Hep C

I have been spending the last couple of years researching facts about Hepatitis C because I was diagnosed with it three years ago. What astounded me was the lack of knowledge that most people, including my own primary care physician (and most primary care physicians that I know of) have about this disease and it's symptoms and treatment. I joined several online Hep C support boards and educated myself through the experiences and information posted by other Hep C positive people and not only learned more than most of my doctors do about the disease, but also made some great friends along the way. I finally chose to go through the treatment for Hep C back in November of 2007 after much deliberation and at the encouragement of my primary care physician and my boss and co-workers, despite my warnings to them that the treatment is very hard on the patient and the medications have some serious side effects, including mood changes, fatigue and bouts of uncontrollable anger and/or depression. Within the first 2 weeks I had been fired from my job due to an uncontrollable outburst I had directed at our socially and professionally inept office manager. The current standard treatment is weekly shots of Interferon (in most cases Pegulated Interferon) and gobbs and and gobs of Ribavirin. The Ribavirin is the primary cause of the emotional changes as well as causing dry skin (think alligator skin), vision problems and a miriad of other fun side effects. The weekly shot, however, is a whole other ball of wax. It normally results in feeling like you have to flu for 3 or 4 days after - and you have to go through this every week. I am fortunate in that I am on a short treatment plan - 24 weeks and after 6 weeks have already gone undetectable. Many people have to go through the treatment for 52 weeks or more and sometimes have to do the treatment more than once. Let me tell you this now - HEP C SUCKS! And there are a lot of people running around who don't even know they have it. So in the interest of public service and your own health please read the following information about Hep C. One thing noted in the report of great importance is not sharing personal hygiene items such as fingernail clippers, toothbrushes and even combs and brushes. The Hep C virus has the unusual ability to live in the tiniest speck of dried blood for what is thought to be months while retaining it's ability to infect anyone unfortunate enough to come in contact with it. DON'T SHARE YOUR PERSONAL HYGIENE ITEMS FOLKS! And here's the report...

What Is Hepatitis C ?
Hepatitis C virus (HCV) causes inflammation of the liver. A national U. S. survey found that 1.8 percent of Americans – about 3.9 million – have been infected with HCV, of whom most ­ about 2.7 million – are chronically infected with HCV, with many showing no signs or symptoms. The good news is that, in 1995, a reliable antibody test for HCV was finally implemented nationwide. About 41,000 new cases occurred in 1998 with 15-25% recovering spontaneously. Hepatitis C is a slow-progressing disease that may take 10-40 years to cause serious liver damage in some people.


Who Is At Risk?
Since about four million Americans are infected with HCV and most don't know it, you should have a blood test for hepatitis C ­ whether you feel sick or not. About one in ten people infected with HCV have had no identifiable exposure to HCV. That said, here are several obvious risk factors:
Intravenous (IV) drug users – even IV use in the distant past.
Those with multiple sex partners or sex with partners who have other sexually transmitted diseases.
Those with tattoos or body piercing done with unsterile instruments. Anyone who has had a blood transfusion prior to 1992 or clotting factors produced before 1987.
Hemodialysis (diabetes) patients.
The potential for transmission from an HCV-infected mother to her newborn appears to be about 5%.
How Does it Spread?
Injection drug use is the primary risk for HCV infection. Injection drug use accounts for about 60% of all new cases of hepatitis C and is a major risk factor for infection with hepatitis B virus. Among frequent drug users, 50-80% are infected by HCV within the first 12 months of beginning injecting.
Straws shared in snorting drugs are also a potential source of infection of HCV. The hepatitis C virus is found mainly in blood.
HCV is not spread through kissing or casual contact.
In relationships where there is one steady partner, sexual transmission is exceedingly unusual, less than 3% over decades in sexually active couples. Transmission from HCV RNA negative individuals has never been reported. Sexual transmission may be more common among those with multiple sex partners or where there is a history of sexually transmitted disease but this remains controversial and unconfirmed.
HCV may be transmitted by using razors, needles, toothbrushes, nail files, a barber's scissors, tattooing equipment, body piercing or acupuncture needles if these items are contaminated by blood of an infected person.
Healthcare workers have a 2% risk of acquiring HCV after a needle stick contaminated with HCV-positive blood.
There is no evidence indicating that HCV is transmitted through breast milk.
The current transmission rate through blood transfusions is estimated at less than 1 per 1,000,000 units transfused.
Symptoms
Most people who are infected with the HCV do not have symptoms and are leading normal lives. If symptoms are present, they may be very mild and flu-like – nausea, fatigue, loss of appetite, fever, headaches, and abdominal pain. Most people do not have jaundice although jaundice can sometimes occur along with dark urine.

The incubation period varies from 2-26 weeks. Liver enzyme tests may range from being elevated to being normal for weeks to as long as a year. The virus is in the blood and may be causing liver cell damage, and the infected person can transmit the disease to others.

Diagnosis
Test for HCV antibodies: HCV infection can be determined by a simple and specific blood test that detects antibodies against HCV. The current enzyme immunoassay test (EIA) that detects anti-HCV has a sensitivity of about 95% in chronic HCV. HCV infection may be identified by anti-HCV testing in approximately 80% of people as early as five weeks after exposure. This test is not a part of a routine physical examination, and people must ask their doctor for a hepatitis C antibody test. (Note: The antibody itself does not provide immunity, and the test does not distinguish between acute or chronic infection.) If the initial test is positive, it test should be repeated to confirm the diagnosis (and exclude possible laboratory error). If the initial test is negative, but the infection could have occurred within the last six months and HCV is suspected, antibody levels may not be high enough yet to be detectable (antibodies may not be present in the first 4 weeks of infection in about 30% of patients) or you may lack immune response. Under these circumstances, ask you doctor about repeating the test and about alternative test methods.

Test liver enzyme levels: If you may already have chronic infection, your doctor will test the levels of two liver enzymes. These are alanine aminotransferase (ALT) and aspartate aminotrasferase (AST). Both are released when liver cells are injured or die. Elevated ALT and AST levels may appear and disappear throughout the course of the HCV infection. If the liver enzyme levels are normal with chronic HCV, they should be re-checked several times over a 6 - 12 month period. If the liver enzyme levels remain normal, your doctor may check them less frequently, such as once a year.