Hepatitis C – symptoms and transmission

Hepatitis C - symptoms and transmission

Hepatitis C is an inflammation of the  liver  caused by the hepatitis C virus (HCV)   , which can occur in acute or chronic form and lead to impaired liver function. The feared complications include, for example,  liver cirrhosis  (shrinkage of the liver), but liver inflammation can usually be cured with the appropriate treatment. How you can get infected with hepatitis C, what symptoms you suffer from and which therapy is effective can be found in the following article.

What is hepatitis C?

Hepatitis C is a viral inflammation of the liver. This means that the disease is caused by viruses. There are five different types of this liver inflammation that are caused by a virus, type C is one of them. The genetic composition of the hepatitis C virus, the so-called genotype, can vary.

In Germany, around 0.3 percent of the population is infected with the hepatitis C virus, and this affects around 1 percent of all people worldwide. Since liver inflammation is often chronic and can result in both liver cirrhosis (shriveled liver) and  liver cancer  , and the cost of therapy is high, the disease is a major problem worldwide, especially in poorer countries.

Two forms can be distinguished: acute and chronic hepatitis C. Both forms can be associated with impaired liver function.

Chronic hepatitis C in particular can lead to destruction of the liver over time and, if left untreated, promote the development of liver cirrhosis (shrinkage of the liver due to irreversible scarring of the liver). Another risk is the formation of hepatocellular carcinoma (liver cancer).

Is hepatitis C contagious?

Without treatment, hepatitis C is contagious and can be transmitted. The infectivity can be estimated based on the amount of virus components in the blood, the so-called viral load. As long as virus components are detectable, there is always a risk of infection and transmission.

How is hepatitis C transmitted?

There are several mechanisms by which the disease is transmitted. A few are mentioned below:

  • through the use of contaminated needles, such as when using drugs, piercing or tattooing
  • for injuries caused by contaminated needles, such as those suffered by medical personnel
  • in transplantations of organs, blood transfusions and special blood purification procedures (due to the introduction of diagnostic testing of all blood products, this is no longer a significant transmission route since 1991)
  • at birth – from the infected mother with a high viral load to the newborn child
  • sexual (less common compared to  HIV  or  hepatitis B )

The hepatitis C virus can also be present in body fluids such as  saliva  and  sweat , depending on the viral load  . However, contagion via these is very unlikely.

Since there are different genetic compositions of HCV, it is possible to become infected again with a different genotype of the virus even after undergoing an infection.

Symptoms: How Do I Know I Have Hepatitis C?

The incubation period, i.e. the time from infection to the onset of the disease, is usually eight weeks. In rare cases, the period may be shorter.

Only about 20 percent of  acutely  infected people develop symptoms. This includes:

  • a yellowing of the body and especially the eyes
  • abdominal pain and  nausea
  • Weakness, exhaustion, lassitude and  tiredness
  • joint and muscle pain

The remaining 80 percent of those infected have no symptoms.

Overall, around 50 to 85 percent of those affected develop  chronic hepatitis C.  This can be accompanied by exhaustion, exhaustion, lassitude and tiredness. Over the course of months or years, chronic hepatitis C can also spread to disease outside of the liver. These can affect, for example, the joints, muscles, skin and blood and blood vessels. The salivary gland, thyroid and kidneys can also be affected. Another possible consequence is  diabetes  mellitus (blood sugar disease).

Diagnosis of Hepatitis C

If hepatitis C infection is suspected, a blood sample can be used in the doctor’s office to  carry  out a screening test for antibodies  (anti-HCV test)  . This can be positive in the case of an acute, chronic or an infection that has already healed.

However, the search test is not always conclusive, for example in the case of immunosuppression, HIV infection or people on regular  dialysis . In such cases, direct determination of the virus components in the blood using a PCR test is recommended. The  PCR test  is also added to a positive search test result and carried out directly if an acute infection is suspected. It is also important for therapy planning.

Hepatitis C is  notifiable,  so if the disease is suspected, the health department must be notified in order to prevent further transmission.

Can you cure hepatitis C?

Anyone with acute or chronic hepatitis C should seek treatment. Even in the case of chronic disease, a cure is possible in more than 90 percent of cases.

The chances of recovery depend to a large extent on the genotype of the hepatitis C virus and whether liver cirrhosis (shriveled liver) has already developed as a complication of the liver inflammation – this cannot be cured, but adequate liver function can be maintained with timely and adequate treatment.

Since spontaneous healing is also possible in some cases, the therapy can sometimes be dispensed with. However, this is a case-by-case decision and should be discussed thoroughly with the doctor treating you.

One is considered cured if there is a “permanent virological response”, the so-called sustained virological response (SVR). This value reflects the response to therapy. This occurs when no more virus components can be detected in the blood sample three months after the end of therapy.
This should also be checked every three to six months in the further course.

treatment with medication

In the past, preparations containing  interferon  and ribavarin were used for therapy. However, these led to significant side effects. Nowadays, the standard therapy consists of substances with a direct antiviral effect (DAA). The medication usually lasts about eight to twelve weeks.

Laboratory tests of the liver values ​​should be carried out before the start of therapy and every four weeks during the course. It should also be checked whether other liver inflammations, such as hepatitis B, are also present. To check the effectiveness of the therapy, the number of virus components should also be determined over the course of the disease.

A lasting response to antiviral  drugs  can lead to a normal life expectancy even in advanced chronic hepatitis C.

Since the new hepatitis C drugs are under patent protection in Germany, the costs for the therapy are very high. Therefore, before the start of therapy, the assumption of costs should be clarified with the health insurance company, because sometimes the health insurance companies only reimburse the costs for certain medications.

Prevention: vaccination against hepatitis C?

Compared to other forms of hepatitis, such as hepatitis A  or B, there is no vaccination against the hepatitis C virus  .

Measures to prevent hepatitis C infection consist of treating infected people to reduce the risk of transmission and avoiding contact with possible sources of hepatitis C. This includes, for example, protection against needlestick injuries, disinfection of medical devices or advice and education for drug users who use injection needles to use drugs.

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