Hepatitis C is an inflammation of the liver caused by the hepatitis C virus. This virus can cause both acute and chronic hepatitis. If left untreated, the disease can cause serious liver damage and is at high risk of threatening the patient’s life.
What is hepatitis C?
Hepatitis C is a liver infection caused by the hepatitis C virus (HCV). The disease causes liver cells to become inflamed, causing liver dysfunction, leading to serious liver damage .
Hepatitis C can take the form of acute or chronic hepatitis:
- Acute hepatitis C is a short-term liver infection with HCV. Patients often have no symptoms and most cases are not life-threatening. It is estimated that about 15-45% of people infected with hepatitis C virus automatically eliminate the virus within 6 months of infection without treatment. However, 55-85% of acute hepatitis C cases lead to chronic hepatitis C.
- Chronic hepatitis C is a liver infection with HCV that lasts more than 6 months. Normally, chronic hepatitis C can be cured with medication taken every day for 2-6 months. If left untreated, the disease can last a lifetime, seriously affecting health, leading to problems such as cirrhosis , liver failure , liver cancer … Risk of cirrhosis in people with chronic hepatitis C estimated at 15-30% within 20 years.
However, about half of people with hepatitis C do not know they have the disease. The main reason is that the patient has no obvious symptoms, and it can take decades for signs of infection to appear.
Symptoms of hepatitis C
1. Symptoms of acute hepatitis C
Statistics show that, after initial infection, about 80% of patients do not show any symptoms. Typically, acute symptoms appear 1-3 months after exposure to the hepatitis C virus and last 2 weeks to 3 months. However, the incubation period for hepatitis C can range from 2 weeks to 6 months.
When signs and symptoms of acute hepatitis C virus infection appear, the person may experience:
- Fever
- Tired
- Anorexia
- Nausea and vomiting
- Stomach-ache
- Dark urine
- Pale stools
- Joint pain, muscle pain
- Yellow skin and whites of eyes
Acute hepatitis C infection does not always become chronic, but every case of chronic hepatitis C infection begins with an acute phase. However, acute hepatitis C often goes undiagnosed because this stage rarely presents with symptoms.
2. Signs of chronic hepatitis C
Long-term hepatitis C virus infection is called chronic hepatitis C. Chronic hepatitis C is often a silent infection for many years, until the virus damages the liver severely enough to cause signs and symptoms of liver disease. Signs and symptoms include:
- Bleeds easily
- Easily bruised
- Tired
- Eat poorly
- Yellow skin and eyes
- Dark urine
- Itchy skin
- Abdominal distention due to fluid accumulation in the peritoneal cavity (also called ascites or ascites)
- Be swelled the leg
- Lost weight
- Confusion, drowsiness, and slurred speech (hepatic encephalopathy)
- Spider-like blood vessels appear on the skin (spider angiomas)
Causes of hepatitis C
1. Cause
Hepatitis C infection is caused by the hepatitis C virus (HCV). According to world statistics, hepatitis C virus exists in many distinct forms, called genotypes. There have been 7 distinct HCV genotypes and more than 67 subtypes identified.
2. Who is susceptible to hepatitis C?
The risk of hepatitis C infection increases in the following cases:
- Getting a piercing or tattoo in an unclean environment and using non-sterile equipment
- Infected with HIV
- As a healthcare worker who has been exposed to infected blood, this can happen if an infected needle penetrates the skin
- Received a blood transfusion or organ transplant before 1992
- People who received clotting factor concentrates before 1987
- Have been receiving hemodialysis treatment for a long time
- Been in prison
- Born from 1945 to 1965, is the age group with the highest rate of hepatitis C infection
How is hepatitis C transmitted?
