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Ampula: Info you can use: Hepatitis C

Friday, September 02, 2005

Info you can use: Hepatitis C

Hepatitis C is a form of hepatitis (liver inflammation) caused by a virus, the Hepatitis C virus (HCV). Before the virus was discovered, in 1989, the syndrome was initially referred to as a "non-A-non-B hepatitis".

Symptoms
In most cases, carriers with chronic hepatitis C infection have no symptoms. However, over time this blood borne virus can cause long term damage to the liver, including cirrhosis and hepatocellular carcinoma. Severe liver damage may not develop until 10-40 years after infection. Certain medical phenomena have been associated with the presence of hepatitis C, such as thyroiditis, cryoglobulinemia and some types of glomerulonephritis. Carrier of the virus may begin to develop symptoms after only a few years. Symptoms, when developed, are variable and dependent on individual carrier. They may include prolonged flu-like symptoms and any combination of the following: body aches, headaches, nightsweats, loss of appetite, diarrhea, fatigue, nausea, mild abdominal pain, upper right quadrant pain.
Most people are not aware that they carry the hepatitis virus until something causes them to require a physical exam, and then something routine is done, such as blood work. There are also cases where carriers have found out through blood donation or plasma donation that their blood carried a positive response to a HCV test.
There are several risk factors that qualify one for a higher risk of exposure to HCV virus. They include
Needle sharing.Those who inject drugs are at high-risk for getting hepatitis C because they may be sharing needles and other drug paraphernalia, which may be contaminated with HCV-infected blood. In fact, 60% to 80% of all IV drug users have hepatitis C infection.
Unprotected sex. Although HCV is not classed as a sexually transmitted disease, there is some transmission due to sexual activity. This is often as a result of infection with an actual STD. Many STDs cause sores or wounds around the genitals, and thus sexual activity will lead to the spread of HCV. It is important to note however, that the spread is due to blood-blood contact, rather than the presence of the virus in vaginal fluid or semen.
Multiple piercings or tattoos. Tattooing dye or needles used in tattooing or body piercing can carry HCV-infected blood from one customer to another if the tattoo/body piercing parlors do not use sterile techniques or supplies.
(Tattoos done non-professionally, as in a penal institution, are of great concern.)
Blood transfusions BEFORE 1992. Those who have had a blood transfusion before 1992 and hemophiliacs who have received clotting factor before that time are at risk because blood banks did not fully test the blood supply for hepatitis C before that year. Today, however, the risk of getting hepatitis C from a blood transfusion is almost zero.
Other risk factors include needlestick injuries, especially among health care workers, hemodialysis (equipment that filters blood may not be adequately sterilized between patients), and organ transplant before 1992.

Treatment
Treatment is mainly based on interferon alpha (IFNα), combined with other drugs; though this action does not guarantee results. Currently, the preferred treatment is pegylated interferon together with ribavirin. Studies have shown sustained cure rates of 75% or better in people with genotypes 2 or 3 HCV (which is easier to treat) and about 50% in those with genotype 1.
Individuals with Hepatitis C should be vaccinated for Hepatitis A and B if they have not yet been exposed to these viruses.
It is well known that alcohol makes HCV associated liver disease progress faster, and makes interferon treatment less effective.
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Hepatitis C co-infection with HIV
Approximately 40% of U.S. patients infected with HIV are also infected with the hepatitis C virus (HCV), mainly because both viruses share the same routes of transmission. HCV is one of most important causes of chronic liver disease in the U.S. It has been demonstrated in clinical studies that HIV infection causes a more rapid progression of chronic hepatitis C to cirrhosis and liver failure in HIV-infected persons. This is not to say treatment is not an option for those living with co-infection. The APRICOT international trial indicated that a svr (sustained viral response) was high in those with the genotype 2 & 3. Less favorable results where associated with genotype 1, however it became evident that should treatment with pegylated ribivirin-interferon not return a 2 log viral reduction after 12 weeks the chance of treatment sucess is less than 1%.
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Alternative and experimental therapies
Several "alternative therapies" purport to reduce the liver's duties, rather than treat the virus itself, thereby slowing the course of the disease or keeping the quality of life of the person. As an example, extract of silybum marianum and licorice are sold for their HCV related effects; the first is said to provide some generic help to hepatic functions, and the second to have a mild antiviral effect and to raise blood pressure.
It is always important to tell your doctors all medications you are currently taking as well as herbal ones. If you are a post transplant patient it is even more important to notify your doctor of these herbal medications because silybum marianum (aka silymarin or Milk thistle) may inhibit the metabolism of certain drugs[1].
There are new drugs under development like the protease inhibitor NM 283,BILN 2061 or VX 950 that are looking promising but are all in early phase of development[2] [3]. Unfortunately, the BILN 2061 had to be discontinued due to safety problems early in the clinical testing. Some more modern new drugs that provide some support in treating HCV are Albuferon, Zadaxin, and DAPY.
All of these are not approved remedies and have not yet demonstrated their efficacy in clinical trials.
Immunoglobulins against the Hepatis C virus exist and newer types are under development. Thus far, their roles have been unclear as they have not been shown to help in clearing chronic infection or in the prevention of infection with acute exposures (ie. needlesticks). They do have a limited role in transplant patients.
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Prominent patients
Celebrities Naomi Judd and Pamela Anderson have famously been infected with hepatitis C and gone public with their experiences.
Francisco Varela, biologist, recorded his experiences, including a liver transplant, in "Intimate Distances"1.

This information is provided by: http://en.wikipedia.org/wiki/Hepatitis_C

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