Hepatitis C Information Page
***THANK YOU TO LADYELEC AND ALL OF MY OTHER GREAT FRIENDS WHOM I HAVE MET AT DANIEL'S HCV LIST WHO HAVE HELPED ME TO CREATE THIS PAGE AND IMPROVE MY LIFE THROUGH YOUR SUPPORT!***
I LOVE YOU!!!
I have created this page as a resource of information for those wanting to learn about the Hepatitis C Virus. Approximately 10,000 people die each year as a result of this disease. It is believed that 1.8 to 2.0 of the population in the United States alone is infected with this virus. Let us work towards a common goal to erradicate this disease and to educate the world about it's significance for this planet.
Love to you,
Wind Dancer, the Dragon Slayer
WHAT IS HEPATITIS?
What is Hepatitis ? Hepatitis is an inflammation of the liver. The word comes from a combination of two Greek words: "Hepatos-" ("liver"), and "-itis" ("inflammation"). The inflammation of the liver (hepatitis) can be caused by several factors: - viruses - viral hepatitis is caused by several viruses that attack mainly the liver. The viruses identified until now have been named as A, B, C, D, E, and G, from which A and E are contagious. - toxic agents - alcohol, drugs or other chemicals. - auto-immune disorders. Chronic Hepatitis If inflammation and necrosis of hepatocytes persist for more than 6 months we are dealing with chronic hepatitis. Based on histological criteria, chronic hepatitis classification is as follows: chronic persistent; chronic lobular and chronic active hepatitis. A) Chronic Persistent Hepatitis and Chronic Lobular Hepatitis They usually follow acute hepatitis B or C. These disorders may persist for years, but are mild and rarely progress to chronic active hepatitis or cirrhosis. Clinical features for both are : vague or no symptoms (anorexia, weakness and nausea) clinical signs are absent. Sometimes liver enlargement can be detected persistently high transaminase values Liver biopsy shows: Chronic Persistent Hepatitis: portal mononuclear inflammation (portal hepatitis) without significant fibrosis or acinar disarray (signs of evolution into cirrhosis). Chronic Lobular Hepatitis: diffuse lobular inflammation, with features of persisting acute hepatitis. There is low portal infiltrate. No signs of evolution into cirrhosis. Treatment is not necessary and natural recovery is usual. However, periodic controls are recommended. Hepatitis C Hepatitis C is a form of hepatitis caused by an RNA (Ribo Nucleic Acid) virus, and accounts for most of the hepatitis cases previously referred to as non-A, non-B hepatitis. The Hepatitis C Virus (HCV) was first identified in 1988 and a hepatitis C antibody test (anti-HCV) to identify individuals exposed to HCV became commercially available in 1990. In 1995 the hepatitis C virus was seen for the first time by using an electron microscope. The hepatitis C virus has a high mutation rate. These ongoing changes in the virus make it difficult for the body's own immune system to fight it off, as by the time the immune system figures out the virus, it has changed to look different. For the same reason it is very difficult to develop a vaccine. Hepatitis C is considered a bloodborn disease, and it is thought that many people with hepatitis C contracted it either through a blood transfusion or by receiving blood products (gammaglobulin, plasma, etc.) that were contaminated with hepatitis C, or by sharing needles with intravenous drug users that were infected with hepatitis C. Prior to 1990 blood could not be screened for HCV due to the absence of a reliable test, and therefore people who received blood products before that year are considered as having been at risk. Thanks to HCV testing after 1990 the risk of acquiring hepatitis C from blood transfusion has been reduced to well under 1%. There are cases of hepatitis C with no evidence of blood to blood exposure (receiving blood transfusions or products, needle sticks or needle sharing), where it is unknown how these individuals became infected. Chronic Hepatitis C Hepatitis C Virus (HCV) infection becomes chronic in about 50-80% of cases, therefore HCV is known to cause the most cases of Chronic Active Hepatitis. Chronic hepatitis C behaves differently from hepatitis B. The disease is generally milder and most people are asymptomatic or have vague (mild asthenia) or no symptoms. Nevertheless, 10-15 years (and even more) from the infection, the complications of cirrhosis appear in about 20-30% of patients, sometimes unexpectedly. The percentage of patients who develop cirrhosis is much greater than in chronic hepatitis B, while primary liver cancer appears to be much less common. About 80% of patients have abnormal aminotrasferase values. A characteristic feature of chronic hepatitis C is the fluctuation in aminotrasferase values seen in approximately 