BBC - Health: Hepatitis C

Monday, 25 October 2010

Hepatitis C - A Post by Dr Rob Hicks for BBC News

Inflammation of the liver - hepatitis - has many causes, including several viruses. One of these is hepatitis C. There is currently no vaccine to prevent infection, so it's important to be aware of it and avoid it.

What is hepatitis C?


Hepatitis C is an infection with the hepatitis C virus. Although there is no vaccine to protect against infection, there is effective treatment available.

Estimates suggest over 250,000 people in the UK have been infected with hepatitis C, but eight out of ten don’t know that they have it because they have no symptoms. Worryingly, about 75% of these people go on to develop a chronic hepatitis. But because it can take years, even decades, for symptoms to appear, many people (possibly 100,000 or more) remain unaware that they have the problem. By the time they become ill and seek help, considerable damage has been done to the liver. This might have been prevented if the person had been diagnosed earlier.

Elsewhere in the world, hepatitis C is even more common – the World Health Organisation estimate that three per cent of the world’s population (about 170 million people) have chronic Hepatitis C, and up to four million people are newly infected each year.

Symptoms

In most cases, the initial infection doesn't cause any symptoms. When it does, they tend to be vague and non-specific.

Possible symptoms of hepatitis C infection include:

•Fatigue

•Weight loss

•Loss of appetite

•Joint pains

•Nausea

•Flu-like symptoms (fever, headaches, sweats)

•Anxiety

•Difficulty concentrating

•Alcohol intolerance and pain in the liver area

The most common symptom experienced is fatigue, which may be mild but is sometimes extreme. Many people initially diagnosed with chronic fatigue syndrome are later found to have hepatitis C.

Unlike hepatitis A and B, hepatitis C doesn't usually cause people to develop jaundice.

About 20-30% of people clear the virus from their bodies - but in about 75% of cases, the infection lasts for more than six months (chronic hepatitis C). In these cases the immune system has been unable to clear the virus and it will remain in the body long term unless medical treatment is given. Most of these people have a mild form of the disease with intermittent symptoms of fatigue or no symptoms at all.

About one in five people with chronic hepatitis C develops cirrhosis of the liver within 20 years (some experts believe that, with time, everyone with chronic hepatitis C would develop cirrhosis but this could take many decades).

Causes and risk factors

Hepatitis C virus is usually transmitted through blood-to-blood contact. One common route is through sharing needles when injecting recreational drugs - nearly 40% of intravenous drug users have the infection and around 35% of people with the virus will have contracted it this way.

Similarly, having a tattoo or body piercing with equipment that has not been properly sterilised can lead to infection.

Before 1991, blood transfusions were a common route of infection. However, since then all blood used in the UK has been screened for the virus and is only used if not present.

Hepatitis C can be sexually transmitted, but this is thought to be uncommon. It can be passed on through sharing toothbrushes and razors. It is not passed on by everyday contact such as kissing, hugging, and holding hands - you can't catch hepatitis C from toilet seats either.

If someone needs a blood transfusion or medical treatment while staying in a country where blood screening for hepatitis C is not routine, or where medical equipment is reused but not adequately sterilised, the virus may be transmitted.

Most people diagnosed with hepatitis C can identify at least one possible factor which may have put them at risk but for some, the likely origin of the infection isn't clear. Because it can remain hidden and symptomless for so many years, it may be very difficult to think back through the decades to how it might have begun.

There are a number of ways to reduce the risk of the infection being transmitted. Those most at risk of contracting the infection are injecting drug users, who should never share needles or other equipment.

Practising safe sex by using condoms is also important.

People with hepatitis C infection aren't allowed to register as an organ or blood donor.

Treatment and recovery

People with chronic hepatitis C infection should be seen by a hospital liver specialist who may recommend antiviral drug treatments either as single drug therapy or as combination therapy.

Whether treatment is needed, and if so which type, depends on a number of factors. These include blood tests to identify which strain of hepatitis C infection is present and how well the liver is functioning, and a liver biopsy to establish whether cirrhosis is occurring.

Hepatitis C can be treated with pegylated interferon alpha and ribavirin. These drugs offer the best chance to clear the virus from the body, and are often used together as dual or combination therapy which has been shown to be effective in 55% of cases. Some strains or genotypes of the Hepatitis C virus are more likely to respond than others. Even if the virus isn’t completely cleared, the treatments can reduce inflammation and scarring of the liver. They may, however, cause side effects that some people find difficult to tolerate.

Many people also find that complementary and lifestyle approaches help – there is little evidence that these can reduce levels of the virus but they may help to deal with symptoms and improve quality of life.

If you think you could have been in contact with the hepatitis C virus at any point in the past, you can have a test to find out if you've been infected. You should ask you GP. Local drug agencies and sexual health clinics (sometimes called genito-urinary medicine or GUM clinics) may also offer testing.

