Hepatitis C is a virus infection of the liver cells. The virus causes liver cells to be inflamed. About 3% of the population carries the virus. There are about six types of Hepatitis viruses and they are: A, B, C, D, E and G. Hepatitis C runs a chronic cause in the carrier and may eventually develop into liver cancer.
How is Hepatitis C Contacted?• The commonest mode of transmission is through blood and blood products. This mode was common prior to the development of a sensitive test to detect the virus in blood donors. • Needle sticks: Sharing needles, accidental needle stick carries a risk of about 0.3% (compared to 30% for Hepatitis B and 3% for HIV).• Sexual transmission is possible but the risk is very low in a monogamous relationship.• Other means: Scarring done with sharp objects in certain cultures and religious practices. Getting a tattoo may put you at risk too.
How does Hepatitis C Present?• Having no symptoms at all is the commonest mode of presentation. Hence the infection may be longstanding without the person knowing.• Abnormal liver test: Inflammation of liver cells causes the release of some liver enzymes in higher than normal levels alanine transaminase (ALT) and aspartate transaminase (AST).• Symptoms related to complication: Liver cancer with or without jaundice (yellowness of the sclera in the eye), right sided abdominal pain and mass.• Non specific symptoms: Tiredness, right sided upper abdominal discomfort• Other non hepatic manifestations: Purpura cutaneous tarda (skin photosensitivity with some additional symptoms), arthralgia (joint pains), cryglobulinemia.
Who Should Be Tested For Hepatitis C?• Anyone who received blood transfusion or blood products prior to 1992.• Hemophiliacs• History of substance abuse• History of repeated needle use among several people. • Anyone infected with HIV.• People who did scarifications prior to immigrating to the U.S• All health care workers• People infected with other forms of Hepatitis such as Hepatitis B (Hep. B)

How is Hepatitis C Detected?Through blood screening: The body generates antibodies against the virus once infected.The virus itself can be quantified if screening test is positive, that is the viral load.False negative test (someone infected, but whose test is negative) can occur in people with suppressed immune system.
How is Hepatitis C Treated?It is not everyone infected that is treated. Decision to treat depends on several factors some of which are:• Increase in liver test AST and ALT • Results of biopsy of the liver (sample of the liver is taken to determine the amount of damage done to the liver). Liver biopsy is done because the level of increase of liver tests does not correlate with the amount of liver damage. • Presence of other diseases that can impact treatment(that is co morbid diseases)• Presence of medical problems that can become worse with treatment such as major depression and very low blood cell levels The decision to treat or not to treat depends on the outcome of all these considerations. There are two major drugs used in the treatment of Hepatitis C. These are interferon (an injection) and ribavirin (an antiviral drug). The length of treatment also depends on the specific genotype of the virus. Genotype 1 is treated for longer periods than genotypes 2 and 3. The viral load is used to monitor response to therapy.
What is the long term consequence of Hepatitis C Infection. • There may be no effect • Some people develop cancer of the liver over 20-30 years from the time of infection. Unfortunately, most people when detected do not know how long they have had the infection.• Others develop cirrhosis (distortion of the liver architecture) with disease in the liver function. 
Some precautions that need to be taken in infected people • Test for HIV co-infection• Check whether you are protected against Hepatitis A and B. If not, get the immunization. This is because infection with any other type of hepatitis virus may be more severe than usual.
Take Home MessageHepatitis C is a viral infection of the liver that may not present with any symptoms. Screening is simply done in blood test and it is treatable. If left untreated, it may develop into liver cancer in the long run. The risk of transmission through sex in a monogamous relationship is very low.
Dr. Oluwatoyosi Dairo can be reached at Amazing Medical Services located at 110-16 Sutphin Blvd, Jamaica NY 11435 or by phone at (718)526-7600.Disclaimer: This article is intended for education purposes only and is not intended to replace the advice of your doctor.