Hepatitis C

What is Hepatitis C?

Hepatitis C refers to the inflammation of the liver caused by the hepatitis C virus (HCV). The primary mode of transmission is through blood. The disease develops as an acute infection and progresses to chronic in 80% of the affected. The acute infection lasts for a maximum of 6 months and recovery is possible without any treatment while the chronic infection lasts for a longer duration and may lead to cirrhosis and carcinoma (cancer).

Based on the genotype, HCV is classified into 6 types ranging from 1 to 6. Genotype 3 is the most commonly reported in India followed by genotype 1. Identification of genotype is necessary to provide appropriate treatment.

According to WHO, the prevalence of HCV infection in the Indian subcontinent is 0.5 - 1% against 1.6% worldwide and proves as a threat to the population.

What are its main signs and symptoms?

Acute phase

Time usually taken for your symptoms to appear varies from 2 weeks to 6 months. 80% of infected individuals are asymptomatic but may experience:

• Weakness
• Nausea
• Vomiting
• Reduced appetite
• Yellow discolouration of the eyes and the skin
• Abdominal discomfort

Chronic phase

In later stages, there is:

• Fluid accumulation in the abdomen and associated bacterial infection
• Bleeding in stools or in the vomit
• Dark stools
• Difficulty in breathing
• Pain in joints

What are the main causes?

HCV is mainly transmitted by blood through the following ways:

• Sharing of needles and personal products like razors in drug users
• Usage of infected needles and syringes in hospitals
• Inappropriate sterilization of medical equipment
• Blood transfusion with contaminated blood

Other modes of transmission are:

• Sexual route
• Mother to baby

Infection doesn’t spread through contaminated food and water nor by sharing household items.

How is it diagnosed and treated?

If you experience the mentioned symptoms, consult your doctor and he/she may recommend blood tests to determine the level of liver enzymes along with HCV antibody (Anti -HCV) and HCV ribonucleic acid (HCV RNA) tests to detect the virus. This test can detect the virus within just a week.

Liver biopsy is done to identify the extent of liver damage. HCV genotype testing is also carried out prior to initiation of therapy.

Direct acting antivirals are the newest drugs available for the treatment of hepatitis C infection with a treatment duration of 3 months. Due to the unaffordable nature of newer agents in India, conventional therapy is still used widely.

Currently, no vaccination is available for prevention of infection, but the disease can be prevented to a great extent by reducing the exposure to the virus (avoiding needle and syringe sharing, blood transfusion and sexual contact with affected individuals).

Proper adherence to the medication given by your doctor can help overcome the infection and improve your quality of life.

1. World Health Organization [Internet]. Geneva (SUI): World Health Organization; Hepatitis C
2. European Association. Natural history of hepatitis C. November 2014Volume 61, Issue 1, Supplement, Pages S58–S68
3. Prasanta K Bhattacharya, Aakash Roy. Management of Hepatitis C in the Indian Context: An Update. Department of General Medicine, North Eastern Indira Gandhi Regional Institute of Health & Medical Sciences, Shillong, India
4. Sandeep Satsangia, Yogesh K. Chawla. Viral hepatitis: Indian scenario. Med J Armed Forces India. 2016 Jul; 72(3): 204–210. PMID: 27546957
5. Center for Disease Control and Prevention [internet], Atlanta (GA): US Department of Health and Human Services; Hepatitis C Questions and Answers for the Public

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