What is hepatitis C? Causes and proper care.

• Hepatitis C virus is a bloodborne and sexually transmitted infection similar to hepatitis B virus. It often leads to cirrhosis or liver cancer in the long term. There are six main genotypes, with genotypes 1 and 3 being the most common in Thailand.
• Hepatitis C can be transmitted through contaminated needles, tattooing, body piercing with unclean equipment, blood transfusions or organ transplants received before 1992, multiple sexual partners, mother-to-child transmission, and sharing personal items.
• Prevention of hepatitis C can be achieved by avoiding sharing needles, sharp objects, tattooing equipment, and piercing equipment. Gloves should always be worn when handling blood, and condoms should be used during sexual intercourse.

Hepatitis C is a viral infection that causes chronic liver inflammation without the infected person knowing, because they often show no symptoms in the early stages. It can be transmitted through blood, such as sharing needles, from tattooing or piercing that isn't hygienic, and also through sexual contact. If left untreated, the virus can damage the liver, leading to cirrhosis or liver cancer. Those at risk should get tested for the virus to ensure timely treatment before the infection progresses.

This article will help you learn more about hepatitis C, from its causes and symptoms to prevention, so you can live a healthy liver and live with confidence.

What is Hepatitis C?

Hepatitis C (HCV) is a blood-borne and sexually transmitted infection similar to hepatitis B, often leading to cirrhosis or liver cancer in the long term. This disease is not transmitted through sharing food, breastfeeding, or coughing/sneezing. Although it often presents with no symptoms in its early stages, it is now curable with oral antiviral medications.

How many types of Hepatitis C virus are there?

Hepatitis C virus is classified according to its genotype, which is important for selecting treatment approaches and evaluating treatment outcomes. Currently, according to the World Health Organization (WHO) classification, there are six main genotypes (Genotypes 1–6), and each genotype has several subtypes such as a, b, etc.

• Genotype 1 is the most common genotype in Thailand and is further divided into two subtypes: 1a and 1b.
• Genotype 2 is less common than genotype 1, often responds well to treatment, and requires shorter treatment durations in many cases.
• Genotype 3 is another relatively common genotype in Thailand. It is associated with a higher risk of fatty liver disease and liver fibrosis compared to other genotypes, and therefore requires close monitoring.
• Genotype 4 is more common in the Middle East and North Africa. It is uncommon in Thailand, and current treatment outcomes are comparable to other genotypes.
• Genotype 5 is relatively rare, found mainly in certain areas of Africa.
• Genotype 6 is common in Southeast Asia, including parts of Thailand. It has numerous subtypes and responds well to newer antiretroviral drugs.

How many stages are there in Hepatitis C virus infection?

• Acute stage: The first 6 months after infection. Often asymptomatic, but some people may experience fever, joint pain, or jaundice (yellowing of the skin and eyes).
• Chronic stage: If the body cannot eliminate the virus within 6 months, it enters the chronic stage where the virus silently damages the liver, leading to cirrhosis and eventually liver cancer.

What causes Hepatitis C?

How is Hepatitis C transmitted?

• Sharing needles contaminated with infected individuals' blood.
• Tattooing/body piercing with unclean or reused equipment.
• Blood transfusions or organ transplants received before 1992.
• Sexual intercourse with multiple partners.
• Mother-to-child transmission during pregnancy or childbirth.
• Personal items such as razors, nail clippers, and toothbrushes.

Who is at risk of contracting Hepatitis C?

• Individuals who have received blood or blood products before 1992, as hepatitis C screening of donated blood was not yet available.
• Individuals with a history of intravenous drug use or who have shared equipment, even if only once.
• Individuals with positive liver function test results.
• Individuals with more than one sexual partner, or those who have had sexual relations with someone infected with Hepatitis C.
• Individuals who received tattoos, piercings, or acupuncture in substandard or unsanitary establishments.
• Using personal items contaminated with the blood of an infected person.
• Medical personnel who have been accidentally pricked by a needle from someone with chronic Hepatitis C infection.
• People infected with HIV/AIDS
• Infants born to mothers infected with hepatitis C virus

Hepatitis C Symptoms:

Hepatitis C often shows no symptoms in its early stages, leading some individuals to remain unaware of their infection for a long time. However, some individuals may experience symptoms (rare):

• Extreme fatigue
• Loss of appetite
• Nausea
• Muscle pain
• Weight loss
• Ascites (found when liver damage worsens/chronic stage)
• Jaundice (yellowing of the skin and eyes) (rare)
• Abdominal pain, particularly in the right rib cage
• Dark urine (may occur)

Conditions Caused by Hepatitis C Virus:

• Acute hepatitis: The initial stage, often asymptomatic or with flu-like symptoms, fatigue, and jaundice.
• Chronic hepatitis: Found in 75-85% of infected individuals, where the virus remains dormant, continuously damaging the liver for more than 6 months.
• Cirrhosis: When chronic hepatitis occurs, fibrosis leads to cirrhosis, resulting in liver failure, ascites, and easy bleeding.
• Liver cancer: The most serious complication, often developing after more than 20 years of chronic infection.

Hepatitis C Diagnosis:

• Blood test for the virus
• Anti-HCV antibody test
• HCV RNA (PCR) test
• Severity assessment
• Liver ultrasound
• Fibroscan
• Liver biopsy

Treatment options for Hepatitis C:

• Antiviral medications
• Combination drugs
• Oral and injectable medications such as Pegylated Interferon and Ribavirin, but these have side effects and should be used under a doctor's guidance.

How to Take Care of Yourself When Infected with Hepatitis C:

• Get vaccinated against Hepatitis A and B.
• Get enough rest.
• Avoid alcohol.
• Avoid medications that are harmful to the liver.
• Eat a balanced diet.
• Exercise regularly.
• Refrain from donating blood, organs, and sperm.
• Avoid sharing sharp objects with others.

Ways to Prevent Hepatitis C:

• Do not share needles.
• Do not share sharp objects.
• Always wear gloves when handling blood.
• Always wear gloves when handling blood.
• Do not share tattooing or piercing equipment.
• Use condoms every time you have sexual intercourse.

Hepatitis C Screening at Vibhavadi Hospital:

If you suspect or want to be screened for Hepatitis C, early detection allows for timely treatment. We recommend screening at the Gastroenterology Center, Vibhavadi Hospital, where expert physicians are ready to provide care. Screening includes Anti-HCV antibody testing, HCV RNA (PCR) testing, severity assessment, and precise treatment for improved kidney health.

Summary

Hepatitis C virus (HCV) is a silent threat transmitted through blood and sexual contact. There are six main serotypes, with serotypes 1 and 3 being the most common in Thailand. The virus damages the liver, progressing from acute to chronic stages, eventually leading to cirrhosis and liver cancer. Key at-risk groups include those who received blood transfusions before 1992 and those who share needles. Infection often presents without symptoms but can be detected through blood tests (Anti-HCV/PCR) and fibroscan assessment.

Currently, treatment involves oral antiviral medications (DAAs) combined with abstaining from alcohol and avoiding sharing sharp objects to prevent transmission. If you observe symptoms or have a history of risk factors for hepatitis C infection, screening is available at Vibhavadi Hospital. We are equipped with modern technology for accurate diagnosis and treatment, promoting better health.