Hepatitis C- Screening, Prevention, Diagnosis & Treatment

Hepatitis C is an extreme and probably life-threatening virus that affects the liver. Left untreated, it can cause persistent irritation of the liver, leading to cirrhosis, liver cancer, or even death. Fortunately for the ones stricken by this virus, improvements in medicinal drugs have allowed us to expand touchy screening tests as well as powerful interventions for prevention, consisting of vaccination and accelerated cognizance.

Furthermore, accurate diagnosis and treatment protocols are available, making hepatitis C preventable and treatable when detected early on. This blog post will explore how hepatitis C is screened for, prevented through various measures such as vaccination or behaviour modification techniques, diagnosed using laboratory tests, and treated with antiviral therapies and other healthier lifestyle modifications.

Understanding Hepatitis C

Hepatitis C is a viral infection impacting the liver, potentially inflicting acute or chronic infection, with extreme cases being life-threatening.

This infection spreads through touch with infected blood, frequently taking place for the duration of activities like needle-sharing or unsafe clinical approaches regarding unscreened blood products. Symptoms include:

• Fever
• Fatigue
• Loss of Urge for Food,
• Nausea
• Vomiting
• Belly Ache
• Dark Urine
• and Jaundice (Yellowing of the Skin or Eyes).

Unlike some other illnesses, there isn't a vaccine for hepatitis C. However, antiviral medications provide powerful treatment options. Swift identification and intervention are pivotal in preventing liver harm and enhancing long-term well-being.

Acute hepatitis C infections are frequently asymptomatic, with approximately 30% of individuals spontaneously clearing the virus within six months without treatment. Conversely, the remaining 70% may progress to chronic HCV infection. Among those with chronic HCV, the risk of developing cirrhosis ranges from 15% to 30% within two decades. Early diagnosis significantly improves the outlook for individuals grappling with this condition.

Hepatitis C Screening

Getting screened for hepatitis C is an essential step in defending your health. Screening entails checking for the hepatitis C virus in your blood. It's an important method because hepatitis C can lead to acute and chronic illnesses, and early detection is crucial to preventing excessive liver damage. Here's what you want to realize about hepatitis C screening:

Who Should Get Screened?

• Individuals with a history of injection drug use.
• Those who received blood products or organ transplants before July 1992.
• People who underwent long-term haemodialysis.
• Individuals born to HCV-positive mothers.
• Healthcare workers or public safety workers after needlestick injuries involving HCV-positive blood.
• Those with HIV infection.
• Anyone with signs or symptoms of liver disease.

Where to Get Screened?

• Healthcare providers, including primary care doctors, can perform hepatitis C screening.
  
• Many health departments and community health clinics offer hepatitis C testing.
• Testing may also be available at local outreach programs and events.

Types of Hepatitis

Hepatitis A:

• How does it spread? Mainly through contaminated food or water.
• Is it serious? Usually, it's alright; it only sticks around for a short time.

Hepatitis B:

• How does it spread? Through contact with infected blood or certain fluids.
• Is it serious? It can be, mainly if it sticks around.
• How to stay safe? Get the Hepatitis B vaccine, and be careful with personal stuff like needles.

Hepatitis C:

• How does it spread? Mainly through infected blood, often by sharing needles.
• Is it serious? Yup, and it can lead to some pretty tough liver issues.
• How to stay safe? There is no vaccine yet, so be super careful with needles.

Hepatitis D:

• How does it spread? Similar to B, through infected blood or certain fluids.
• Is it serious? It can be trickier than just B alone.
• How to stay safe? Get the Hepatitis B vaccine.

Hepatitis E:

• How does it spread? Mainly through iffy water or food.
• Is it serious? Usually, it's alright, and it only sticks around for a short time.
• How to stay safe? Watch what you eat and drink clean water.

Autoimmune Hepatitis:

• Is it serious? Yeah, it can affect your liver in the long run.
• How to stay safe? There is no magic trick here, but doctors have ways to help.

Hepatitis C Transmission

The hepatitis C virus is primarily transmitted through bloodborne means. Common modes of transmission include:

• Reuse or insufficient sterilization of medical equipment: This is especially pertinent to syringes and needles in healthcare settings.
• Transfusion of unscreened blood and blood products: Instances where proper screening measures are not employed, can contribute to the transmission of HCV.
• Injecting drug use: Sharing injection equipment among individuals engaging in injecting drug use is a significant avenue for HCV transmission.

