Hepatitis C

Hepatitis C is a liver disease caused by the hepatitis C virus (HCV). The infection is most commonly spread by contact with the blood of an infected person. The Hepatitis C (HCV) virus was identified in 1989.

Approximately 3% (170 million) of the world's population is infected with HCV. In most countries, the prevalence of infection is 1% - 3%; however, in some regions it is greater than 10%.

Unlike the other types of viral hepatitis, hepatitis C is very difficult for the immune system to overcome. As a result, most Hepatitis C infections (80-90%) become chronic, and liver disease develops in 70% of persons with chronic infection, including cirrhosis (scarring of the liver tissues) and liver failure.

For every one person that is infected with the AIDS virus, there are more than four infected with Hepatitis C. The CDC estimates that there are up to 230,000 new hepatitis C infections in the U.S. every year. Currently, 8,000 to 10,000 deaths each year are a result of HCV.

Symptoms and Diagnosis

Because the symptoms of Hepatitis C infection are usually very mild and can be virtually undetectable, the disease is rarely recognized until it has caused significant damage to the liver. The cycle of disease from infection to significant liver damage can take 20 years or more.

When there are symptoms, the most common one, commencing sometimes years after initial infection, is fatigue. Other symptoms include mild fever, muscle and joint aches, nausea, vomiting, loss of appetite, vague abdominal pain, and sometimes diarrhea. Many cases go undiagnosed because the symptoms are suggestive of a flu-like illness which just comes and goes. Blood tests are available to diagnose HCV infection.

Risk

Travelers' risk for contracting HCV infection depends on their potential risks for exposure to blood. Almost any direct or indirect exposure to infected blood can transmit the virus. This includes I.V. drug use and poorly sterilized medical instruments, blood spills, unbandaged cuts or injuries, and tattooing or body piercing, as well as less obvious sources of blood, such as shared razors or toothbrushes, or body secretions (such as mucous) that may contain small amounts of blood. In about 10% of all cases, no risk factors have been identified. In regions where blood donor screening and hospital and clinical infection control practices are insufficient, the risk of transmission of HCV and other bloodborne infections from transfusions, injections, or other medical procedures is increased.

Prevention and treatment

There is no vaccine for Hepatitis C at present, and because of the virus's frequent mutation, it may be a long time before one becomes available. However, because of Hepatitis C's slowly progressive infection, infected patients have long life expectancies, and with proper treatment, many of them can recover completely.

Current treatment of chronic Hepatitis C infection with interferon alpha leads to sustained viral clearance in only 15% of patients. Newer therapeutic regimes such as the combination of interferon alpha and ribavirin can lead to up to 30% of patients having a sustained virologic response to therapy. However, even with current combination regimes, at least 70% of patients have no therapeutic benefit.

Diseases

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