Disclaimer

All content within BBC Health is provided for general information only, and should not be treated as a substitute for the medical advice of your own doctor or any other health care professional. The BBC is not responsible or liable for any diagnosis made by a user based on the content of the BBC Health website. The BBC is not liable for the contents of any external internet sites listed, nor does it endorse any commercial product or service mentioned or advised on any of the sites. See our Links Policy for more information. Always consult your own GP if you're in any way concerned about your health.

Dr Trisha Macnair last medically reviewed this article in February 2009.



BBC - Health: Hepatitis C

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Hepatitis C Virus Damages Brain Cells

News > 2010 > October > Hepatitis C Virus Causes Brain Inflammation Leading to Neuron Injury



Hepatitis C Virus Causes Brain Inflammation Leading to Neuron Injury


SUMMARY: Hepatitis C virus (HCV) can breach the blood-brain barrier and infect support cells in the brain, triggering inflammatory changes that ultimately result in damage to neurons, suggests new research published in the open access online journal PLoS One. Findings from this autopsy study may help explain how HCV infection causes neurocognitive impairment, including the poor concentration and memory problems commonly referred to as "brain fog."

Below is the text of a press release issued by the University of Alberta describing the study findings.

U of A Medical Research Team Discovers - Hepatitis C Virus Damages Brain Cells

Edmonton, Alberta -- October 7, 2010 -- A University of Alberta researcher specializing in neurological infections has discovered that the hepatitis C virus injures and inflames brain cells, resulting in neurological issues for some patients living with the disease. Until now, no one has been able to prove this.

A recent Canadian study suggests that 13 per cent of people with hepatitis C, a chronic condition that affects 300,000 Canadians, also have neurological problems. Other research has suggested the hepatitis C virus might penetrate the blood-brain barrier. Chris Power, the Canada Research Chair in Neurological Infection and Immunity with the Faculty of Medicine and Dentistry, and his team decided to tackle this theory conducting experiments on human cadavers.

"We saw the virus in the brain of a deceased patient who had hepatitis C," said Powers, who noted that normally it is very difficult for any type of virus or infection to pass the blood-brain barrier. Based on this discovery, the researchers made three new and major findings. The hepatitis C virus damaged those neurons in the brain responsible for motor functions, memory and concentration. The virus also triggered inflammation of the brain, which contributed to more neurons being damaged. And, thirdly, the virus stopped a natural process in the brain cells called autophagy, in which the cells get rid of unwanted toxic proteins. So, instead, the brain cells were accumulating large amounts of these toxic proteins, causing further damage to the brain cells.

"For a long time, the medical community has recognized some people who have hepatitis C also have memory loss and poor concentration, which is very disabling for those patients," says Power. "Now we have some understanding about the cause of these neurological symptoms that can lead to the development of future treatments for people with hepatitis C."

"This discovery is significant because this is the first time anyone has confirmed that the hepatitis C virus can infect and injure brain cells."

The research conducted by Power and his team was funded by an Emerging Team Grant from the Canadian Institutes of Health Research. He collaborated with Babita Agrawal and Jack Jhamandas, both of the U of A, and Chris Richardson of Dalhousie University in Halifax. The discoveries by Power and his team were just published in the prestigious Public Library of Science (PLoS) One journal.

10/15/10. Source - R Maurier, University of Alberta. U of A medical research team discovers hepatitis C virus damages brain cells. Press release. October 7, 2010



http://www.hepctrust.org.uk/

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What Is Hepatitis C?

Hepatitis C Information:

Hepatits C is a blood-borne viral disease which can cause liver inflamation, fibrosis, cirrhosis and liver cancer. The Hepatitis C virus (HCV) is spread by blood-to-blood contact with infected person's blood. Many people with HCV infection have no symptoms and are unaware of the need to seek treatment. Hepatitis C infects an estimated 150-200 million people worldwide. It is the leading cause of liver Transplant...

Hepatitis C is an inflamation of the liver caused by infection with the Hepatitis C virus is one of the five known hepatitis viruses: A, B, C, D & E. Hepatitis C was previousley known as non-A non-B hepatitis prior to isolation of the virus in 1989.

Symptoms of Acute Hepatitis C:

Acute Hepatitis C refers to first 6 months after infection with HCV. Remarkably, 60% - 70% of people develop no symptoms during the acute phase. In the minority of patients who experience acute phase symptoms, thet are generally mild and non-specific, and rarely lead to specific diagnoses of Hepatitis C. Symptoms of acute hepatitis C include decreased appetite, fatigue, abdominal pain, jaundice, itching and flu-like symptoms.

Symptoms of Chronic Hepatitis C:

Chronic Hepatitis C is defined as infection with the Hepatitis C virus persisting for more than six months. The course of chronic hepatitis C varies considerably from one person to another. Virtually all people infected with HCV have evidence of inflamation on liver biopsy however, the rate of progression of liver scarring (fibrosis) shows significant inter-individual variability.

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