The Mystery of Hepatitis C

By Lindsey Townsend

When Mary White*, 42, was told 11 years ago by her doctor that she had elevated liver levels, she shrugged it off as a minor problem that was probably caused from “drinking too much.” Five years ago, when she went to donate blood for her back surgery, she was told that she carried hepatitis C antibodies. She was asked if she had ever had a blood transfusion or done IV drugs. Because the answer was no to both questions and she had no symptoms, she says, “I blew it off.” Two years ago, when she went to the doctor for her annual checkup, she was told she had hepatitis C.

Mary’s experience, unfortunately, is not uncommon. According to the Hepatitis International Foundation, each year, about 28,000 Americans contract hepatitis C, an RNA virus which is a common cause of inflammation of the liver. Although the disease affects almost four million Americans in the U.S., many people are unfamiliar with it. Originally called non-A non-B hepatitis, the virus was discovered in the mid-1970’s, but it wasn’t until 1989 that a test for identifying its specific antibodies became available.

The World Health Organization estimates that there are approximately 100 million chronic HCV persons worldwide who are at risk for progressive liver disease. About 70% to 80% of all carriers will develop chronic liver disease, regardless of whether or not they have symptoms.

Although the virus is found in blood, it is not yet clear whether semen or saliva can actually transmit HCV. It may be transmitted by using razors, needles, toothbrushes, nail files, tattooing, body piercing, or acupuncture needles used by an infected person. All people with HCV are potentially infectious.

With so many people chronically infected with the HCV, Hepatitis C is probably the single most important cause of chronic liver disease, cirrhosis, and liver cancer in the Western world. It is currently the major indication for liver transplantation in the U.S.

Mary White was lucky. After beginning treatment, she is currently free of symptoms and shows no early signs of cirrhosis or cancer. She says, “I have side effects from the interferon, but mostly just headaches and muscle aches the day after the injection…my doctor tells me that we won’t know for sure if I am a responder until after 12 months, but my blood tests look pretty good.”

Symptoms of HCV

One of the most insidious things about hepatitis C is that many people who are infected with the virus have mild or no symptoms. The most frequent complaint is fatigue. Other symptoms can include nausea, poor appetite, fever, headaches, muscle aches, and weight loss. There may or may not be jaundice (yellowing of the skin and eyes).

The incubation period varies but averages about seven to eight weeks. An infected person’s liver test may range from being elevated to being normal for various lengths of time. Even if an infected person has a normal liver test, he or she may carry the virus and can transmit the disease to others. After being infected, there are three possible scenarios that may occur: you may go on to clear the virus from your body; you may become a healthy carrier; or you may experience chronic hepatitis, which can cause long-term liver damage.

Diagnosing HCV

Often an asymptomatic patient will learn of his or her hepatitis infection through a routine physical examination or while donating blood. It is frequently detected only by elevated liver enzyme tests. Diagnosis of the hepatitis C virus can be determined with a simple and specific blood test that detects antibody against HCV. It’s important to realize, however, that this test is not part of a routine physical, and you must specifically request it from your physician in order to receive it.

If the initial test if positive, a second test will be performed to confirm the diagnosis and measure the level of liver enzymes. Unfortunately, few people are able to completely clear the virus from their blood. Over 80% of the cases reported each year become chronic, where liver enzyme levels remain elevated for at least six months after the initial acute infection.

Living With HCV

Currently, there is only one specific treatment for chronic Hepatitis C: Interferon. Interferon is a genetically engineered form of a naturally-occurring protein that is usually administered by injection. Because it frequently causes side effects such as headache, fever, fatigue, and depression, HCV patients must be assessed carefully and monitored frequently during treatment.

Although there is presently no proven alternative to Interferon as the primary treatment of chronic HCV, some patients have experienced success by practicing a holistic lifestyle and utilizing supplemental therapies that strengthen the immune system. According to Prescription for Natural Healing by Dr. James Balch (Avery Publishing Group, 1997), all B vitamins are essential for normal liver function. Dr. Balch recommends taking 50-100 mg of vitamin B complex three times daily with meals. The book also recommends a number of herbs that may be beneficial, including milk thistle, burdock, dandelion, and black radish.

If you have HCV, it’s important to learn how to pace yourself and rest when you feel tired. Try to maintain a positive attitude, get moderate exercise, and eat a well-balanced diet. Avoid all fats, sugar, and highly processed foods, and eliminate alcohol from your diet.

To reduce your risk of contracting HCV, be sure to clean up blood spills with household bleach. Use care when handling anything that may have the blood of an infected person on it such as razors, scissors, nail files, etc. Although it is believed that HCV is transmitted only occasionally through sexual contact, always practice safe sex using a latex condom.

* Mary White is not her real name.

Are You At Risk?

People who are most at risk of acquiring hepatitis C include anyone who has had a blood transfusion before 1990, IV drug users, hermodialysis patients, those with tattoos, people who have unprotected anal sex, and those with multiple sex partners. Body-piercing and cocaine snorting also are risk factors. However, an estimated 10% of partners have no identifiable history of exposure to the virus. If you have concerns about hepatitis C, discuss with your doctor whether or not you should have the diagnostic test.

For referrals to specialists in your area, contact the Hepatitis Foundation International at (800) 891-0707.