What is Hepatitis C|
|Hepatitis C infection is Australia’s most commonly notified disease with 210,000 Australians infected and 16,000 new infections each year
In the Northern Rivers there have been more than 5,000 cases diagnosed with a case rate of 161/100,000 people.
Hepatitis C is generally spread though blood contact.
The test for hepatitis C was developed in 1989. The virus's recent spread is thought to be due to receipt of blood products before the introduction of testing (Feb 1990) and to an increase in injecting drug use
Universal testing by blood banks has minimised the risk of transmission via blood products. However, there is little evidence that the campaign that successfully reduced the spread of HIV through education, needle exchanges and methadone clinics, has had much impact on the spread of hepatitis C.
It is estimated that 80- 85% of patients who are infected with the virus will develop chronic infection. This happens despite a healthy immune system. There is no evidence to indicate that most patients with Hepatitis C have any immune defect. The virus appears to subtly alter its genetic structure over time and this is one of the theories on how it evades immune clearance. The virus can be found within the liver cell (hepatocyte) and in the blood.
On current evidence, most patients will not have their life span altered by Hepatitis C infection. On current evidence, most patients will not have their life span altered by Hepatitis C infection.
About 1/4 patients may develop significant liver diseases including
- 20% cirrhosis (scaring and damage to the liver) after 20 years
- 10% hepatocellular carcinoma after 30 years
Many patients will have no complaints. Some patients describe symptoms including lethargy, right upper abdominal pain, malaise, and headache.
The challenge of therapy is to treat patients to prevent cirrhosis and hepato- cellular carcinoma without unduly disturbing those who will have mild chronic hepatitis only.
If 100 people catch the hepatitis C virus at the same time
- 15 - 20 people get rid of the virus within two to six months (but will continue to carry antibodies for some time).
- 80 - 85 people have chronic (long - term) hepatitis C infection.
- Around 20 people will never develop any liver damage or physical symptoms.
- Between 60 to 65 people will develop some level of long term symptoms or signs of liver damage (after an average 13 years)
- Between 20 to 25 of people with liver damage will develop cirrhosis of the liver (over an average 20 year period)
- Between 5 to 10 of people with cirrhosis will experience liver failure of liver cancer (after an average 25 to 30 years, all up)
Life style change
Hepatitis C is a chronic disease and lifestyle modifications are important to improve the sense of well being, to give a feeling of control over the disease process and to prevent further liver damage.
Alcohol and hep C
Alcohol has an additive effect on liver inflammation, increasing the progress to fibrosis though not to hepatocellular carcinoma. Patients with Hepatitis C often find they cannot tolerate alcohol. It may cause an exacerbation of their symptoms; fatigue or liver pain or it may make them nauseated.
Reduce alcohol intake to 1 standard drink per day. If this is impossible then use low alcohol drinks and avoid binge drinking
The liver plays a central role in metabolism and nutrition. Liver dysfunction gives rise to a variety of nutrient imbalances. The degree of deficiency is related to the severity of the disease. Hepatitis C may cause gastrointestinal symptoms such as loss of appetite, nausea, reflux or diarrhoea, which may contribute to nutrient deficiency. Fatty foods often increase gastrointestinal symptoms.
Hep A and B vaccination
Should be performed to reduce the risk of further liver damage.
Stress often causes an increase in symptoms in patients with Hepatitis C. Patients should be encouraged to improve their stress management.
Prevention of spread
- Do not donate blood or other tissue
- Do not share needles or any other injecting equipment
- Advise health care workers and dentists of Hepatitis C status
- Do not share toothbrushes, razors and other personal articles
- Cover cuts and wounds with waterproof dressings
- Dispose of blood stained articles in a plastic bag before placing in the garbage
- Practice safe sex avoiding blood contact during intercourse (during menstruation, with coexistent STDs or traumatic intercourse). Condoms should always be used for anal intercourse
- There is no evidence that kissing transmits Hepatitis C.
Hepatitis C council of Australia
the Australian Hepatitis Council