Among the most significant causes of chronic liver disease in the United States, the Hepatitis C virus can lay dormant for years, often displaying few or no symptoms until serious liver damage has occurred. In the premiere issue of Bella, Dr. E. Coy Irvin, medical director for the Executive Physical program at Andrews Institute in Gulf Breeze, ranked Hepatitis C and chronic liver disease among the top 10 health risks in the Pensacola Bay Area. This virus causes an estimated 10,000 to 20,000 deaths each year, and it affects an estimated 1.4 million Americans. In the world, the number of cases is believed to be about 170 million.
“It’s a very under-recognized illness,” said Dr. Ronald Powell, a gastroenterologist at the Medical Center Clinic. “Nationwide, about 1 to 2 percent of the population has the virus. The problem is that a vast majority of people are asymptomatic.

Usually with Hepatitis C there’s no symptom. Most of the time it’s showing up when people have blood work done during a routine doctor visit or an insurance physical. But a lot of times people will walk around for many decades and not notice it.”

The bad news is that Hepatitis C can lead to cirrhosis, end-stage liver disease or liver cancer. The good news is that Hepatitis C is easy to detect, and if caught early, then treatment can be highly successful.

Hepatitis C virus is primarily transmitted through blood and blood products. The most common method of transmission today is through the use of shared or improperly sterilized needles, especially associated with drug use. But before 1992, the virus was not screened for in-blood transfusions, so many of the cases being reported today were actually contracted more than a decade ago.

One reason that Hepatitis C is so perplexing is that it can have different effects on different people. Some patients might experience little or no liver damage, while others experience severe damage. And 10 to 15 percent of the time, the body’s immune system seems able to clear the virus, Powell said. Because of this variation, aggressive treatment is not always recommended.

The primary treatment of Hepatitis C is a combination of two drugs for either a 24-week or 48-week course. The first drug is called interferon, which is a natural, chemical- immune product that has antiviral qualities. This is administered in a weekly injection. The second drug is ribavirin, a pill usually taken twice daily, which works in conjunction with interferon.

Powell said that there are subtypes of the Hepatitis C virus, and the length and success rate of the treatment varies depending on the type. The success rate varies accordingly, from a 50 percent to an 80 percent chance of the virus going into long-term remission.

Preventing Hepatitis C
Hepatitis C is not believed to be transmittable through casual contact, so even if you have a family member with the virus, few special precautions need to be taken. Don’t share razors or toothbrushes with someone who has the virus, and certainly don’t share needles. There is some evidence that it can be contracted through sexual contact, but this is believed to be from blood, not other bodily fluids.
For more information about Hepatitis C, visit the Web site of the American Liver Foundation, www.liverfoundation.org. 

Who should be screened?
Powell said that there is controversy in the medical literature about whether everyone should be screened for Hepatitis C, but he recommends screening for anyone who had surgery or blood transfusion before 1992. This includes women who may have received blood transfusions during childbirth.
Other people at risk are those who may have experimented with injected drugs or anyone who got a tattoo more than 10 years ago. The screening itself is relatively simple. Ask your doctor if you can have liver bloodwork drawn, and this will include the Hepatitis C antibody test, which will show whether or not you have been exposed to the virus.