Hepatitis C infection (HCV) is caused by a virus. The infection is spreading fast in India and over one lakh people get infected by the deadly HCV virus every year, according to an Indian National Association for the Study of Liver (INASL) study.
Nearly 1.25 crore Indians suffer from HCV related liver disease affecting the liver. Every 15th carrier of the Hepatitis C virus in the world is an Indian.
Who is at risk?
The Hepatitis C virus (HCV) is spread through blood-to-blood contact. The impact of this infection is just emerging in India. The commonest cause of spread of this infection in India is due to improperly sterilised equipment and through blood transfusions.
India’s blood-banking system has serious shortcomings. Professional blood donation continues to flourish despite a law condoning this.
Studies have shown that almost 20 percent of patients who had blood transfusions prior to regular testing have HCV infection. Injectable drug use is another serious risk factor - almost 90 percent of I.V. drug users, according to an Indian study were infected. Patients on dialysis are also at risk from improperly sterilised equipment. In a study from Hyderabad of renal failure patients on haemodialysis, HCV infection was present in 46 percent cases. Healthcare workers are also at a higher risk for acquiring hepatitis C infection as they come in contact with potentially infected patients.
Hepatitis is not easily spread through sexual intercourse. However, high-risk behaviour, such as multiple sexual partners, is associated with an increased risk of HCV. In the first 6 months after being infected with HCV - the acute hepatitis C - a minority of patients show symptoms like other forms of hepatitis infection including loss of appetite, fatigue, abdominal pain, jaundice. Of these patients, 70-80 percent develop long-term (chronic) infection. In the long term, Hepatitis C is responsible for as many as one in four cases of liver cancer and 20 percent of chronic liver disease is because of Hepatitis C. Around 5-15 percent of patients with Chronic HCV infection may eventually need a liver transplant.
How is HCV diagnosed?
Hepatitis C virus is usually detected through a blood test. Most patients have elevated liver enzyme levels. Testing is done for antibodies to HCV as well as for virus itself.
What other information should patients with Hepatitis C be aware of?
HCV is not spread by sneezing, hugging, coughing, food or water, sharing eating utensils or drinking glasses, or casual contact.
* Persons should not be excluded from work, school, play, child-care or other settings on the basis of their HCV infection status.
* Involvement with a support group may help patients cope with hepatitis C.
* A referral to or consultation with a specialist for further evaluation and possible treatment may be considered if a person is anti-HCV positive and has elevated liver enzyme levels.
What is the treatment for chronic hepatitis C?
Antiviral drugs such as interferon used alone or in combination with ribavirin, are approved for the treatment of persons with chronic hepatitis C. Interferon combined with ribavirin works in about 30-40 percent patients. Newer drugs (such as boceprevir and telaprevir) may lead to response in 70-80 percent of infected patients. Identification of patients with a specific genetic subtype (IL28 polymorphism) may help in identifying patients likely to respond to treatment.
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