What is Hepatitis C?

There are at least six viruses known to cause liver disease: hepatitis A, B, C, D, E, and G, which vary in their severity and characteristics. Hepatitis C can lead to serious, permanent liver damage, and in many cases, death.

The Hepatitis C (HCV) virus was identified in 1989. Unlike the other types of viral hepatitis, hepatitis C is very difficult for the immune system to overcome.

As a result, most Hepatitis C infections (80-90%) become chronic and lead to liver disease, including cirrhosis (scarring of the liver tissues) and liver failure. Hepatitis C infection is typically mild in its early stages, and it is rarely recognized until it has caused significant damage to the liver. The cycle of disease from infection to significant liver damage can take 20 years or more.

Blood transfusions account for nearly 10% of all cases of Hepatitis C. Prior to 1990, there were no tests for hepatitis C in donated blood, and the risk of infection was between 8 and 10%. Since 1993, risk has been negligible.

Almost any direct or indirect exposure to infected blood can transmit the virus. This includes I.V. drug use and poorly sterilized medical instruments, blood spills, unbandaged cuts or injuries, and tattooing or body piercing, as well as less obvious sources of blood, such as shared razors or toothbrushes, or body secretions (such as mucous) that

may contain small amounts of blood. In about 10% of all cases, no risk factors have been identified.

Heterosexual and homosexual activity, particularly with multiple partners and in the absence of protective measures, can transmit the virus. Close contact between household members has also been implicated.

The symptoms of Hepatitis C are often very mild, at least in the early stages of infection and can be virtually undetectable. The most common symptom, commencing sometimes years after initial infection, is fatigue. Other symptoms include mild fever, muscle and joint aches, nausea, vomiting, loss of appetite, vague abdominal pain, and sometimes diarrhea. Many cases go undiagnosed because the symptoms are suggestive of a flu-like illness which just comes and goes.

When the disease progresses and damages the liver badly enough, the

Electron micrograph of the hepatitis C viruses.

symptoms become commensurate with cirrhosis and liver failure, including jaundice, abdominal swelling (due to fluid retention called ascites),and finally coma.

There is no vaccine for Hepatitis C at present, and because of the virus's frequent mutation, it may be a long time before one becomes available. However, because of Hepatitis C's slowly progressive infection, infected patients have long life expectancies, and with proper treatment, many of them can recover completely.