Hepatitis C

Hepatitis C, a small RNA virus that causes infection and damage to the liver, had its moment of public recognition when the well-endowed silverscreen celebrity Pamela Anderson of Baywatch fame got diagnosed with it. The way she contracted it was equally sensational: she had shared the needle for a skin tattoo with her boyfriend, Tommy Lee, who carried the infection. The gossipy tale went further to her litigating against him for concealed the information, but as often happens there, they finally united by wedlock!

Hepatitis C infection is indeed more common than most of us probably know. Of all us who consider ourselves perfectly healthy and volunteer to donate blood, 1% harbour the infection. In other words, approximately 10 million people in India have the infection and do not know it.

Hepatitis C virus is a stealthy one that hardly ever produces jaundice, the commonly known symptom of liver disease. It lodges in the liver and nibbles away at its cells over years. During this phase of 10-20 years, the host has hardly any symptom and hence does not seek medical attention. When considerable liver damage has resulted in liver cirrhosis (20%develop it), symptoms begin to appear: lethargy, fatigue, swelling of the feet, abdominal distention or vomiting of blood, drawing attention to this underlying cause. It also increases the risk of developing liver cancer.

There are 2 common scenarios: one is of a person in forties, who, while undergoing blood tests for a visa application or executive checkup finds his liver tests (SGPT) to be abnormal, and further tests reveal the cause to be Hepatitis C; or tests positive during screening for blood donation. Almost invariably, when asked, they recall having had a blood transfusion, surgery or injections with non-disposable needles. These are the lucky ones as their liver disease is usually not advanced, and stand a good chance of cure with anti-viral treatment.

The other scenario is of a person, who presents with symptoms of Liver Cirrhosis, having had a blood transfusion from a commercial blood bank 20 or more years ago. They do not tolerate treatment well, their disease progresses relentlessly and find themselves in need of a liver transplanation.

Hepatitis C is the cause of liver cirrhosis in 20 -30%, alcohol and Hepatitis B being the other common ones. Any person who has underone a blood transfusion or surgery should get himself tested for this infection, as should anyone whose liver function test shows derangement. If diagnosed before much liver damge has occured, the infection is curable. Antiviral treatment consists of weekly injections of Interferon and daily tablets of ribavirin for periods of 6 to 12 months. The viral strain common in India (genotype 3) fortunately responds well to treatment, as more than 250 happy patients treated at SGPGI will tell you.

There is unfortunately no vaccine yet for preventing Hepatitis C, unlike Hepatitis B. Hence prevention and early detection assume greater importance. If you have ever received a blood transfusion or undergone a surgery, make sure you have taken the test for Hepatitis C, and have come out negative.

Published in HT City of Hindustan Times Lucknow edition dated 14 February, 2010.