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Hepatitis C: Catch It, Before It Catches You…

   

DS a 30 yr female was admitted for hysterectomy (removal of uterus ) due to fibroids . As part of routine preoperative testing she had the Hepatitis B, C and HIV screening test.She was found to have Hepatitis C infection . Further evaluation revealed that she had Liver cirrhosis from Chronic hepatitis C infection. She probably had the infection for several years but was unaware as she had no symptoms. She was also found to have a small liver cancer . This news came as a shock to her and her family , from not knowing anything regarding the Hepatitis C infection and this being incidentally detected due to the hysterectomy surgery.

• HEPATITIS C INFECTION IS A SILENT KILLER, YOU DON’T KNOW YOU HAVE IT UNTIL IT IS TOO LATE

• EARLY TESTING ( SCREENING BLOOD TEST FOR HEPATITIS C) EVEN IN ABSENCE OF SYMPTOMS IS RECOMMENDED

• EARLY DETECTION CAN HELP TO PROVIDE COMPLETE CURE FROM THE HEPATITIS C INFECTION AND PREVENT RISK OF COMPLICATIONS SUCH AS CIRRHOSIS AND LIVER CANCER

Hepatitis C is an infectious disease caused by the hepatitis C virus (HCV) that primarily affects the liver. During the initial infection people often have mild or no symptoms. Occasionally a fever, dark urine, abdominal pain, and yellow tinged skin occurs. The virus persists in the liver in about 75% to 85% of those initially infected. Early on chronic infection typically has no symptoms. Over many years however, chronic hepatitis C often leads to progressive liver damage resulting in cirrhosis. In some cases, those with cirrhosis will develop complications such as liver cancer, and complications of Liver failure in the form of vomiting blood( Hematemesis ) , passing blood in stool ( malena ) , swelling of feet and abdomen ( ascites ) , confusion, drowsiness( Hepatic encephalopathy ) , worsening kidney function with low urine output ( hepatorenal syndrome )

How Do You Get It?

The virus spreads through the blood or body fluids of an infected person. You can catch it from:

• Sharing drugs and needles
• Having sex, especially if you have an STD, an HIV infection, several partners, or have rough sex
• Being stuck by infected needles
• Birth -- a mother can pass it to a child
• Hepatitis C isn’t spread through food, water, or by casual contact.

Who is at Risk of having this infection ?

Health care workers
Dialysis patients
Previous blood transfusions / surgery/dental procedures
Tattooing
IV drug users
Reusing needle and syringes
Multiple sexual partners

How Is Hepatitis C Diagnosed?

• You can get a blood test to see if you have the hepatitis C virus.
• If your screening test is positive ( AntiHCV ) it simply means that you were exposed to the virus and does not indicate active infection.
• If the AntiHCV is positive, you will need confirmatory tests such as HCV RNA to confirm whether you have the infection
• Also there are different genotypes of HCV infection( 1,2, 3, 4, 5,6) , In India Genotype 3 is the commonest . The genotype of the HCV infection is important as it determines which medication will work best to treat the infection

What happens if you have active HCV infection ? Is there curative treatment ?

• You will need to see a Liver specialist
• The doctor will assess the degree of Liver damage with help of blood tests such as LFTS, HCV RNA viral load and Fibroscan ( bed side test used instead of Liver biopsy to assess degree of Fibrosis ).
• The HCV RNA can be treated using effective antiviral medication( Ledipasvir, sofosbuvir, Daclatasvir ) for 12 -24 weeks . This is an all oral regime with a very good response rate approximately > 90 % in most cases . These medications are safe and do not produce much adverse reactions . The newer medication is available in India at a much lower rate compared to Western countries where it can cost 80000 USD . In India the monthly cost has reduced to < 20000 INR . Previously, Injectable Peglated interferon was used along with ribavirin with a poor response and higher chance of side –effects .

   may 2nd , 2016


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