Hepatitis C is currently thought to affect over 200,000 people in the UK alone. Most of these people do not know they have it. It can cause damage to the liver and sometimes cirrhosis and liver cancer. It is spread in a number of ways but mainly:-
- Through sharing dirty injecting equipment for drugs or anabolic steroids
- Contaminated blood transfuions or blood products in the UK before the late 1980's early 1990's
- Dental or medical treatment in countires where infection control is poor
- Regular sexual partner of someone with Hepatitis C
- Has had a tatoo, piercing, acupuncture in a place where hygiene is poor.
- Children of Hepatitis C infected mothers
Testing for Hepatitis C
Testing for Hepatitis C is straightforward usually. A blood test is taken for hepatitis C antibodies. The incubation period may be up to six months after possible infection although antibodies are usually present by three months. If there is a high probability of infection and the hepatitis C antibody test is negative then the test should be repeated at the appropriate interval and sometimes a hepatitis C RNA test is done.
If the antibody test is positive then a further confirmatory sample should be taken. The antibody test will tell whether a person has ever been infected with Hepatitis C. A positive hepatitis C antibody test is followed by a Hepatitis C RNA test. This test will show whether the person is still infected or not.
Only about 30% of people with new infections of Hepatitis C will show symptoms in the acute or beginning phase. The early symptoms, if they develop are usually flu like symptoms, nausea, abdominal pain, fever, and sometimes jaundice where the person becomes yellow coloured.
Hepatitis C virus testing is not currently recommended routinely for HIV negative men who have sex with other men because it is rare.
About a quarter - 25% of people with Hepatitis C infection will clear it in the acute stage. The remaining 75% will vary in what will happen to them over the next years and decades. Some stay perfectly well and do not develop any other damage to their liver. About 20% will develop liver fibrosis and a very small number will develop a liver cancer or liver failure. Some people will have the disease but with only very mild symptoms.
Having other blood-borne infections such as HIV or Hepatitis B together with Hepatitis C will increase the chances of liver problems.
Testing for liver damage - liver fibrosis.
A common test for liver fibrosis is to have a liver biopsy, where a needle is introduced into the liver through the skin and a sample is collected for examination under the microscope. Understandably many patients are frightened of this test and look for alternatives.
High resolution Ultrasound Scanning of the liver can provide important information about the structure of the liver, but not quite as well as a biopsy. A Southampton laboratory, iQur, has developed a blood test called ELF (Enhanced Liver Fibrosis) Test which uses a combination of blood tests to give a high degree of diagnostic accuracy and which may well delay or abolish the need for liver biopsy in Heaptitis C positive patients.
Treatment recommended by the National Institute for Clinical Excellence in the UK suggests use of pegylated interferon together with the drug ribavirin. Various subtypes of the virus may complicate matters as may the presence of another disease such as HIV, but overall cure rates are in excess of 50%.