Hepatitis C

2024/05/20

What is Hepatitis C?

Hepatitis means "inflammation of the liver". Hepatitis C essentially means an infection with the Hepatitis C virus.

Hepatitis C virus size = 0.000 004cm

Symptoms

Most patients with hepatitis C do not have symptoms and/or do not feel different from normal. By the time the symptoms do develop, liver damage is usually severe.

It is important to note that the absence of symptoms does not mean hepatitis C nor liver damage are under control.

Symptoms of acute infection are:

Jaundice
Fever
Tiredness

Symptoms of severe liver damage may include:

Jaundice
A distended, fluid-filled abdomen (ascites)
Edema of the legs
Small, spider-like veins, usually on the chest and back (spider angiomas)
Confusion
Bleeding from the gastrointestinal tract

Is this infection common?

There are an estimated 150 million carriers of the hepatitis C virus around the world, with over 500,000 to 750,000 dying annually from HCV-related liver disease.

In Singapore, the prevalence rate is about 0.2%.

What are the complications of Hepatitis C?

The hepatitis C virus itself does not damage the liver. Liver damage occurs due to the body's immune system trying to fight the hepatitis C virus. Liver damage can be measured by blood tests such as ALT (also known as SGPT).

If liver damage is prolonged, the liver becomes scarred (liver cirrhosis), which can lead to liver failure, liver cancer and early death.

All these complications are potentially life-threatening.

Who is at risk of Hepatitis C infection?

Those who have a past history of blood transfusion, plasma infusions or clotting factor concentrates before 1990
Those with a history of tattoos
Household contacts with individuals with hepatitis C
Intravenous drugs users
Individuals undergoing dialysis
Those with a history of dental work
Healthcare workers

In Singapore, the majority of hepatitis C patients are intravenous drug users.

How do I know if I have been infected with Hepatitis C?

As hepatitis C is usually asymptomatic, the only way to diagnose hepatitis C is by a simple blood test.

A positive Anti-HCV blood test (antibody to hepatitis C) means contact with the hepatitis C virus. In order to confirm active infection, the HCV RNA test (another blood test) will be conducted. A positive Anti-HCV test but a negative HCV RNA test indicates clearance of an infection with Hepatitis C previously.

A negative anti-HCV test would imply that the person does not have Hepatitis C infection.

How do I prevent myself from being infected with Hepatitis C?

There is no vaccine to prevent hepatitis C infection.

The only method to prevent infection is to avoid risk factors for hepatitis C infection such as tattoos and intravenous drug abuse.

What should I do if I have Hepatitis C?

Today, with the availability of potent antiviral medications, all patients should be evaluated for treatment. With early detection and appropriate therapy, most patients can be cured of the disease.

All persons with Hepatitis C should undergo regular medical follow-up, the purpose of which is to check for liver cancer and any active liver inflammation. During follow-up, an ultrasound will help to screen for liver cirrhosis and liver cancer. Early detection of liver cancer gives the best chance for cure. Blood tests should be done routinely, including liver function tests to detect liver inflammation, and alpha fetoprotein for liver cancer.

Patients are advised to avoid alcohol and/or traditional medicines as these substances may cause additional liver damage. Patients should notify their doctors of their hepatitis C and go for routine medical check-ups.