Hepatitis is an inflammation of the liver. Inflammation causes soreness and swelling. Hepatitis can be caused by many things. Hepatitis is most commonly caused by one of the six hepatitis viruses (A, B, C, D, E or G). All types of hepatitis cause inflammation of the liver, which interferes with its ability to function. Lack of blood supply to the liver, poison, autoimmune disorders, excessive alcohol use, an injury to the liver and taking certain medicines can also cause hepatitis. Less commonly, viral infections such as mononucleosis or cytomegalovirus can cause hepatitis
There are 2 main kinds of hepatitis, acute hepatitis (short-lived) and chronic hepatitis (lasting at least 6 months). If you have acute hepatitis, the liver might become inflamed very suddenly and you might have nausea, vomiting, fever and body aches. Or you may not experience any symptoms. Most people get over the acute inflammation in a few days or a few weeks. Sometimes, however, the inflammation doesn't go away. When the inflammation doesn't go away in 6 months, the person has chronic hepatitis.
How does hepatitis affect the liver?
The liver breaks down waste products in your blood. When the liver is inflamed, it doesn't do a good job of getting rid of waste products. One waste product in the blood, called bilirubin (say "billy-roo-bin"), begins to build up in the blood and tissues when the liver isn't working properly. The bilirubin makes the skin of a person who has hepatitis turn a yellow-orange color. This is called jaundice (say "john-dis"). Bilirubin and other waste products may also cause itching, nausea, fever and body aches.
What is hepatitis C?
There are 6 viruses that cause hepatitis. Each hepatitis virus is named with a letter of the alphabet: hepatitis A, hepatitis B, hepatitis C, hepatitis D, hepatitis E and hepatitis G. Hepatitis C is usually spread through contact with blood products. People who use intravenous (IV) drugs can get hepatitis C when they share needles with someone who has the virus. Health care workers (such as nurses, lab technicians and doctors) can get these infections if they are accidentally stuck with a needle that was used on an infected patient. You are also at a higher risk if you got a blood transfusion or an organ transplant before 1992 (improvements in blood-screening technology were made in 1992).
What are the symptoms of hepatitis C?
At first, hepatitis C does not usually produce any symptoms. When it does, symptoms are typically flu-like and can include:
- Mild fatigue
Achiness in your joints and muscles
Nausea
Lack of appetite
Tenderness in the areas of your liver
As the disease progresses, symptoms may still not appear. When they do, they can include:
- Fatigue
Nausea
Vomiting
Lack of appetite
Jaundice (yellowing of the skin and eyes)
Low-grade fever (fever up to 102 degrees)
I've never used IV drugs or been stuck with a dirty needle. How did I get hepatitis C?
Yes, as far as we know, once you have hepatitis C, you can always give it to someone else. If you have hepatitis C, you cannot donate blood. You should avoid sharing personal items like razors and toothbrushes, although it is very rare to pass hepatitis C in these ways. Always use a condom when you have sex. If you have hepatitis C, your sexual partners should be tested to see if they also have it.
Talk to your doctor first if you want to have children. The virus isn't spread easily from a mother to her unborn baby, but it is possible so you need to take precautions. However, if you're trying to have a baby, do not have sex during your menstrual cycle, because the hepatitis C virus spreads more easily in menstrual blood.
How should I take care of myself if I have hepatitis C?
You should eat a healthy diet and start exercising regularly. A dietitian can help you plan a diet that is healthy and practical. Talk to your doctor about medicines that you are taking, including over-the-counter medicine. Many medicines, including acetaminophen (brand name: Tylenol) are broken down by the liver and may increase the speed of liver damage. You should also limit alcohol use, as it also speeds the progression of liver diseases like hepatitis C. An occasional alcoholic drink may be okay, but check with your doctor first.
Is there a vaccine for hepatitis C?
No, not for hepatitis C. There are vaccines for hepatitis A and hepatitis B. If you have hepatitis C, your doctor may want you to take the vaccine for hepatitis B (and maybe the vaccine for hepatitis A), if you don't already have these viruses. If you have hepatitis C, you are more likely to catch hepatitis A or hepatitis B, which would cause more damage to your liver.
Is there a treatment for hepatitis C?
Good health habits are essential for those who have hepatitis C, especially avoidance of alcohol and other medicines and drugs that can put stress on the liver. Although there is not yet a proven cure for hepatitis C, some people benefit from drug treatment. You should discuss treatment with a doctor if you have hepatitis C.
The standard method of treatment for hepatitis C is a combination of pegylated interferon alfa shots and ribavirin supplements. The pegylated interferon alfa shot is given weekly and can include the following medicines:
- peginterferon alfa-2b (brand name: PEG-Intron)
peginterferon alfa-2a (brand name: Pegasys)
The ribavirin supplement pill (some brand names: Copegus, Rebetol, Virazole) is taken twice daily.The course of treatment typically clears the virus from the bloodstream in 40-80% of hepatitis C cases.
What should I know about interferon?
Before you can start taking interferon, you will have a liver biopsy. This means that a tiny bit of your liver will be taken out in a surgical operation and your doctor will check this sample to see how much damage there is. Younger patients who have mild liver disease and fewer virus particles in the liver usually respond better to interferon and ribavirin treatment.
What are the side effects of drug treatment?
Side effects of interferon therapy may include the following:
- Trouble sleeping
Nausea
Vomiting
Fever
Body aches
Extreme fatigue
Irritability
Depression- Concentration and memory problems
Side effects of ribavirin supplements may include the following:
- Decrease in red blood cells (anemia)
Skin rashes and itchiness
Extreme fatigue
Nasal congestion
Birth defects
Side effects are usually worst during the first few weeks of treatment and become less severe over time. If you are having trouble dealing with the side effects of your medicine, talk to your doctor. He or she can suggest ways to relieve some of the side effects. For example, if your medicine makes you feel nauseated, it may help to take it right before you go to sleep.
The decision to use drug therapy can be hard to make because of the side effects. Your doctor will pay attention to the type of the virus and the amount of the virus in your body. Your overall health, the results of your blood tests and the liver biopsy are also important factors to consider before you and your doctor start drug treatment for your hepatitis C.