| Hepatitis C |
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This is one of the commonest cause of hepatitis in this country. |
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It is a viral infection which affects the liver and leads to
liver damage or inflammation called Hepatitis C.
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Most patients with hepatitis C do not have any symptoms. |
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The disease spreads through use of IV street drugs
(e.g. heroin, cocaine), blood transfusion (This was more common prior to the present method of testing
for Hepatitis was available), snorting cocaine and in homosexual men. Heterosexual transmission can occur
but is less likely. Tattoos is another way the virus can spread. |
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After 20 - 30 years of Hepatitis C, patients can develop
cirrhosis of the liver. This is a condition where the normal liver is replaced by scar tissue and
the liver no longer works effectively. After another 10 years, patients can develop
liver cancer.
Patients who drink or are HIV +, often develop these changes a lot sooner. |
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Once cirrhosis of the liver develops, at present,
liver transplantation is often considered. |
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Patients who are Hepatitis C positive, should
abstain from drinking alcohol. |
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There are several different kinds of Hepatitis
C viruses. The commonest cause of hepatitis C in USA is type 1. It occurs in about 75-80%
of the cases in USA. Type 1 can be either 1a or 1b. However, as far as treatment is concerned
there is no difference between type 1a or type 1b. This type of virus is more difficult to
eradicate. Treatment is generally required for 1 year. |
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The other types of Hepatitis C virus is type 2 or type 3.
Type 2 virus is easier to eradicate and occurs more frequently than type 3. Generally type 2 virus
treatment requires 6 months of treatment and type 3 virus requires 1 year of treatment. |
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Generally, prior to treatment, most gastroenterologist
recommend getting a liver biopsy. The liver biopsy will give us 2 important pieces of information. |
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Amount of inflammation present in the liver. The more the inflammation, more likley the need for treatment. |
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Fibrosis or scar tissue present in the liver. F0 means no fibrosis and F4 means significant fibrosis and
at this point it is called cirrhosis of the liver. F1, F2 and F3 fibrosis are in between. |
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There are 2 forms of treatment available. Interferon injection to be
taken thrice a week with a tablet called Ribavarin or the new PEGylated interferon with the tablet Ribavarin.
Preliminary information suggests that the PEGylated interferon with Ribavarin may be more effective. These
medicines have a lot of side effects and patients MUST have their blood tests checked frequently. |
