What is HCV?
HCV stands for Hepatitis C Virus, Hepatitis means inflammation of the liver, and it has many different causes. Hepatitis C virus HCV is carried in the blood, and affects the liver by preventing it from working properly, and causing the liver cells to die. Over time, the virus can cause inflammation, scarring (fibrosis) and, sometimes, significant damage to the liver (cirrhosis).
Cirrhosis increases the risk of developing liver cancer, which can be fatal.
HCV is transmitted through blood. The use of unsterilized injecting equipment is the main route of transmission. Where blood is involved, it is transmitted through other means such as:
- Having medical or dental procedures in countries where Hepatitis C is common and infection control is inadequate
- Receiving blood products or a blood transfusion where infection control is inadequate
- Tattooing, piercing or cosmetic injection procedures if any equipment is reused or inadequately sterilized
- Occupational exposure for healthcare workers, for example through a needle injury
- Transmission from mother to baby during birth
- Activities where there is a risk of blood to blood contact
- Sharing items such as razors or toothbrushes.
HCV can be treated and, in most cases, it can be cured.
What are the types of HCV?
There are six basic types of the Hepatitis C virus
These are called genotypes 1, 2, 3, 4, 5 or 6. Some genotypes have further variations called subtypes, for example 1a and 1b. Generally, all genotypes can affect the liver the same way. If you have Hepatitis C and are thinking about treatment, knowing your genotype is important, as different genotypes respond differently to treatments.
What are the stages and symptoms of HCV?
Acute Hepatitis C occurs after infection, and lasts for about six months.
- Most people do not experience symptoms during the acute phase
- Some people may have flu-like symptoms, including fever, tiredness, loss of appetite, stomach pains, nausea and vomiting and, occasionally, jaundice
- Around 20 to 25% of people will clear Hepatitis C during the acute stage
Clearing the virus will not protect you against getting Hepatitis C again.
- The second stage is chronic (long-lasting) infection, where the virus remains in the body
- The 75 to 80% of people who don’t clear the virus in the acute phase will develop chronic hep C
- Symptoms of chronic Hepatitis C include: fatigue and low energy; depression; disrupted sleep; memory loss and difficulty concentrating; sweats and chills; appetite loss and nausea; muscular aches and pains; abdominal pain; dry and itchy skin; blurred vision.
Having Hepatitis C doesn’t automatically mean you’ll experience symptoms or develop serious liver disease.
What are the symptoms of Liver Cirrhosis?
Symptoms of Liver Cirrhosis
Approximately one in five people with chronic Hepatitis C will develop cirrhosis within 20 years. Liver Cirrhosis is a slowly progressing condition in which the healthy liver tissue is replaced with scar tissue, eventually preventing the liver from functioning properly. The scar tissue blocks the flow of blood through the liver and slows the processing of nutrients, hormones, drugs and toxins. There are usually few symptoms in the early stages of cirrhosis. However, as your liver becomes more damaged and loses its ability to function properly, you might experience symptoms including:
- Loss of energy, and feeling tired; feeling depressed; loss of appetite; feeling sick; weight loss or sudden weight gain; bruising easily; itchy skin; light coloured or dark, tarry-looking stools;
and if the liver damage becomes very serious it can cause:
- Jaundice (yellowing of skin or whites of the eyes)
- Build-up of fluid (oedema) leading to swelling of the abdomen, legs and ankles.
- Abdominal pain, especially in the liver area and bloating (ascites)
- Vomiting blood
- Confusion, disorientation, and personality changes( encephalopathy)
If the damage continues, eventually the working parts of the liver can no longer support, or compensate for, the damaged parts. This is known as decompensated cirrhosis and can lead to serious and life-threatening complications.
How to live well with HCV?
Fatigue and sleep problems
Fatigue, an intense tiredness or lack of energy, is the most common Hepatitis C symptom.
Allow yourself to rest when you are able to. Eating small meals throughout the day, gentle exercise and drinking plenty of water can help maintain energy.
Hepatitis C fatigue is not necessarily related to sleep problems, although people with Hepatitis C can also have trouble sleeping.
Sleep problems can be helped by:
- Introducing some exercise into your day
- Avoiding heavy exercise, meals, caffeine, alcohol or computer use close to bed time
- Relaxation tapes, meditation or deep muscle relaxation
- Talking to someone about, or writing down, any recurring thoughts or anxieties that might be disturbing your sleep
Fatigue and sleep problems can also be caused by stress, depression and a variety of health problems. If you are affected by lack of sleep for any length of time, tell your doctor.
Depression, irritability and anxiety
Hepatitis C can cause or increase low mood, depression, irritability and anxiety. Understanding the connection between these feelings and your Hepatitis C can help, especially if you are able to get support from those close to you.
Consider talking to your doctor. They might advise a course of anti-depressants, talking therapy (such as CBT) or lifestyle changes, such as taking up exercise or relaxation techniques. Connecting with friends and/or support groups can also help.
Nausea and poor appetite
Hepatitis C can cause episodes of nausea and indigestion which can affect your appetite. Try eating small meals often and avoiding fatty and highly processed foods. Ginger, peppermint, spearmint, fennel seed and aniseed teas can reduce nausea, bloating and abdominal cramps. Bitter foods (lemon and water, olives, rocket) taken before meals can aid digestion.
Lack of concentration and forgetfulness
Many people with Hepatitis C experience forgetting where thinking clearly or concentrating can be difficult. Like other symptoms of Hepatitis C, the condition can come and go. The exact cause of is poorly understood but complementary therapies like deep breathing exercises ease symptoms. Practical tips include making lists of things you need to do and talking through important decisions with someone you trust. Many people find they are able to think more clearly after successful Hepatitis C treatment.
Hepatitis C can cause liver discomfort. Soreness may be felt just below the ribs on the right hand side. Some people find heat packs helpful, especially at night. Over the counter pain relief (e.g. paracetamol) can help, but get medical advice from your doctor first.
Dry skin, rashes and itching
Skin rashes and complaints are fairly common and may come and go. Unperfumed soap and moisturisers can help to reduce skin dryness and soothe irritations, minor rashes and itching. Your pharmacist or doctor can provide advice on over-the-counter or prescription medicines (such as steroid creams) to manage skin complaints.
Some Hepatitis C symptoms (such as dry skin and nausea) are similar to Hepatitis C treatment side effects.
Is Hepatitis C treatable and curable?
Hepatitis C is treatable and curable.
Choosing whether or not to start treatment is not always an easy decision. There are many factors to consider, including how you’re feeling right now, the treatments available and how any side effects might affect daily activities, relationships or work.
Recent drug developments have resulted in shorter, better tolerated and more effective treatments, although these are not widely available for all. Generally speaking, if your liver is in good health you can afford to wait, but if you have advanced Fibrosis having treatment sooner will be the better option.
Your doctor or healthcare professional can guide you about your treatment options, and whether it’s better for you to be treated now or to wait. People who have been through treatment themselves can provide support and guidance.
Is there a treatment for HCV?
Studies have developed a new class of drugs for treating Hepatitis C virus; a range of second generation therapies have been developed to offer shorter treatments with fewer side effects and higher cure rates. They are safe for earlier treatment and for people with cirrhosis or advanced liver disease.
Management of side effects has improved over the years and with the right help most people who start treatment could complete it.