Health Matters: Hepatitis C: Know the Risks

https://www.princetonhcs.org

By Sari L. Yehuda, M.D.

An estimated 2.4 million Americans are living with hepatitis C, according to the Centers for Disease Control and Prevention (CDC), yet many don’t even know it. 

Spread through direct contact with blood from a person infected with the virus, hepatitis C causes the liver to become inflamed, and if left untreated, can cause serious health complications. 

Symptoms of hepatitis C normally don’t occur until its advanced stages, making it critical to know the risk factors and to talk to your doctor about screening. 

Virus Damages Liver  

There are two types of hepatitis C. 

Acute hepatitis C usually occurs within six months after someone is exposed to the virus. It can cause a short-term illness and may lead to a chronic infection. 

Chronic hepatitis C can last a lifetime and usually causes serious health issues when left untreated, including liver damage, cirrhosis (scarring of the liver), cancer and death.  

According to the CDC, 75 to 85 percent of people infected with hepatitis C will develop a chronic infection, while 10 to 20 percent will develop cirrhosis of the liver over time. 

Of people with hepatitis C and cirrhosis, three in six will develop liver failure and one in six will develop liver cancer. 

Baby Boomers at Greater Risk  

While anyone can contract the virus, three in four people presently diagnosed with hepatitis C were born between 1945-65, according to the CDC. 

It’s not entirely clear why baby boomers are infected with hepatitis C at such a high rate, but prior to 1992 the virus was commonly spread through blood transfusions and organ transplants. 

However, thanks to more rigorous blood screening methods that were put in place in 1992 to eliminate hepatitis C from the United States blood supply, transfusions are no longer a common mode of transmission. 

Today, new hepatitis C infections usually occur by sharing needles or other equipment involved in drug use. 

Those most at risk for contracting hepatitis C include: 

  • Current or former injection drug users, even if they only injected once, many years ago
  • Baby boomers born between 1945 and 1965
  • Recipients of clotting factor concentrates made prior to 1987 
  • People who received blood transfusions or organ transplants before July 1992 
  • Hemodialysis patients
  • People living with HIV
  • Children born to infected mothers
  • Healthcare workers who have been exposed to patients with hepatitis C
  • People living with HIV
  • Individuals who have been incarcerated
  • People who received piercings or tattoos using non-sterile instruments

Symptoms Signal Advanced Virus 

People who are infected with hepatitis C usually do not exhibit noticeable symptoms until their condition is advanced. Symptoms may include: 

  • Fever
  • Fatigue 
  • Dark urine/clay-colored bowel movements 
  • Easy bleeding or bruising 
  • Abdominal pain
  • Jaundice (yellow colored in eyes or skin) 
  • Joint pain 
  • Nausea 
  • Poor appetite 
  • Vomiting 

Easy to Treat – If You Know You Have It 

The CDC reports that 15 to 25 percent of people who are infected with the hepatitis C virus clear it from their bodies without treatment, although doctors are not entirely sure why this occurs in some people and not others. 

Yet because symptoms don’t develop until the advanced stages of hepatitis C, it is important to recognize if you are at risk for the virus and to get screened. 

It is recommended that everyone born between 1945 and 1965 be screened at least once in their lifetime with a simple blood test. Typically it takes four to 10 weeks following exposure to hepatitis C before an infection is detected on a blood test.  

Hepatitis C can be successfully treated – if you know you have it. 

The virus is typically treated with oral antiviral medication. The antiviral medications now available are more effective and require shorter treatment courses than the ones used in the past. Treatment regimens can be tailored to the hepatitis C genotype, prior treatments tried and the amount of damage already present in the liver. The typical course of medication lasts a maximum of three months. 

As a result of recent medical advancements, oral medications cure more than 90 percent of patients with hepatitis C. 

At present, there is no vaccine for hepatitis C. As the American Academy of Family Physicians notes, the only sure way to prevent the virus is to avoid coming in direct contact with an infected person’s blood.  Don’t do intravenous drugs. Don’t share personal care items, such as razors or toothbrushes with a person who has hepatitis C. If you’re a healthcare worker, follow your workplace’s safety practices.  

To find a physician with Penn Medicine Princeton Health, call 888-742-7496 or visit www.princetonhcs.org.

Sari L. Yehuda, M.D., is board certified in internal medicine and pediatrics, and is a member of Penn Medicine Princeton Health medical staff.