1.0.7 Hepatitis C (HCV)
Hepatitis C is a form of hepatitis caused by an RNA virus of the Flaviviridae family that targets the liver. HCV accounts for the majority of the hepatitis cases previously referred to as non-A, non-B hepatitis, and is responsible for 150,000 to 250,000 new cases of hepatitis each year.
Those infected with the virus can show symptoms such as fatigue, nausea, loss of appetite, dark urine, and jaundice. If left untreated it can lead to liver failure, liver cancer and death. HCV is also a trigger for a host of autoimmune disorders and various other diseases, such as diabetes, non-Hodgkin’s lymphoma, retinal complications and thyroiditis (inflammation of the thyroid gland). According to a recent report by a committee sponsored by the National Institutes of Health, nearly four million individuals in the U.S. are infected with HCV. The report also noted that treatment of the disease with current drugs is disappointing and estimated that the number of U.S. deaths caused by HCV will triple in the next 10-20 years.
In 1987, Michael Houghton and colleagues at Chiron Corporation in California discovered part of the genetic material of HCV using molecular recombinant technology. This discovery allowed the development of tests to detect specific antibodies. The first enzyme immunoassay (EIA) test made available in 1989 employed only a single recombinant protein to detect antibodies and produced a significant proportion of both false positive and false negative results. An antibody test that could be used to increase the safety of the blood supply and of transplantable organs and tissues was available by 1990.
In mid-1995 the hepatitis C virus was seen for the first time ever by scientists with the aid of an electron microscope. It is linear, single-strand RNA (ribonucleic acid) virus 40-50 nanometers in size.
It is covered with a lipid envelope and is encased with glycoprotein peplomers or “spikes”.
According to Bruce Devenne of Hepatitis Nova Scotia, governments and medical communities had knowledge of hepatitis C well before 1987, and could have done much to prevent the deaths of thousands. But they didn’t. Consider the poisoning of those in Ireland and France with HCV infected blood, and where court cases clearly found criminal liability on the part of blood merchants and governments. Consider also the history of blood safety in Canada, and the current Arkansas Blood Trail scandal (See Appendix E, below).
- You should be tested for hepatitis C if you have ever:
Received a blood transfusion or blood products before screening was introduced (1986 in the US, 1990 in Canada)
- Shared injecting equipment for drugs
- Been tattooed or had body piercing
- Had a needle stick injury or performed “exposure-prone procedures”
People with abnormal liver function tests with no apparent cause would also benefit from having a hepatitis C antibody test. We (HepCBC) also recommend that anyone who has had dental procedures where blood was present, or who has had manicures or pedicures be tested. Studies (Minerva Urol Nefrol. 2005 Sep; 57(3):175-97) show that persons undergoing hemodialysis are still at risk, as are many cured cancer patients.
Hepatitis C currently causes between 150,000 and 250,000 new cases of chronic infection in the United States each year. Hemophiliacs and intravenous drug users are at the greatest risk, but anyone, of any status or age, and in any walk of life, is at risk for acquiring the hepatitis C virus. Researchers have found that many people infected with hepatitis C don’t even know it. 20-40% of patients in inner-city hospitals are infected, as are 80 % of intravenous drug users.
“Relax...you have cooties...but they aren’t as bad as you are imagining.” - Cindy Torchin: firstname.lastname@example.org Listowner HEPV-L
Most people with hepatitis C contracted it through either a contaminated blood transfusion or product (plasma, gammaglobulin, etc.) or by sharing contaminated needles. Prior to 1990, the official line was that blood in Canada could not be screened for HCV (see, Appendix E: History of Blood Safety).
Thanks to HCV testing with modern methods, the risk of acquiring hepatitis C from blood transfusion is now less than 1%. The other people who acquire hepatitis C include health care and laboratory workers that may get stuck with an infected needle or instrument, people receiving medical/dental procedures, people undergoing hemodialysis, body piercing, sharing razors, toothbrushes, nail clippers or people who have had tattoos or manicures that were performed with poorly sterilized equipment. Infected mothers can pass the virus to the fetus in utero; statistics for transmission from mother to child are around 5%. It may occur more readily if the mother is also infected with the human immunodeficiency virus (HIV) that causes AIDS--16% transmission rate.
Cases of hepatitis C with no evidence of exposure through blood transfusions, needlesticks or needle sharing are called “sporadic.” How these individuals became infected is unknown. As early as 1956 the Merck Manual stated that Non-A/Non-B hepatitis could be spread through the use of glass syringes and other then current medical testing and mass vaccination devices.
Forty percent of all cases of hepatitis C were contracted through unknown means by people who are in no current risk category.
What this means is that we are all at risk for contracting hepatitis C.
- The virus is in the blood of an infected person.
- Hepatitis C can be spread by using something with infected blood on it such as:
- razors, nail clippers or scissors
- tooth brushes and water pics
- tattoo or body piercing needles
- illicit IV drug needles and paraphernalia (cottons, spoons, etc.)
- tampons or sanitary napkins
- The virus must enter through a break in the skin or mucous membrane.
- The hepatitis C virus is NOT airborne.
- It is NOT spread by:
- sneezing and coughing
- holding hands
- kissing (unless there is deep-kissing and open sores present)
- using the same toilet
- eating food prepared by someone with HCV
- holding a child in your arms
- swimming in the same pool
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|1.0.6 What is the Function of the Liver?|
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