Hepatitis C: Diagnosis and Treatment

Hepatitis C is a very important viral illness that primarily affect the liver. Most recent estimates indicate that about 1-2% of US population are affected by this illness. It is one of the most frequent causes of chronic liver condition, leading to hardening and cancer of the liver. Not surprisingly, hepatitis C remains one of the most common indications for liver transplant surgery in the United States.

In general, hepatitis C virus is transmitted through blood products. As a result, hepatitis C is contracted from items that are contaminated with blood such as needles and IV drugs. However, this virus is inadvertently to be transmitted by casual contact, or from food. In addition, unlike hepatitis B, hepatitis C is rarely trasmitted from sexual contact. Unfortunately, there is no effective form of vaccination for hepatitis C.

Hepatitis C is a chronic viral illness in which the infection lasts longer at least 6 months in duration. In general, patients with chronic hepatitis C infection are not aware of their illness, because symptoms associated with this disease is rare early on. However, as the viral infection persists, individuals may start to experience persistent and chronic lassitude (fatigue). Others may complain of anorexia, nausea, and even weight loss in rare cases. As the illness advances, there may be finds such as yellowing of the skin (jaundice), vomiting of blood (hematemesis), fluid in the abdomen (ascites), and altered level of consciousness and confusion (encephalopathy). However, even more worrisome complication of chronic hepatitis C is the occurrence of cirrhosis or the hardening of liver, and liver cancer, known as hepatocellular carcinoma (hepatoma).

Hepatitis C is diagnosed using blood tests. The first step in the diagnosis includes hepatitis C antibody (ELISA based), and liver function test (ALT / AST). If the antibody is detected, hepatitis C viral RNA test will confirm the active infection. For cases of hepatitis C confirmed with viral RNA, additional tests that are often necessary include genotyping, alpha-feto-protein (AFP), a serum marker for liver cancer, and ultrasound of the liver. Finally, a liver biopsy may be obtained to fully characterize the overall condition of the liver disease and to exclude presence of fibrosis (cirrhosis).

The treatment options for hepatitis C is rapidly evolving. Currently available treatments include ribavirin, PEG-interferon, and protease inhibitor such as telaprevir and boceprevir. For patients with genotype 1 hepatitis C, a triple combination of ribavirin, interferon, and protease inhibitor is recommended for 6-12 months. They can expect cure rate of approximately 70%. On the other hand, patients with genotype 2 and 3 are treated for 6 months with a dual regimen of interferon and ribavirin. They have a higher cure rate of 80-90%.

Chronic hepatitis C is a very serious condition. For individuals with this illness, it is very important that they undergo a regular check-up including periodic liver function test, AFP determination, and sonogram. It is also advisable to avoid alcohol, and any unnecessary medication. For individuals with active viral replication, the treatment with anti-viral drugs is recommended to prevent potential complications including cirrhosis and hepatoma.