When it comes to hepatitis C, what you don’t know can hurt you. That’s because most people who have the liver infection don’t have symptoms, so may not even know they have it. UR Medicine Gastroenterology and Hepatology clinical pharmacy specialist Lisa Cristofaro explains what it is, why detecting it matters, and who’s at risk.
A lack of symptoms doesn’t mean hepatitis C can be ignored. Doing so may have serious consequences, as it may cause long-term health problems, and even death. And with reported cases on the rise—nearly tripling between 2010 and 2015—screening for people who are at risk has grown increasingly important.
Hepatitis C, one of several forms of hepatitis, is a liver infection caused by the hepatitis C virus. It is spread by blood-to-blood contact, so commonly transmitted by shared, unclean needles used to inject drugs, for tattoos or acupuncture, or by needle-stick injury in the health care setting. Before universal screening of the blood supply began in 1992, people may have been exposed to it through a blood transfusion or organ transplant. Although less common, it is possible for hepatitis C to be passed through sexual contact or from a pregnant mother to her baby.
Most people with hepatitis C do not have symptoms but, after many years of infection, may develop liver damage that could cause fatigue, weakness, weight loss, yellowing of the skin or eyes, gastrointestinal bleeding, abdominal swelling, or confusion. Unfortunately, the discovery of liver damage is how many people learn they have hepatitis C.
Untreated hepatitis C progresses differently from person to person. Over time, the infection can lead to liver complications such as cirrhosis (scarring of the liver), liver failure, or liver cancer. It can also affect other organs and increase the risk of conditions such as type 2 diabetes, depression, and certain skin problems. Complications of hepatitis C infection may trigger the need for a liver transplant or even cause death.
Advances in Treatment
The good news is that recent drug developments have revolutionized treatment for hepatitis C. Previous regimens required cumbersome injections and were mildly effective, curing only half of those infected. Now, after a course of pills taken over eight to 12 weeks, with few side effects, up to 95 percent are cured.
With an effective cure available, it makes sense to proactively screen at-risk people to detect disease and avoid long-term complications. Screening is done with a simple blood test.
Should You Be Tested?
Since the highest risk appears to be in baby boomers, the Centers for Disease Control recommends hepatitis C screening for everyone born between 1945 and 1965, even if they don’t think they’ve ever been exposed. In fact, New York State law reinforces that, requiring that the test must be offered to all in that age group who get health care from a hospital, outpatient center or primary care provider.
In addition to baby boomers, others at high risk include those who:
- Use illegal drugs, both injectable or taken through the nose
- Have tattoos or acupuncture in an unregulated setting
- Had a blood or organ transplant before July 1992 or received clotting factor concentrates produced before 1987
- Received blood from a donor or are born to a mother who is HCV-positive
- Have been on long-term hemodialysis
- Have unexplained chronic liver disease or persistently abnormal liver blood tests
- Have HIV infection
- Are a health care or public safety worker exposed to HCV-positive blood through needle-sticks, sharps or mucosal contact
- Have sex with someone who has hepatitis C
- Have ever been in jail
When it comes to hepatitis c and your risk, the best advice is to discuss it with your doctor. He or she can help you decide if screening is right for you.
Lisa Cristofaro is a Clinical Pharmacy Specialist at UR Medicine’s Specialty Pharmacy. She works with patients with hepatitis C and other liver conditions.