While less common, HCV can also be transmitted:

• From an infected mother to her baby: This transmission route is possible but occurs less frequently.
• Via sexual practices leading to blood exposure: This is more likely in scenarios such as having multiple sexual partners or among men who have sex with men.

It's important to note that hepatitis C is not spread through:

• Breast milk
• Food or water
• Casual contact like hugging, kissing, or sharing food or drinks with an infected person

Hepatitis C Diagnosis And Testing

New HCV infections frequently don't cause any symptoms, and the infected individual frequently is unaware of their illness. Early diagnosis is difficult since symptoms may not show up for years, even in people with chronic HCV infection.

The severe liver damage that eventually causes symptoms usually occurs decades after the initial infection. The process of diagnosing HCV infection involves two key steps:

1. Testing for anti-HCV antibodies: This initial test identifies individuals exposed to the virus.
2. Nucleic acid test for HCV RNA: If the anti-HCV antibodies test is positive, a follow-up test for HCV RNA is conducted to confirm chronic infection and the necessity for treatment. This step is crucial because approximately 30% of those infected can naturally clear the virus through a robust immune response. Despite no longer having the virus, they will still test positive for anti-HCV antibodies. The nucleic acid test can be performed in a laboratory or with a simple point-of-care machine in a clinic.

Excitingly, there are innovative tests like the HCV core antigen in development, aiming for a one-step diagnosis of active hepatitis C infection in the future.

A diagnosis of chronic HCV infection is followed by an evaluation to ascertain the degree of liver damage (cirrhosis and fibrosis). This can be accomplished by a number of non-invasive diagnostics or a liver biopsy.

The degree of liver damage guides decisions about treatment and overall disease management.

Early prognosis no longer only prevents health problems on account of the contamination but additionally stops the unfold of the virus. The World Health Organization (WHO) recommends checking out for the ones with extended chance of infection.

In areas with an excessive incidence of HCV antibodies inside the well-known population, WHO shows screening blood donors and focused checking out for unique high-hazard organizations. 

Migrants from endemic areas, healthcare personnel, those who inject capsules, persons in prisons, males who have sex with men, promiscuous people, and HIV-infected men and women are among these categories.

WHO emphasizes that all adults need access to and be presented with HCV trying out, together with connections to prevention, care, and remedy services.

Globally, approximately 2.3 million humans (6.2% of the anticipated 37.7 million living with HIV) have proof of past or present HCV contamination. Chronic liver sickness poses a good-sized danger to the fitness of those residing with HIV on a global scale.

Hepatitis C Treatment

To treat hepatitis C, doctors frequently use antiviral drugs such as a drug called so and Daclatasvir.  Some people's immune systems can naturally battle the illness, and if the infection is young, it may not necessarily require treatment. However, chronic hepatitis C always needs treatment.

In addition to medication, making lifestyle changes can also help. For those with hepatitis C, things like abstaining from alcohol and keeping a healthy weight can be beneficial. Many people can fully recover from the infection and have healthy lives with the correct care.

Regardless of age, the World Health Organization (WHO) recommends treating all patients with chronic hepatitis C infection with pan-genotypic direct-acting antivirals (DAAs). With relatively few adverse effects, these oral medicines are curative and short-term. 

The majority of HCV patients can be cured with DAAs, and the course of treatment is often brief—12 to 24 weeks, depending on whether cirrhosis is present or not. WHO expanded its recommendations in 2022 to include adolescents and children, using the same pan-genotypic treatments as adults.

While these pan-genotypic DAAs can be expensive in many wealthier countries, prices have significantly dropped in many places, especially in low-income and lower-middle-income countries, thanks to the availability of generic versions. 

One widely used and affordable pan-genotypic DAA combination is sofosbuvir and daclatasvir. In numerous low- and middle-income countries, the curative treatment course costs less than US$ 50.

Access to HCV treatment is improving, but it must still be widely available. Out of the 58 million people living with HCV infection globally in 2019, only about 21% (15.2 million) knew about their diagnosis. Of those diagnosed with chronic HCV infection, roughly 62% (9.4 million) had received treatment with DAAs by the end of 2019.