Hepatitis is the diagnosis of an inflammation of the liver. There are a number of different sources, including viral infections, certain medications and irritation from alcohol and chemical exposures. Hepatitis C is an increasingly common infection showing up in ageing adults, and may exist without any symptoms or complaints for years or decades after the initial infection. Sources of this infection include any current or remote history of drug injection with shared needles or syringes, or receiving an organ transplant, blood products or transfusions prior to the early 1990’s. However once this virus had been identified around that era, screenings have been in place to minimize the possibility of transmission of this infection. There continues to be a risk of infection to health care workers who may experience an accidental needle stick from an infected patient or those using injectable drugs. There is up to ninety percent likelihood that a person infected with HIV using IV drugs will develop Hepatitis C as well.
There are other common hepatitis infections, including Hepatitis A and Hepatitis B. Hepatitis A usually will resolve without medical treatment after an acute infection. Hepatitis B may persist chronically within an infected person, but since the development of both Hepatitis A and B immunizations, the incidence continues to decrease over time for both infections in the past twenty years. Unfortunately there is not yet an immunization for Hepatitis C.
The CDC estimates that 3.2 million people in the US have chronic Hepatitis C. Up to twenty five percent of people who became infected will have the virus clear their system without treatment. But many of those with infection will develop chronic liver disease resulting in liver damage, failure, cancer and even death. For those diagnosed with chronic Hepatitis C, there are several treatments now available that are more effective with fewer side effects than some of the older medications.
There are several blood tests for Hepatitis C. Some are ordered individually, others may be a part of a panel or screen. Hepatitis C is also a concern for causing elevated liver function that has no confirmed explanation. The initial test is usually for the presence of Hepatitis C antibodies in the individual. The presence of antibodies indicates a prior exposure to the infection but does not confirm active or present infection. A positive screen is usually followed by a second test looking for the presence of the virus in the system. This ‘viral load’ is also used as a marker to determine the success of treatment.
The incidence of Hepatitis C is increasing in the US population over the past decade. As the “baby boomers” are getting older, be aware of this concern with changes in liver function tests. If you have a potential exposure to this infection, talk to your family physician if you may be at risk of Hepatitis C.
Bradford Croft, DO
East Flagstaff Family Medicine