What is Hepatitis C?
Hepatitis C is an infection with the hepatitis C virus (HCV). Estimates suggest over 250,000 people in the UK have been infected with hepatitis C, but 8 out of 10 don’t know they have it because they have no symptoms. About 75% of these people go on to develop a chronic hepatitis. Because it can take years, even decades, for symptoms to appear, many people (possibly 100,000 or more) remain unaware they have a problem. By the time they become ill and seek help, considerable damage has been done to the liver. This might have been prevented if the person had been diagnosed earlier. About 20-30 per cent of people clear the virus from their bodies – but in about 75 per cent of cases, the infection lasts for more than six months (chronic hepatitis C). In these cases, the immune system has been unable to clear the virus and will remain in the body long term unless medical treatment is given. Most of these people have a mild form of the disease with intermittent symptoms of fatigue or no symptoms at all.
About one in five people with chronic hepatitis C develops cirrhosis of the liver within 20 years. Hepatitis C virus is usually transmitted through blood-to-blood contact. One common route is through sharing needles when injecting recreational drugs – nearly 40 per cent of intravenous drug users have the infection and around 35 per cent of people with the virus will have contracted it this way. Similarly, having a tattoo or body piercing with equipment that has not been properly sterilised can lead to infection. Hepatitis C can be sexually transmitted, and it can be passed on through sharing toothbrushes and razors.
How is Hepatitis C treated?
Hepatitis C can be treated with pegylated interferon alpha and ribavirin. These drugs offer the best chance to clear the virus from the body, and are often used together as dual or combination therapy which has been shown to be effective in 55 per cent of cases. Some strains or genotypes of the hepatitis C virus are more likely to respond than others. Even if the virus isn’t completely cleared, the treatments can reduce inflammation and scarring of the liver. They may, however, cause side effects that some people find difficult to tolerate. Many people also find that complementary and lifestyle approaches help. There is little evidence these can reduce levels of the virus, but they may help to deal with symptoms and improve quality of life.
People with chronic hepatitis C infection should be seen by a hospital liver specialist who may recommend antiviral drug treatments either as single drug therapy or as combination therapy. Whether treatment is needed, and if so which type, depends on a number of factors. These include blood tests to identify which strain of hepatitis C infection is present and how well the liver is functioning, and a liver biopsy to establish whether cirrhosis is occurring.
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