Hepatitis C is one of six identified hepatitis viruses — the others are A, B, D, E and G. All cause the liver to become inflamed, which interferes with its ability to function. Hepatitis C is generally considered to be among the most serious of these viruses.
Infants born to mothers known to carry hepatitis B can be treated with antibodies to the hepatitis B virus (hepatitis B immune globulin or HBIg). When given with the vaccine within twelve hours of birth, the risk of acquiring hepatitis B is reduced 95%. This treatment allows a mother to safely breastfeed her child.
Causes
Hepatitis C infection is caused by the hepatitis C virus (HCV). People who may be at risk for hepatitis C are those who:
Infants born to mothers known to carry hepatitis B can be treated with antibodies to the hepatitis B virus (hepatitis B immune globulin or HBIg). When given with the vaccine within twelve hours of birth, the risk of acquiring hepatitis B is reduced 95%. This treatment allows a mother to safely breastfeed her child.
Causes
Hepatitis C infection is caused by the hepatitis C virus (HCV). People who may be at risk for hepatitis C are those who:
- Have unprotected sexual contact with a person who has hepatitis C
- Have regular contact with blood at work (for instance, as a health care worker)
- Have been on long-term kidney dialysis
- Inject street drugs or share a needle with someone who has hepatitis C
- Share personal items such as toothbrushes and razors with someone who has hepatitis C
- Received blood, blood products, or solid organs from a donor who has hepatitis C
- Were born to a hepatitis C-infected mother
Sypmtoms
Early-stage signs and symptoms
Commonly, hepatitis C infection produces no signs or symptoms during its earliest stages. When it does, they're generally mild and flu-like and may include:
* Slight fatigue
* Nausea or poor appetite
* Muscle and joint pains
* Tenderness in the area of your liver
Later stage signs and symptoms
Even if you develop chronic hepatitis from the hepatitis C virus, you may have few, if any, symptoms. In many cases, signs and symptoms may not appear for decades. Sometimes, though, you may experience one or more of the following:
* Fatigue
* Lack of appetite
* Nausea and vomiting
* Persistent or recurring yellowing of your skin and eyes (jaundice)
* Low-grade fever
Hepatitis C can cause damage to your liver, even if you don't have symptoms. You're also able to pass the virus to others without having any symptoms yourself. That's why it's important to be tested if you think you've been exposed to hepatitis C or if you engage in behavior that puts you at risk.
Treatment
There is a very small chance of clearing the virus spontaneously in chronic HCV carriers (0.5 to 0.74% per year),however, the majority of patients with chronic hepatitis C will not clear it without treatment.
Current treatment is a combination of pegylated interferon alpha (brand names Pegasys and PEG-Intron) and the antiviral drug ribavirin for a period of 24 or 48 weeks, depending on genotype. Indications for treatment include patients with proven hepatitis C virus infection and persistent abnormal liver function tests. Sustained cure rates (sustained viral response) of 75% or better occur in people with genotypes HCV 2 and 3 in 24 weeks of treatment, about 50% in those with genotype 1 with 48 weeks of treatment and 65% for those with genotype 4 in 48 weeks of treatment. About 80% of hepatitis C patients in the United States have genotype 1. Genotype 4 is more common in the Middle East and Africa. Should treatment with pegylated interferon + ribavirin not return a 2-log viral reduction or complete clearance of RNA (termed early virological response) after 12 weeks for genotype 1, the chance of treatment success is less than 1%. Early virological response is typically not tested for in non-genotype 1 patients, as the chances of attaining it are greater than 90%. The mechanism of action is not entirely clear, because even patients who appear to have had a sustained virological response still have actively replicating virus in their liver and peripheral blood mononuclear cells.
The evidence for treatment in genotype 6 disease is currently sparse, and the evidence that exists is for 48 weeks of treatment at the same doses as are used for genotype 1 disease.[23] Physicians considering shorter durations of treatment (e.g., 24 weeks) should do so within the context of a clinical trial.
Treatment during the acute infection phase has much higher success rates (greater than 90%) with a shorter duration of treatment; however, this must be balanced against the 15-40% chance of spontaneous clearance without treatment (see Acute Hepatitis C section above).
Those with low initial viral loads respond much better to treatment than those with higher viral loads (greater than 400,000 IU/mL). Current combination therapy is usually supervised by physicians in the fields of gastroenterology, hepatology or infectious disease.
Early-stage signs and symptoms
Commonly, hepatitis C infection produces no signs or symptoms during its earliest stages. When it does, they're generally mild and flu-like and may include:
* Slight fatigue
* Nausea or poor appetite
* Muscle and joint pains
* Tenderness in the area of your liver
Later stage signs and symptoms
Even if you develop chronic hepatitis from the hepatitis C virus, you may have few, if any, symptoms. In many cases, signs and symptoms may not appear for decades. Sometimes, though, you may experience one or more of the following:
* Fatigue
* Lack of appetite
* Nausea and vomiting
* Persistent or recurring yellowing of your skin and eyes (jaundice)
* Low-grade fever
Hepatitis C can cause damage to your liver, even if you don't have symptoms. You're also able to pass the virus to others without having any symptoms yourself. That's why it's important to be tested if you think you've been exposed to hepatitis C or if you engage in behavior that puts you at risk.
Treatment
There is a very small chance of clearing the virus spontaneously in chronic HCV carriers (0.5 to 0.74% per year),however, the majority of patients with chronic hepatitis C will not clear it without treatment.
Current treatment is a combination of pegylated interferon alpha (brand names Pegasys and PEG-Intron) and the antiviral drug ribavirin for a period of 24 or 48 weeks, depending on genotype. Indications for treatment include patients with proven hepatitis C virus infection and persistent abnormal liver function tests. Sustained cure rates (sustained viral response) of 75% or better occur in people with genotypes HCV 2 and 3 in 24 weeks of treatment, about 50% in those with genotype 1 with 48 weeks of treatment and 65% for those with genotype 4 in 48 weeks of treatment. About 80% of hepatitis C patients in the United States have genotype 1. Genotype 4 is more common in the Middle East and Africa. Should treatment with pegylated interferon + ribavirin not return a 2-log viral reduction or complete clearance of RNA (termed early virological response) after 12 weeks for genotype 1, the chance of treatment success is less than 1%. Early virological response is typically not tested for in non-genotype 1 patients, as the chances of attaining it are greater than 90%. The mechanism of action is not entirely clear, because even patients who appear to have had a sustained virological response still have actively replicating virus in their liver and peripheral blood mononuclear cells.
The evidence for treatment in genotype 6 disease is currently sparse, and the evidence that exists is for 48 weeks of treatment at the same doses as are used for genotype 1 disease.[23] Physicians considering shorter durations of treatment (e.g., 24 weeks) should do so within the context of a clinical trial.
Treatment during the acute infection phase has much higher success rates (greater than 90%) with a shorter duration of treatment; however, this must be balanced against the 15-40% chance of spontaneous clearance without treatment (see Acute Hepatitis C section above).
Those with low initial viral loads respond much better to treatment than those with higher viral loads (greater than 400,000 IU/mL). Current combination therapy is usually supervised by physicians in the fields of gastroenterology, hepatology or infectious disease.
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