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Hepatitis C

Hepatitis C (HCV) was discovered in 1988. While acute infection rarely causes symptoms, 80% of all HCV infection results in chronic disease that lasts for more than 6 months. Remission can occur in up to 15% of people infected with HCV. It is a slow-developing disease that can lead to liver damage and liver cancer 30 years after infection. Four percent of infected people die from HCV disease.

Causes and Risk Factors
Risk factors for HCV are the same for HBV. HCV is most commonly contracted from injection drug use, blood transfusion (before 1995), and probably through sexual contact. Contraction of HCV from a shared, blood-contaminated cocaine straw has been reported. Hemodialysis patients and health care workers are also at risk.

Signs and Symptoms
Signs and symptoms are the same as for other types of hepatitis. Chronic infection may persist without producing symptoms.

Testing the blood for the HAC antibody and elevated transaminase enzymes is the first step in diagnosis. Because the disease commonly causes severe liver damage, a biopsy is often performed if the antibody is found. A biopsy involves inserting a needle into the liver to obtain a tissue sample. The tissue is examined for structural deterioration, inflammatory cells, and any other changes in cell size or shape.

Treatment of HCV involves interferon and ribavirin, also an antiviral drug. Ribavirin is given orally and may cause side effects like depression and anemia (below-normal number of red blood cells). It is also associated with birth defects and should be avoided during pregnancy and during the 6 months prior to conception. Interferon is given as an injection, usually three times a week. Newer formulations are given only once weekly. Treatment is needed for 6 to 12 months and a significant number of patients are cured.

HCV-related liver damage may result in liver failure and the need for transplant. Nearly one-half of all liver transplants in the United States are performed for HCV illness.

There is no vaccine for HCV. The same preventive guidelines apply for HCV as apply to other types of hepatitis.

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