Hepatitis-C - Treatment -Symptoms -Diagnosis.
Dr Pawan Rawal- Liver Disease Specialist | Gastroenterologist is one of the leading and most experienced Gastro. Physician of North India and is HOD - Hepatobiliary sciences and Gastroenterology at Artemis Hospital ,Gurgaon,India. A New generation Hospital with best Medical equipment and Best Liver transplant ICUs and Paramedical ICU staff in the country.
What is Hepatitis-C ?
Hepatitis C is a viral infection that infects liver and causes inflammation and scarring of normal liver tissues. If left untreated it may cause serious, life threatening damage to liver over a period of time.
The prolonged and persisting inflammation in liver tissues may cause scarring of healthy liver tissues. An extensive scarring of Liver tissues leads to cirrhosis. It is this stage of chronic liver disease that starts affecting the life of the Infected. Chronic cirrhosis may also cause Cancer of Liver. Hepatitis-C can be cured in many cases with combination of drugs.Sometimes the treatment for cirrhotic liver is Liver transplant.
How one acquires Hepatitis-C Infection?
Hepatitis-C spreads through mingling of blood from a infected person to a healthy person.Usually it is percutaneous transmission of HCV from an infected person to a healthy person.Hepatitis-C is seven times more infectious than HIV. The most common cause of Hepatitis-C infection is Intravenous drug usage and infected needles (Injections). Unhygienic tattooing and body piercing centers which may use unsterile needles for the purpose,It may be transmitted from an infected mother to an unborn child,Very few and rare chances of transmitting through sexual intercourse,Using common household items like a shaving razor,Scissors,Manicuring equipments,tooth brushes etc., People who may have taken a blood transfusion before 1990,Hemodialysis,a medical procedure , an accidental injection needle prick from an infected person in a healthcare worker etc.
Who are at Risk of Hepatitis-C infection?
Healthcare workers,people who uses common shaving and hair cutting saloons,may be because of an infected razor or scissor,People who had a blood transfusion before 1992,people who had received hemodialysis on a machine which has dialysed an HCV infected person,elderly people who may have had a surgery before 1990. An unborn child whose mother may be HCV positive.
Symptoms Of Hepatitis-C:
Majority of people in early stages of Hepatitis-C Infection does not have noticeable symptoms.But once the disease progress the symptoms start appearing, are:
The early symptoms appear in a very small infected population and may be because of other medical conditions too.
Yellowing of Skin (jaundice) and whites of eye,Uncommon fatigue or general malice, Dark coloured urine,loss of appetite,fever,muscles and joint pains, Stomach ache etc.
But in an advanced stage of disease the symptoms may include Itching and rashes on skin,Weight loss,Enlargement of breast in men(Gynecomastia),Easy bleeding and bruising of skin,Prolonged blood coagulation time ( time taken in stopping of bleeding from a wound is prolonged),swelling of feet,rashes on palms,fluid accumulation in stomach (ascites),appearance of spider web like blood vessels ( Spider angiomas),Kidney functions being derailed ( Cryoglobulinemia),persistent yellowing of skin and eye whites.
More severe symptoms of chronic hepatitis-C include portal hypertension ,esophageal varices ( engorged veins in the swallowing tube) that may bleed suddenly,enlarged spleen that may result in anemia,fall in platelets count (thrombocytopenia) that makes the infected person prone to bleeding easily and prolonged time of stopping of bleeding and confusion,disorientation and even coma because of hepatic encephalopathy.
How Hepatitis-C is diagnosed?
HCV Antibody testing ,HCV viral load testing, HCV genotype testing for determining the treatment course and duration,and the possibility of curing the disease.Other tests may be done for a Hepatitis-C patient like LFT (liver function test) to determine the damage to liver,a liver biopsy to determine cirrhosis,imaging tests like ultrasound,CT scan and MRI to determine fatty liver and liver cancer.
Treatment of Hepatitis-C :
Treatment,duration and medication for Hepatitis-C depends on several factors. A gastro. Physician will consider all the aspects in every individual patient before prescribing a medicine or combinations of medicines. Some of the factors determining the course of treatment and management of Hepatitis-C are listed below:
- Genotype of HCV.
- Viral load ( The quantity of virus present in blood stream)
- treatment history ( Previously treated or untreated patient)
- degree of damage to liver (Cirrhosis).
- status of patient,i.e., if patient is a liver transplanted patient or a candidate for a planned liver transplant in future.
- Patient's general health and tolerability of treatment.
The invention and approval of sofosbuvir
a new drug for treating Hepatitis-C infection have brought in a dramatic change in the outcome of treatment of HCV.
Sofosbuvir can be used in combination with ribavirin or as a three drug combination of Sofosbuvir,pegylated Interferon Alfa and ribavirin.
There are contraindications for Sofosbuvir and it should not be used as an empirical therapy for every Hepatitis-C patient.