“Hepatitis” means inflammation of the liver. Toxins, certain drugs, some diseases, heavy alcohol use, and bacterial and viral infections can all cause hepatitis. Hepatitis is also the name of a family of viral infections that affect the liver; the most common types are Hepatitis A, Hepatitis B, and Hepatitis C
Difference Among Hepatitis A, B, and C?
Hepatitis A, Hepatitis B, and Hepatitis C are diseases caused by three different viruses. Although each can cause similar symptoms, they have different modes of transmission and can affect the liver differently. Hepatitis A appears only as an acute or newly occurring infection and does not become chronic. People with Hepatitis A usually improve without treatment. Hepatitis B and Hepatitis C can also begin as acute infections, but in some people, the virus remains in the body, resulting in chronic disease and long-term liver problems. There are vaccines to prevent Hepatitis A and B; however, there is not one for Hepatitis C. If a person has had one type of viral hepatitis in the past, it is still possible to get the other types.
The hepatitis C virus infects the cells in your liver, causing inflammation (swelling and tenderness) and fibrosis. In people with chronic (long-term) hepatitis C infection, inflammation and fibrosis continue to spread. Over time, usually many years, this can lead to cirrhosis.
Symptoms of Hepatitis C
Hepatitis C affects people very differently – many people with it may have no symptoms at all and may never know they have the virus. There is often little or no relation between the seriousness of the symptoms and the damage to the liver. Symptoms are often hard to pin down and are frequently blamed on other problems. They can include:
Mild to serious tiredness (fatigue)
Loss of appetite
Inability to tolerate alcohol
Discomfort in the liver area (place your right hand over your lower right ribs and it will just about cover the area of your liver)
Problems concentrating (‘brain fog’)
Flu-like symptoms such as fever, chills, night sweats and headaches
Yellow skin or eyes, called jaundice (this is very rare and is a sign of advanced disease or acute infection).
Some of the symptoms may come and go. It is not unusual for people with hepatitis C to be diagnosed as having ME or chronic fatigue syndrome. Unfortunately, the liver does not start to complain until it is seriously damaged – often only then do people realise that there is anything wrong.
Causes hepatitis C infection
Hepatitis C is caused by the hepatitis C virus. It is spread by contact with an infected person’s blood.
You can get hepatitis C if:
- You share needles and other equipment used to inject illegal drugs. This is the most common way to get hepatitis C in the United States.
You had a blood transfusion or organ transplant before 1992. As of 1992 in the United States, all donated blood and organs are screened for hepatitis C.
- You get a shot with a needle that has infected blood on it. This happens in some developing countries where they use needles more than once when giving shots.
- You get a tattoo or a piercing with a needle that has infected blood on it. This can happen if equipment isn’t cleaned properly after it is used.
Treating hepatitis C
- Hepatitis C can often be treated successfully by taking medicines for several weeks.
- If the infection is diagnosed in the early stages, known as acute hepatitis, treatment may not need to begin straight away.
- Instead, you may have another blood test after a few months to see if your body fights off the virus.
- If the infection continues for several months, known as chronic hepatitis, treatment will usually be recommended.
Your treatment plan
Treatment for hepatitis C involves:
Making lifestyle changes to help prevent further damage to your liver and reduce the risk of spreading the infection
taking one or more medications to fight the virus
You’ll normally need to take medication for 8 to 48 weeks. The length of time will depend on the exact medicines you’re taking and which version (strain) of the hepatitis C virus you have. Your doctor will advise you about this.
There are six main strains of the virus. In the UK, the most common strains are known as genotype 1 and genotype 3.
During treatment, you should have blood tests to check if your medication is working. If the test shows treatment is having little effect, it may be stopped as further treatment may be of little use.
There are some things you can do to help limit any damage to your liver and prevent the infection spreading to others.
These can include:
Eating a healthy and balanced diet
Cutting out alcohol or limiting your intake
Keeping personal items, such as toothbrushes or razors, for your own use
Not sharing any needles or syringes with others
Hepatitis C medications
Until relatively recently, treatment for chronic hepatitis C usually involved taking two main medicines:
Pegylated interferon – a medication that encourages the immune system to attack the virus
Ribavirin – an antiviral medication that stops the virus reproducing
These medications were frequently just taken together, but now there are new hepatitis C medications that have been shown to make treatment more effective.
In many cases, a combination of these newer medications may be taken without needing to take pegylated interferon and ribavirin as well.
Read more about all these medications below.
Pegylated interferon and ribavirin
Pegylated interferon is usually taken as a weekly injection. You can be trained to inject yourself at home. It usually needs to be taken for up to 48 weeks, depending on your circumstances.
Ribavirin is available as capsules, tablets or an oral solution. It’s normally taken twice a day with food. It needs to be taken alongside pegylated interferon for up to 48 weeks.
For more information, see the National Institute for Health and Care Excellence (NICE) guidelines on peginterferon alfa and ribavirin for the treatment of chronic hepatitis C.
There are also a number of newer medicines that are used to treat hepatitis C nowadays.
Some of these are taken alongside pegylated interferon and ribavirin, but in most cases they can be taken on their own or in combination with other new medicines.
These medications include:
4. A combination of ledipasvir and sofosbuvir
5. A combination of ombitasvir, paritaprevir and ritonavir, taken with or without dasabuvir
6. A combination of sofosbuvir and velpatasvir
- These medications are taken as tablets once or twice a day for between 8 and 48 weeks, depending on the exact medicine you’re taking, your hepatitis C genotype, and the severity of your condition.
These medicines are generally used to treat people with either genotype 1 or genotype 4 hepatitis C, although sometimes they’re also used to treat people with other genotypes.
Treatment during pregnancy
- The medications used to treat hepatitis C, particularly ribavirin, can be harmful to unborn babies and aren’t normally used during pregnancy.
- If you’re pregnant when diagnosed with the infection, treatment will usually be delayed until you have given birth.
- Otherwise, you’ll be advised to use contraception throughout your treatment and may need to have regular pregnancy tests.
- If you’re a man taking ribavirin, you shouldn’t have sex with a pregnant women unless you use a condom.
- If your partner isn’t pregnant, you should ensure contraception is used during the course of your treatment. Your partner may need to have regular pregnancy tests
Center For Disease Control