Hepatitis C is a liver disease that can have grave effects. It is caused by the Hepatitis C Virus, HCV, which may manifest itself as an acute disease of short duration but most often becomes a chronic lifetime disease. In this review, we attempt to revisit hepatitis C in light of various permutations on symptoms, modes of transmission, and possible triggers, with its available treatments.
05 October 2024
5 min read
1991
Hepatitis C: The Hidden Menace
Hepatitis C usually doesn't come into prominence because it is often asymptomatic. In 2017, the CDC reported 3,186 confirmed acute Hepatitis C cases in the US-a number that likely represents only a small fraction of the true rate, given the high proportion of underreported cases. The estimated number living with chronic Hepatitis C was approximately 3.5 million in the US in 2020.
Hepatitis C can take several courses, from a mild disease lasting a few weeks to a chronic illness that can result in cirrhosis of the liver, liver cancer, and even death. A six-month-long acute infection with Hepatitis C will either resolve spontaneously or progress to a chronic stage of disease. This disease will progress from an acute to a chronic illness in an alarming 75%–85% of the cases, while 15% to 25% of infected patients are able to spontaneously or medically clear the initial infection.
HCV Transmission: Is Hepatitis C an STD?
Though less common than other modes, sexual transmission of HCV is considered one of the risk factors. The most common routes of HCV transmission include sharing of contaminated needles and vertical transmission. Other behaviors identified to increase an individual's risk of infection involve sharing personal care items such as toothbrushes or razors, sexual relations with multiple sex partners or a known HCV-infected partner, and receiving tattoos or piercing in an unconducive environment without necessary precautions.
Those who already have a sexually transmitted disease, or are HIV positive, or those who practice rough sex are at higher risks and should be tested for Hepatitis C. Moreover, one should know that Hepatitis C is sexually transmitted even if there are no symptoms at all.
How to Diagnose Hepatitis C: Recognize its Symptoms
Acute Hepatitis C is often asymptomatic and usually goes unnoticed. The symptoms vary from mild lethargy, nausea, and loss of appetite to fever and jaundice. After an infection, symptoms can take up to 2 to 12 weeks to appear.
On the other hand, Chronic Hepatitis C might also start with no signs or symptoms at all or mild symptoms like fatigue and depression. Gradually, it advances to the chronic liver disease, liver cirrhosis, which is the precancerous scarring of the liver. In most cases, this advancement results in the development of liver cirrhosis into a kind of liver cancer called hepatocellular carcinoma or liver cancer. Thus, early detection through testing becomes so crucial for the treatment because of the very sneaky behavior of Hepatitis C.
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Acute Hepatitis C patients usually do not require any special treatment themselves but are kept under observation by a practitioner with supportive care. However, if the disease appears to be moving in the direction of chronicity, then immediate and specific treatment is indicated. Usual treatment for Chronic Hepatitis C is an 8-12 week oral administration of Direct-Acting Antiviral drugs, which is quite effective as it has a success rate of approximately 90%. The DAAs that are mainly used include protease inhibitors, polymerase inhibitors, and NS5A inhibitors.
The goal of this treatment is to achieve a Sustained Virological Response, in which the virus is undetectable in the blood within 12 to 24 weeks following treatment. It has to be pointed out that with an achieved SVR, this is considered a cure of the infection, since the virus is no longer detectable in the bloodstream anymore. This reduces the long-term risk for liver damage, cirrhosis, and liver cancer.
In those very rare cases when the standard DAA treatment does not work, further diagnostic tests may be undertaken, along with alternative treatments. Further follow-up of the liver after treatment is important to rule out any residual impact of chronic Hepatitis C infection in persons with advanced liver disease or cirrhosis upon presentation.
Prevention and Education: The Keys to Hepatitis C Control
In fact, while effective treatments do exist, prevention remains the best strategy against Hepatitis C. Public health campaigns targeting the at-risk populations-injecting drug users, health professionals, and those who are considered to have high-risk sexual behaviors-are absolutely critical for the overall control of viral transmission. Safe practices include not sharing needles, making sure that sterile equipment is applied during tattoos and piercings, and using protection during sexual intercourse to greatly minimize the chances of infection.
Moreover, early detection programs through screening among baby boomers and high-risk individuals will go a long way toward reducing the impact of the virus on health in the long term. The earlier Hepatitis C is found, the higher one's chance of successful treatment and preventing severe liver damage.
In fact, the whole unobtrusive yet destructive course of Hepatitis C underlines the need for awareness, testing, and timely treatment. With continuous efforts in education, prevention, and access to sophisticated treatments, we can ease the suffering of this potentially deadly virus and improve the quality of life for those affected.
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