Dr. M.J. Bazos, MD Patient Handout

HEPATITIS C

About Your Diagnosis

Hepatitis is an inflammation of the liver. It is caused by at least five different types of viruses. One of the types of viruses is the C virus. Hepatitis C has also been called non-A, non-B hepatitis. The incidence of hepatitis C is 1 case per 10,000 individuals. Hepatitis C is transmitted though exposure to infected blood or blood products. The hepatitis C virus causes most cases of hepatitis that occur after a blood transfusion. Hepatitis C can also be transmitted through intravenous drug use, and other exposures from contaminated blood or bloodcontaining products. In about 40% of cases, the exposure is not identified. In general, individuals infected with hepatitis C are often identified because they are found to have elevated liver enzymes on a routine blood test. Others are identified because a hepatitis C antibody is found to be positive at the time of a blood donation. At least 50% of the cases of hepatitis C may become chronic. In these individuals, a liver biopsy may need to be done to determine the severity of liver damage.

Living With Your Diagnosis
One of main symptoms of hepatitis C is jaundice, a yellow color to the skin or whites of the eyes. The jaundice is caused by the excess bilirubin in the blood. The excess bilirubin can also lead to other symptoms such as pale or clay-colored stools, dark urine, and generalized itching. “Flulike” symptoms of fatigue, loss of appetite, nausea and vomiting, and low-grade fever may occur several days before the jaundice appears. If chronic hepatitis C develops, the symptoms can vary. Some individuals may remain well. Others will have severe and persistent liver inflammation. This may eventually lead to cirrhosis and liver failure. Cirrhosis is scarring of the liver. The scarring does not allow the liver to do its job of removing toxic substances from the blood. Cirrhosis can lead to additional complications, including accumulation of fluid in the body (ascites) or bleeding from veins in the esophagus (varices). If the liver is chronically scarred, hepatocellular cancer can develop.
Treatment
There is no specific treatment for acute hepatitis C. Most individuals can be cared for at home. Rest and proper diet are recommended when the symptoms are most severe. Individuals with acute hepatitis should avoid alcohol and any substances that are toxic to the liver. Individuals with chronic hepatitis C can be treated with the drug, interferon alpha-2b. However only 10% to 15% of patients treated with interferon have a longlasting response. Patients can be treated a second time in hopes of inducing a remission. The goal of treatment with interferon is to improve or normalize the liver function tests and reduce the inflammation in the liver. This will in turn slow or interrupt the development of the complications of cirrhosis. Interferon frequently causes side effects, including “flulike” symptoms, depression, headache, and decreased appetite. In addition, interferon can cause problems with the bone marrow.
The DOs
• Bed rest may be necessary until the jaundice disappears and the appetite returns.
• A well-balanced diet with plenty of fluids is essential.
• Make sure you properly wash your hands if you have hepatitis or are caring for someone with the disease. This is particularly important after contact with blood or other body fluids.
• An individual with hepatitis C should use separate or disposable eating and drinking utensils.
• If you have multiple sexual partners, a latex condom should be used. It may prevent transmission of the virus.
• If exposed to blood and body fluid on the job, use proper protective equipment such as gloves and eye protection to lessen the chance of accidental exposure.
The DON’Ts
• Avoid any substances that may be harmful to the liver. The avoidance of alcohol is key.
• Fatty foods may not be well tolerated in individuals with hepatitis C
• If you have had hepatitis C, you should not donate blood. All blood is screened for the hepatitis C virus.
• Women who have had hepatitis C or have chronic hepatitis C should not breast-feed their babies.
• If you are an intravenous drug addict, do not share needles and other equipment because they can be contaminated.
When to Call Your Doctor
• If you have been exposed to someone who has hepatitis C or if you have symptoms of the disease.
• If hepatitis C symptoms do not resolve within 16 weeks.