyes).
Causes of hepatitis C
Hepatitis C infection is caused by the hepatitis C virus (HCV). The infection spreads when blood contaminated with the virus enters the bloodstream of an uninfected person.
Globally, HCV exists in several distinct forms, known as genotypes. Seven distinct HCV genotypes and more than 67 subtypes have been identified. The most common HCV genotype in the United States is type 1.
Although chronic hepatitis C follows a similar course regardless of the genotype of the infecting virus, treatment recommendations vary depending on viral genotype.
Hepatitis C infection is caused by the hepatitis C virus (HCV). The infection spreads when blood contaminated with the virus enters the bloodstream of an uninfected person.
Globally, HCV exists in several distinct forms, known as genotypes. Seven distinct HCV genotypes and more than 67 subtypes have been identified. The most common HCV genotype in the United States is type 1.
Although chronic hepatitis C follows a similar course regardless of the genotype of the infecting virus, treatment recommendations vary depending on viral genotype.
Risk factors
Your risk of hepatitis C infection is increased if you:
- Are a health care worker who has been exposed to infected blood, which may happen if an infected needle pierces your skin
- Have ever injected or inhaled illicit drugs
- Have HIV
- Received a piercing or tattoo in an unclean environment using unsterile equipment
- Received a blood transfusion or organ transplant before 1992
- Received clotting factor concentrates before 1987
- Received hemodialysis treatments for a long period of time
- Were born to a woman with a hepatitis C infection
- Were ever in prison
- We were born between 1945 and 1965, the age group with the highest incidence of hepatitis C infection.
Complications
Hepatitis C infection that continues over many years can cause significant complications, such as:
- Scarring of the liver (cirrhosis). After decades of hepatitis C infection, cirrhosis may occur. Scarring in your liver makes it difficult for your liver to function.
- Liver cancer. A small number of people with hepatitis C infection may develop liver cancer.
- Liver failure. Advanced cirrhosis may cause your liver to stop functioning.
testing and diagnosis
Because new HCV infections are usually asymptomatic, few people are diagnosed when the infection is recent. In those people who go on to develop chronic HCV infection, the infection is also often undiagnosed because it remains asymptomatic until decades after infection when symptoms develop secondary to serious liver damage.
HCV infection is diagnosed in 2 steps:
- Testing for anti-HCV antibodies with a serological test identifies people who have been infected with the virus.
- If the test is positive for anti-HCV antibodies, a nucleic acid test for HCV ribonucleic acid (RNA) is needed to confirm chronic infection because about 30% of people infected with HCV spontaneously clear the infection by a strong immune response without the need for treatment. Although no longer infected, they will still test positive for anti-HCV antibodies.
After a person has been diagnosed with chronic HCV infection, they should have an assessment of the degree of liver damage (fibrosis and cirrhosis). This can be done by liver biopsy or through a variety of non-invasive tests.
The degree of liver damage is used to guide treatment decisions and management of the disease.
Getting tested
Early diagnosis can prevent health problems that may result from infection and prevent transmission of the virus. WHO recommends testing people who may be at increased risk of infection.
Populations at increased risk of HCV infection include:
- people who inject drugs;
- people in prisons and other closed settings;
- people who use drugs through other routes of administration (non-injecting);
- people who use intranasal drugs;
- recipients of infected blood products or invasive procedures in health-care facilities with inadequate infection control practices ;
- children born to mothers infected with HCV ;
- people with sexual partners who are HCV-infected;
- people with HIV infection;
- prisoners or previously incarcerated persons; and
- people who have had tattoos or piercings
Treatment
New infection with HCV does not always require treatment, as the immune response in some people will clear the infection. However, when HCV infection becomes chronic, treatment is necessary. The goal of hepatitis C treatment is a cure.
WHO’s updated 2018 guidelines recommend therapy with pan-genotypic direct-acting antivirals (DAAs). DAAs can cure most persons with HCV infection, and treatment duration is short (usually 12 to 24 weeks), depending on the absence or presence of cirrhosis.
