Type C viral hepatitis

Hepatitis C is a dangerous liver infection caused by the hepatitis C virus. It ranges in severity:  the disease can manifest as a mild illness that only lasts a few weeks or months; or it may progress into a serious lifelong illness (unlike other hepatitis viruses, hepatitis C converts to chronic active hepatitis in about 85% of patients). There is no vaccine and no known sure cure. This is the deadliest form of hepatitis, causing more deaths than all other forms put together.  Half of those who have this infection are unaware of their condition.

Hepatitis C can spread through blood-to-blood contact, such as through blood infusions, sharing of contaminated needles, needles, tattooing and body piercing, even manicures are suspect; however, in as many as 40% of the patients the mode of infection is unknown.  While not noted as a sexually transmitted disease, it can be if the partners have open sores, contaminated saliva and blood exchange. The incubation period (time from exposure to the onset of symptoms) is between two weeks to six months.  After  the acute infection period, it becomes a chronic infection. During various periods of ill health when the immune system is weakened, the virus may flare up and create flu-like symptoms that last for weeks or months. These include loss of appetite, nausea, extreme fatigue, fever, abdominal pain and joint pain. Jaundice and clay-coloured stools marks severe cases. However, it is generally asymtomatic, with few symptoms showing until permanent liver damage is done which can lead to cirrhosis, liver failure or liver cancer.
 

Most cases of Non-A Non-B (NANB) hepatitis have been re-diagnosed as hepatitis C. Symptoms of NANB hepatitis appearing after 10 years are fatigue and vague abdominal pain. Cirrhosis of the liver may develop after 20 years, and liver cancer after 30 years.

Discovered in 1989, it is only since 1990 that have physicians been able to detect hepatitis C in the bloodstream. Most infected people show no outward symptoms (more than two-thirds of people who become infected exhibit no symptoms). These factors make it difficult to produce hard demographic numbers.

Globally anywhere between 130 and 150 million hepatitis C cases are reported each yearly. It is estimated that over 170 million people worldwide have this degenerative liver disease. Opinions vary, but research shows that about 5% of patients infected with hepatitis C progress to fulminant hepatitis and liver failure within 3 to 5 years of their initial infection. About 20% will develop cirrhosis within 20 years, with many of those developing hepatocellular carcinoma (HCC), a form of liver cancer.  Risk factors for the disease can include injection-drug use, prior blood transfusions, sexual promiscuity, acupuncture, and electrolysis. Those at most risk for hepatitis C infection include intravenous drug users, healthcare workers, people who have had sex with infected persons, recipients of blood transfusions before Hepatitis C screening was implemented and infants born to infected women. The disease is highly prevalent in areas like North Africa, Central and East Asia and the Middle East.  Some of the countries with high rates of chronically hepatitis C infections include Egypt (22%), Pakistan (4.8%) and China (3.2%).

Hepatitis C is the most common cause of chronic liver disease in the USA.  The U.S. Centers for Disease Control and Prevention (CDC) estimates that 30,000 cases of acute hepatitis C infection are reported every year. In the early 90s, new infections were occurring at about 150,000 Americans per year, but dropped with the development of better testing, eg Hep C was transmitted in 10% to 13% of American blood transfusions carried out in 1981 but by 1992 blood testing had improved and the transmission rate was under 1%.  In 2015, approximately 3.5 million people in the country had the disease.  A 1993 report estimated some 20-40% of people who come to USA inner city hospitals carry the hepatitis C virus, along with 80% of intravenous drug users. 40% of the non-drug users who were carriers claimed they never used intravenous drugs, had not had blood transfusions prior to 1990 and had no reason for contracting the virus through blood-to-blood contact.

Hepatitis C can be passed through tattooing by reusing needles or dye and insufficient sterilization of needles between customers. Researchers in Dallas studied more than 600 patients. They found 18% of these patients had a tattoo. Of those patients with a tattoo, more than 20% were infected with hepatitis C and 33% of those patients had acquired their tattoos in a commercial tattoo parlour. Only 3.5% of patients with no tattoos had hepatitis C. People who had several tattoos have an increased risk of having the potentially fatal disease.

Even with interferon drug treatment, chronic liver infection remains likely. The treatment is not very effective, permanently suppressing liver inflammation in 10% to 20% of patients. Liver transplants are often needed, but the virus usually invades the new liver as well.