Is hepatitis C contagious? Which way is it transmitted? Because the hepatitis C virus is a blood-borne virus, the infection spreads when the blood of a person infected with the hepatitis C virus enters the blood of an uninfected person. That is, hepatitis C is often transmitted through:
- Reusing or sterilizing improper medical equipment, especially syringes and needles
- Transfusion of blood and blood products without screening
- Injecting drugs, especially when sharing injection equipment
HCV can also be transmitted from an infected mother to her baby during pregnancy. Not only that, hepatitis C can also be spread through sexual activities that lead to exposure to blood (for example, people with multiple sexual partners or men who have sex with men). 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 and drinks with an infected person.
Complications of hepatitis C
Continuous hepatitis C infection over many years can cause significant complications, such as:
- Liver scarring (cirrhosis): After decades of infection with the hepatitis C virus, cirrhosis can occur. Scarring in the liver makes it difficult for the liver to function.
- Liver cancer: A small number of people infected with the hepatitis C virus can develop liver cancer.
- Liver failure: Advanced cirrhosis can cause the liver to stop working.
Diagnose
Because new HCV infections are often asymptomatic, few people are diagnosed when first infected. In people with HCV infection that leads to chronic hepatitis C, the disease often goes undiagnosed because there are still no symptoms. Up to decades after infection with the hepatitis C virus, symptoms develop secondary to severe liver damage.
Hepatitis C is diagnosed in 2 steps:
- Step 1: Test for antibodies against hepatitis C virus using a serum test to identify people who have been infected with the virus.
- Step 2: If you test positive for anti-HCV antibodies, a nucleic acid test is needed to find HCV ribonucleic acid (RNA) to confirm whether there is a chronic infection and whether treatment is needed. This test is important because about 30% of people with hepatitis C can clear the virus naturally with a strong immune response without treatment. However, even if these people are no longer infected, they will still test positive for anti-HCV antibodies.
Once a person is diagnosed with chronic HCV infection, an evaluation is needed to determine the extent of liver damage (fibrosis and cirrhosis ), thereby supporting effective treatment of the disease. This can be done with a liver biopsy or through a variety of non-invasive tests.
Hepatitis C treatment
Can hepatitis C be cured? Hepatitis C does not always require treatment, as the immune response in some people can spontaneously clear the hepatitis C virus infection from the body after the acute phase (spontaneous viral clearance). However, when hepatitis C becomes chronic, treatment is necessary.
The World Health Organization WHO recommends treatment with genotypic direct-acting antivirals (DAAs) for all adults, adolescents and children under 3 years of age with chronic hepatitis C infection. DAAs can cure most cases of hepatitis C in the short term (usually 12 to 24 weeks) depending on whether the patient has cirrhosis or not.
In 2022, WHO included new recommendations on treating adolescents and children using the same pangenotypic treatments used for adults. The most widely used low-cost pangenotypic DAA regimens are sofosbuvir and daclatasvir .
Prevent
There is no effective vaccine against hepatitis C. Therefore, prevention of hepatitis C depends on reducing the risk of exposure to the virus in healthcare settings and in high-risk settings.
People who need to focus on preventing hepatitis C include injecting drug users and men who have sex with men, especially those infected with HIV or those taking pre-exposure prophylaxis for HIV.
However, because anyone is at risk of hepatitis C, to prevent the disease, note the following:
- Stop using drugs, especially injections.
- Be careful when getting piercings or tattoos: If you want to get piercings or tattoos, find a reputable cosmetic facility. Ask questions in advance about how the equipment is cleaned. Ensure that staff use sterile needles. If the staff doesn’t answer your questions, find another store.
- Practice safer sex: Do not have unprotected sex with multiple partners or with anyone whose health condition is unclear. The risk of sexual transmission of hepatitis C between monogamous couples is possible but the risk is low.
- Be careful when injecting medicine: Absolutely do not reuse used needles. Medical staff need to be careful during the injection process, avoiding letting the needle pierce their skin.
- Safely handle and dispose of sharp objects and waste.
- Blood testing before donation to determine whether hepatitis B and hepatitis C viruses (as well as HIV and syphilis) are present.