WHO recommends treating all persons with chronic HCV infection over the age of 12. Pan-genotypic DAAs remain expensive in many high- and upper-middle-income countries. However, prices have dropped dramatically in many countries (primarily low-income and lower-middle-income countries), due to the introduction of generic versions of these medicines.
Access to HCV treatment is improving but remains too limited. In 2017, of the 71 million persons living with HCV infection globally, an estimated 19% (13.1 million) knew their diagnosis, and of those diagnosed with chronic HCV infection, around 5 million persons had been treated with DAAs by the end of 2017. Much more need.
Prevention
Primary prevention
There is no effective vaccine against hepatitis C, therefore prevention of HCV infection depends upon reducing the risk of exposure to the virus in health-care settings and in higher risk populations, for example, people who inject drugs and men who have sex with men, particularly those infected with HIV or those who are taking pre-exposure prophylaxis against HIV.
The following list provides a limited example of primary prevention interventions recommended by WHO:
- safe and appropriate use of health care injections;
- safe handling and disposal of sharps and waste;
- provision of comprehensive harm-reduction services to people who inject drugs including sterile injecting equipment and effective treatment of dependence;
- testing of donated blood for HBV and HCV (as well as HIV and syphilis);
- training of health personnel;
- prevention of exposure to blood during sex;
- hand hygiene, including surgical hand preparation, hand washing and use of gloves; and
- promotion of correct and consistent use of condoms.
Secondary prevention
For people infected with the hepatitis C virus, WHO recommends:
- education and counseling on options for care and treatment;
- immunization with the hepatitis A and B vaccines to prevent coinfection from these hepatitis viruses and to protect their liver;
- early and appropriate medical management including antiviral therapy; and
- regular monitoring for early diagnosis of chronic liver disease.
Summary of key recommendations
1. Screening for alcohol use and counseling to reduce moderate and high levels of alcohol intake
An alcohol intake assessment is recommended for all persons with HCV virus infection followed by the offer of a behavioural alcohol reduction intervention for persons with moderate-to-high alcohol intake.
2. Assessing the degree of liver fibrosis and cirrhosis
In resource-limited settings, the aminotransferase/platelet ratio index (APRI) or FIB4 tests should be used for the assessment of hepatic fibrosis rather than other non-invasive tests that require more resources such as elastography or fibrotic.
Recommendations on hepatitis C treatment
3. Assessing for treatment
All adults and children with chronic HCV infection should be assessed for antiviral treatment.
4. Treatment
WHO recommends offering treatment to all individuals diagnosed with HCV infection who are 12 years of age or older, irrespective of disease stage.
WHO recommends the use of pan-genotypic DAA regimens for the treatment of persons with chronic HCV infection aged 18 years and above.
In adolescents aged 12-17 years or weighing at least 36 kg with chronic HCV infection, WHO recommends:
• sofosbuvir/ledipasvir for 12 weeks in genotypes 1, 4, 5 and 6
• sofosbuvir/ribavirin for 12 weeks in genotype 2
• sofosbuvir/ribavirin for 24 weeks in genotype 3.
In children aged less than 12 years with chronic HCV infection, WHO recommends:
• deferring treatment until 12 years of age
• treatment with interferon-based regimens should no longer be used.
New highly effective short-course oral pan-genotypic DAA regimens are likely to become available for children under 12 years of age in late 2019 or 2020. This will provide an opportunity to advance treatment access and cure to a vulnerable group that will benefit from early treatment.
The post Symptoms And Warning Signs Of Hepatitis C: A Reality Check. Hepatitis C is a liver disease caused by the hepatitis C virus (HCV): the virus can cause both acute and chronic hepatitis, ranging in severity from a mild illness lasting a few weeks to a serious, lifelong illness. Hepatitis C is a major cause of liver cancer. appeared first on The Trending.
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