Type C viral hepatitis
Name(s):
Hepatitis C
Hepatitis Non-B
HVC
Nature
Hepatitis C is a virus which targets the liver and creates an initial illness similar to other hepatitis infections, only usually milder. However, 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 and in as many as 40% of the patients, the mode of infection is unknown.
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 and abdominal pain. Jaundice marks severe cases. However, it is generally asymtomatic, with few symptoms showing until permanent liver damage is done. 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.
Background
Hepatitis C is a blood-borne virus, arising from blood-to-blood transmission, and was transmitted in 10% to 13% of American blood transfusions carried out in 1981. By 1992 blood testing had improved, and the transmission rate was under 1%. It is not noted as a sexually transmitted disease, although it can be if the partners have open sores, contaminated saliva and blood exchange. The most common mode of transmission into the blood by any break in the skin. Tattooing, body piercing, even manicures, are suspect.
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.
Only since 1990 have physicians been able to detect hepatitis C in the bloodstream. Most infected people show no outward symptoms. These factors make it difficult to produce hard demographic numbers.
Incidence
This is the deadliest form of hepatitis, causing more deaths than all other forms put together. It is estimated that over 170 million people worldwide have this degenerative liver disease. 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 incidence in the USA is 1.5%, with 4 million sufferers of which 500,000 reside in California. New infections were occurring at about 150,000 Americans per year, but have dropped to 30,000 or 40,000 with the development of better testing. 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 percent of these patients had a tattoo. Of those patients with a tattoo, more than 20 percent were infected with hepatitis C and 33 percent of those patients had acquired their tattoos in a commercial tattoo parlour. Only 3.5 percent of patients with no tattoos had hepatitis C. People who had several tattoos have an increased risk of having the potentially fatal disease.
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Type
(G) Very specific problems