Hepatitis C is a blood-borne, infectious disease of the liver`, which can lead to serious liver problems, including cirrhosis (scarring of the liver) and liver cancer. Hepatitis C virus (HCV) is the leading cause of liver transplants in the United States.1
Approximately 75 to 85 percent of people exposed to the hepatitis C virus (HCV) develop chronic infection, a long-term illness that occurs when HCV remains in a person's body. Of those, approximately 60 to 70 percent of people will develop chronic liver disease, and up to 20 percent will develop cirrhosis, if HCV remains untreated.1 Chronic liver disease due to HCV is marked by inflammation of the liver tissue with gradual damage or scarring of liver tissue (fibrosis). Over many years, some patients may develop cirrhosis where the scarring involves most of the liver. Patients with cirrhosis are at increased risk for developing liver cancer.2
There are at least six major known strains, or genotypes, of HCV and over 50 subtypes. Genotype refers to the genetic make-up of an organism or a virus. Genotype 1 is the most common form of HCV in the United States and accounts for about 75 percent of cases. Patients with genotypes 2 and 3 represent only 10 to 20 percent of the HCV population in the United States.3
An estimated 4 million people in the United States have HCV infection. Often dubbed the "silent disease," HCV infects approximately 17,000 people each year, and many are asymptomatic for years after initial infection. Every year, the disease causes an estimated 8,000 to 10,000 deaths in the United States.1,4 Chronic viral hepatitis infections are three to five times more frequent than HIV infection in the United States.4
The rate of HCV infection is higher among African Americans.4 The HCV-related mortality rate among Latinos is nearly twice the rate among non-Latino whites. HCV in Latinos causes more aggressive inflammatory activity and fibrosis, greater disease progression and greater risk of cirrhosis than in non-Latino whites or African-Americans.5
HCV is spread primarily through contact with infected blood. Common routes of infection include:3,6,7
Patients with chronic HCV infection generally experience no signs or symptoms during early stages of infection. When symptoms do occur, they are generally mild, nonspecific and intermittent.
Many patients experience no symptoms and, for those who do, symptoms may not show up for years or even decades. Chronic liver disease in HCV-infected people usually progresses slowly without detection. Many times, HCV infection is not recognized until it is identified when people are screened for blood donations or through routine examinations.6 HCV is not routinely screened for in regular examination, so it's important that someone who may have been exposed talk to a doctor. When left undiagnosed, HCV can lead to serious liver problems, including cirrhosis and liver cancer, and is the most common reason for liver transplantation in the United States.1
People concerned about being exposed to HCV should consult their health care professional about screening for HCV infection. Common tests include:1,9,10
Currently, there is no vaccine against HCV. Sustained virological response (SVR) may be achieved using the current treatment options. This means that HCV is no longer detected in the blood six months after treatment is completed.6
Currently, the standard of care for the treatment of HCV is pegylated interferon in combination with ribavirin. This combination therapy is typically a 24-week (for genotypes 2 and 3) or 48-week (for genotypes 1 and 4) course. Research has shown that combination therapy with pegylated interferon and ribavirin can result in undetectable levels of HCV in 40-50 percent of people with genotype 1 and 70-80 percent of people with genotypes 2 and 3.11,12,13,14
There are two new types of compounds currently under development by several pharmaceutical and biotechnology companies in the United States.
For more information about HCV, please visit www.HepCFight.com where people with HCV, their family and friends will find various online resources.
1 Centers for Disease Control. "Hepatitis C FAQs for the Public," available online at http://www.cdc.gov/hepatitis/C/cFAQ.htm. Last accessed March 7, 2010.
2 University of Maryland Medical Center. "Liver Disease," available online at http://www.umm.edu/liver/chronic.htm. Last accessed April 1, 2010.
3 National Digestive Diseases Information Clearinghouse. "Chronic Hepatitis C: Current Disease Management," available online at http://digestive.niddk.nih.gov/ddiseases/pubs/chronichepc/. Last accessed February 16, 2010.
4 Colvin, HM, Mitchell, AE. Hepatitis and Liver Cancer: A National Strategy for Prevention and Control of Hepatitis B and C. http://www.nap.edu/openbook.php?record_id=12793&page=1. Accessed March 7, 2010.
5 Rodriguez-Torres M. "Peginterferon Alfa-2a and Ribavirin in Latino and Non-Latino Whites with Hepatitis C." The New England Journal of Medicine. 2009;360:257-267.
6 Center for Disease Control and Prevention. "Hepatitis C Information for Health Professionals," available online at http://www.cdc.gov/hepatitis/HCV/HCVfaq.htm. Last accessed on February 16, 2010.
7 New York Department of Health and Mental Hygiene. "Hepatitis C." http://home2.nyc.gov/html/doh/html/cd/cdhepc-fs4a.shtml. Last accessed on April 2, 2010.
8 Mayo Clinic. "Hepatitis C Symptoms," available online at http://www.mayoclinic.com/health/hepatitis-c/DS00097/DSECTION=symptoms. Last accessed on March 7, 2010.
9 Lab Tests Online. "Hepatitis C. The Test," available online at http://www.labtestsonline.org/understanding/analytes/hepatitis_c/test.html. Last accessed March 8, 2010.
10 National Digestive Diseases Information Clearinghouse. "Liver Biopsy," available at http://digestive.niddk.nih.gov/ddiseases/pubs/liverbiopsy/. Last accessed on March 8, 2010.
11 Fried MW, et al. Peginterferon Alfa-2a Plus Ribavirin for Chronic Hepatitis C Virus Infection. N Engl J Med 2002; 347 (13):975-982.
12 Hadziyannis SJ, et al. Peginterferon-2a and Ribavirin Combination Therapy in Chronic Hepatitis C: A Randomized Study of Treatment Duration and Ribavirin Dose. Ann Intern Med 2004;140(5):346-355.
13 Manns MP. et al. Peginterferon alfa-2b Plus Ribavirin Compared With Interferon Alfa-2b Plus Ribavirin for Initial Treatment of Chronic Hepatitis C: A Randomised Trial. The Lancet 2001; 358: 958-965.
14 McHutchinson JG, et al. Peginterferon Alfa-2b or Alfa-2a with Ribavirin for Treatment of Hepatitis C Infection. N Engl J Med 2009. 361 (6):580-593.
15 Pawlotsky, JM et al. The Hepatitis C Virus Life Cycle as a Target for New Antiviral Therapies. Gastroenterology 2007;132:1979-1998.