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Hepatitis and Your Liver Health
Weighing about three pounds, the liver functions as a unique organ with many crucial roles to sustain life. From circulation to digestion, the liver continuously processes the blood used by the rest of the body. The liver performs over 500 functions to keep us healthy including converting food into substances needed for life and growth, storing glycogen (a blood-sugar regulator), amino acids, protein, and fat. It also makes the enzymes and bile that help digest food and neutralizes harmful toxins and waste.
Hepatitis means inflammation of the liver. Hepatitis is also the name of the family of viral infections that affect the liver. The most common types are Hepatitis A, Hepatitis B, and Hepatitis C.
Hepatitis C Virus (HCV)
Hepatitis C attacks the liver but can remain without symptoms for decades. HCV is not vaccine preventable and is the most common blood borne infection in the United States (U.S.). According to the Centers for Disease Control and Prevention (CDC) an estimated 3-4 million persons in the U.S. have chronic Hepatitis C virus infection. Most people do not know they are infected because they don’t look or feel sick. Of those, it is estimated that 2.7 million are currently living with chronic HCV infection. HCV related Chronic Liver Disease (CLD) is the leading indication for liver transplant among adults in the United States.
HCV is most often spread by direct blood-to blood contact. HCV is usually spread when blood from a person infected with the Hepatitis C virus enters the body of someone who is not infected. The HCV can live in dried blood and on environmental surfaces for days. The virus can be spread easily to others through blood, even in amounts too small to see.
What are the risk factors for Hepatitis C?
Common risk factors include:
Injecting Drug Use (IDU):
The sharing of needles, syringes and other IDU equipment is the most common mode of HCV transmission in the US. It can also be spread by other drug use equipment (i.e, items used for snorting/straws, cottons, cookers, etc).
HCV was commonly spread through blood transfusions and organ transplants before 1992 when widespread screening of the blood supply began. HCV was also spread through blood products (for clotting problems) made before 1987. HCV can be transmitted through needlestick injuries as well.
Transmission of HCV from infected mothers to infants occurs about 6% of the time. The CDC states that transmission risk is not related to the following:
- Delivery method, unless there is prolonged exposure to ruptured membranes and blood
- Breast feeding, unless nipples are cracked and bleeding
Tattooing and Piercings:
Transmission of HCV is possible when poor infection-control practices are used during tattooing or piercing, or if the tattoo or piercing instruments are not sterilized correctly. HCV can also live in tattoo inks so they should never be re-used. Body art is becoming increasingly popular in the United States, and unregulated tattooing and piercing are known to occur in prisons and other informal or unregulated settings.
The CDC states that sexual contact is an “inefficient means” of HCV transmission, however sexual transmission is possible and the numbers of HCV infections traced to sexual transmission is growing. The likelihood of HCV transmission through sexual contact is related to the following:
- The number of lifetime sex partners
- A history of sexually transmitted diseases (STDs), especially the presence of an STD at the time of exposure to HCV
- Sex involving tissue trauma leading to exposure to blood
Other Risks can include:
- Sharing personal care items that may have come in contact with another person’s blood, such as razors, toothbrushes or nail clippers
- Inoculation practices involving multiple use needles or immunization air guns
- Exposure of broken skin to HCV infected blood
- HIV infected persons
People with current or past risk behaviors should consider HCV testing and consult with a physician. HCV testing is currently not available at most public health clinics in Missouri. For information about HCV testing that is available, call the HCV Program Coordinator at 573-751-6439.
Approximately 70%-80% of people with acute Hepatitis C do not have any symptoms. Some people, however, can have mild to severe symptoms that occur from 2 weeks to 6 months after being infected, including:
- Jaundice (yellowing of the skin and/or eyes)
- Abdominal pain
- Loss of appetite
- Unexplained weight loss
- Nausea and vomiting
- Low-grade fever
- Pale or clay colored stools
- Dark urine
- Skin rash
What are long term effects of Hepatitis C?
Hepatitis C virus infection can last a lifetime and lead to serious liver problems, including cirrhosis (scarring of the liver) or liver cancer. Of every 100 people infected with the Hepatitis C virus about
- 75-85 people will develop chronic Hepatitis C virus infection; of those,
- 60-70 people will go on to develop chronic liver disease
- 5-20 people will go on to develop cirrhosis over a period of 20-30 years
- 1-5 people will die from cirrhosis or liver cancer
Current Treatment Recommendations:
For the latest treatment guidelines, see CDC’s website at:
Persons who receive and early diagnosis of HCV infection and receive care are more likely to have a sustained virological response (SVR - meaning that the virus is not detected in blood for 6 months after treatment) to drug therapy. Since the liver has incredible regenerative ability, achieving SVR as quickly as possible is important because some liver damage can be reversed if the cause of the damage is removed.
CDC’s recommendations for prevention and control of the hepatitis C virus infection state that people should not be excluded from work, school, play, childcare or other settings because they have Hepatitis C. There is no evidence that people can get Hepatitis C from food handlers, teachers, or other service providers without blood-to-blood contact.
Missourians can greatly reduce the risk of contracting HCV by practicing the following:
- Never share needles, syringes and other IDU equipment for any reason
- Avoid sharing personal items (razors, nail clippers, toothbrushes)
- Sexual abstinence, mutual monogamy with a sex partner who is not infected with HCV, and use of condoms and other barriers during sexual contact
- Testing of pregnant women for HCV infection prior to delivery
- Practice universal precautions in healthcare settings
- Use safe tattooing and piercing practices