50% of cases. Fluctuations seem to represent effects of mutations in the virus or episodic immune reactions. Transaminase values don't correlate well with histological features of disease. About 20% of patients with positive diagnostic tests for HCV (anti-HCV positive) have persistently normal liver enzymes. Some of them progress to more advanced disease, in others infection appears to remain quiescent. HCV has the property to involve bile duct epithelial cells, causing a significant cholestatic component (stoppage or obstacle of the flow of bile), with abnormalities of serum Alkaline Phosphatase and Gamma Glutamyl Transferase (GGT) levels. However, pure cholestasis has not been described. Clinical consequences of Chronic Active Hepatitis Chronic liver injury caused by Chronic Active Hepatitis can lead to cirrhosis and hepatocellular carcinoma. 1) Cirrhosis About 20% of patients with chronic hepatitis C and 25% of those with chronic hepatitis B progress to cirrhosis after 15-20 years from onset of the infection. Rapid progress to cirrhosis (evolution within 5-10 years from infection) is associated to: genotypes 1a or 1b (in HCV infection) high viral load history of concomitant alcohol abuse immune compromised state (immunosuppression and HIV infection) co-infection with other hepatitis viruses (HBV, HCV, HDV or HGV) The scar tissue that forms in cirrhosis replaces the normal liver cells, making the flow of blood through the liver increasingly difficult. The loss of normal liver tissue slows the processing of nutrients, hormones, drugs, and toxins by the liver, as well as the production of proteins and other substances made by the liver. 2) Hepatocellular carcinoma (HCC) Liver cirrhosis is associated with development of HCC and therefore it can be considered a pre-cancerous lesion. Approximately 5% of chronic HBV and 10% of chronic HCV carriers develop HCC (about 50% of patients with cirrhosis). HCC can also be found in patients with chronic hepatitis but without cirrhosis. This situation is more frequent in patients with chronic hepatitis B (HBV becomes integrated into hepatocytes' genome) than in chronic hepatitis C. Diagnosis Chronic hepatitis is frequently asymptomatic, therefore it is often discovered casually, during routine blood tests. The first element of suspicion is the elevation of transaminase levels, sign of liver injury. Positivity for HBsAg and/or anti-HCV confirms the suspicion. Chronic hepatitis can be distinguished from an acute form because it persists and gives no sign of recovery (blood tests are persistently abnormal). In chronic hepatitis B antibody of IgM class against antigen c (HBcAb IgM) are negative (it's positive only in acute infection). Positivity for anti-HCV does not necessary mean presence of chronic hepatitis C, because this antibody persists for some months after recovery from an acute form. Diagnosis of chronic hepatitis C can be posed only after the detection of HCV in patient's blood with PCR, which can detect minute amounts of viral genome (RNA). If chronic hepatitis is present a liver biopsy should be performed to assess the degree of liver inflammation and extent of fibrosis (hepatitis staging and grading). In fact, if cirrhosis is present, treatment requires caution and, in some cases, cannot be applied.
FACTS
There is no cure at the present time for HCV.
Hepatitis C is the leading cause of liver transplantation
It is believed that approximately 85% of all individuals infected with HCV will develope chronic liver disease.
The National Institute of Health reports that nearly 4 million Americans are infected with the HCV virus.
Approximately 10,000 Americans alone die each year as a result of this disease and the figures are expected to triple by the year 2000.
There is no known vaccine for this disease.
RISK FACTORS
Blood tranfusions prior to 1990
Health care exposure
Sharing needles or snorting devices
Organ transplantation
Body piercing
High risk sexual behavior
Tattooing with unclean needles
Any form of illegal IV drug use
SOME COMMON SYMPTOMS
Many infected persons remain asympotmatic (with no symptoms) for years. Some feel the effects within 6 weeks of contracting the virus but this is rare.
Common symptoms may be abdominal pain, fatigue, elevated liver enzymes, loss of appetite, nausea, forgetfulness, irritablility, vomiting, weight gain or loss, pain in the joints, general body aches, loss of concentration, depression, jaundice.
OTHER INFORMATION RESOURCES
Hepatitis Foundation International 1-800-891-0707 30 Sunrise Terrace Cedar Grove, NJ 07009
American Liver Foundation 1-800-223-0179 1425 Pompton Avenue Cedar Grove, NJ 07009-0179
SOME INFORMATIVE WEBSITES
The Hepatitis Place
HepCBC Home Page
**Daniel's Hepatitis C Web Site**
DO CHECK THIS ONE OUT!
BACafe Home Page Hepatitis C HCV
