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Hepatitis C is a viral infection caused by the hepatitis C virus (HCV) that primarily affects the liver. It can lead to both acute and chronic liver disease, including cirrhosis, liver failure, and liver cancer if left untreated. Here’s a comprehensive guide to understanding, diagnosing, and treating hepatitis C:

Transmission

Hepatitis C is spread through contact with infected blood. Common modes of transmission include:

• Sharing needles: Among people who inject drugs.
• Unsterilized medical equipment: Such as needles or syringes.
• Blood transfusions: In countries where blood is not screened for HCV (rare in developed countries).
• Mother to child: During childbirth (less common).
• Unprotected sex: Rare, but possible, especially with multiple partners or in the presence of other sexually transmitted infections (STIs).
• Tattoos or piercings: If done with unsterilized equipment.

Hepatitis C is not spread through casual contact, such as hugging, kissing, or sharing food.

Symptoms

Many people with hepatitis C do not experience symptoms, especially in the early stages. When symptoms occur, they may include:

• Fatigue
• Fever
• Loss of appetite
• Nausea and vomiting
• Abdominal pain (especially in the liver area)
• Dark urine
• Jaundice (yellowing of the skin and eyes)
• Joint pain

Acute vs. Chronic Hepatitis C

Acute Hepatitis C:

• Short-term infection that occurs within the first 6 months after exposure. Many people clear the virus spontaneously without treatment. Symptoms, if present, are usually mild.

Chronic Hepatitis C:

• Long-term infection that occurs when the virus remains in the body for more than 6 months. Can lead to serious complications, such as cirrhosis, liver failure, or hepatocellular carcinoma (liver cancer).

Diagnosis

Hepatitis C is diagnosed through blood tests:

• HCV Antibody Test: Detects antibodies to the hepatitis C virus, indicating exposure. A positive result requires further testing to confirm active infection.
• HCV RNA Test: Measures the amount of virus in the blood (viral load). Confirms active infection.
• Genotype Testing: Identifies the specific strain of HCV, which helps guide treatment.
• Liver Function Tests (LFTs): Assess liver damage by measuring enzymes and proteins.
• FibroScan or Liver Biopsy: Evaluates the extent of liver fibrosis or cirrhosis.

Treatment

Hepatitis C is now curable in most cases with direct-acting antiviral (DAA) medications. These drugs are highly effective, have fewer side effects, and require shorter treatment durations compared to older therapies.

1. Direct-Acting Antivirals (DAAs)

Common DAAs:

• Sofosbuvir.
• Ledipasvir.
• Daclatasvir.
• Glecaprevir/pibrentasvir (Mavyret).
• Elbasvir/grazoprevir (Zepatier).

Treatment Duration: Typically 8 to 12 weeks, depending on the genotype and severity of liver damage.

Cure Rate: Over 95% for most patients.

2. Monitoring During Treatment

• Regular blood tests to monitor viral load and liver function.
• Follow-up testing after treatment to confirm the virus has been cleared.

3. Lifestyle Changes

• Avoid alcohol to reduce liver damage.
• Maintain a healthy diet and exercise regularly.
• Get vaccinated for hepatitis A and B to prevent additional liver infections.

Complications

Untreated chronic hepatitis C can lead to:

• Cirrhosis: Scarring of the liver.
• Liver failure: When the liver can no longer function.
• Hepatocellular carcinoma (HCC): Liver cancer.
• Extrahepatic manifestations: Conditions outside the liver, such as kidney disease, diabetes, or cryoglobulinemia.

Prevention

• Avoid Sharing Needles: Use sterile equipment for injections.
• Practice Safe Sex: Use condoms, especially with multiple partners.
• Ensure Sterilization: For medical, tattooing, or piercing equipment.
• Screen Blood Products: To prevent transmission through transfusions.
• Get Tested: Early detection can prevent complications.

Who Should Get Tested?

Testing is recommended for:

• People who have ever injected drugs.
• Recipients of blood transfusions or organ transplants before 1992.
• Individuals with HIV.
• Healthcare workers exposed to blood.
• Babies born to mothers with hepatitis C.
• Anyone with unexplained liver disease or abnormal liver tests.

Living with Hepatitis C

• Follow your treatment plan and take medications as prescribed.
• Avoid alcohol and substances that can harm the liver.
• Maintain regular follow-ups with your healthcare provider.

Hepatitis C is a serious but treatable condition. With advances in antiviral therapy, most people can achieve a cure and prevent long-term complications. If you suspect you have been exposed to hepatitis C or are at risk, consult a healthcare provider for testing and treatment options. Early intervention is key to improving outcomes.