Hepatitis C is a liver disease caused by the Hepatitis C virus. It can be acute or chronic. Symptoms of acute hepatitis C infection include fever, abdominal pain with nausea and vomiting, fatigue, a change in bowel habits, and jaundice (yellow skin and eyes). Symptoms can first appear 2 weeks to 6 months after exposure to the virus. Only about 25 percent of people clear the virus spontaneously without treatment, whereas 75 percent go on to develop chronic (long term) hepatitis C infection. Chronic hepatitis C infection can lead to serious liver disease, including cirrhosis, cancer, and death. About 3 million people in the U.S. have hepatitis C, and most don’t know it because they don’t have any symptoms.
How do you get hepatitis C? Infection usually requires direct blood to blood contact with an infected person. Before 1992 when widespread screening for hepatitis C began, many cases were contracted via blood transfusions and organ transplants. However, now the most common means of transmission are sharing needles among those abusing intravenous drugs, needle stick exposures in hospitals, or babies born of a hepatitis C-infected mother. What about tattoos? Licensed, commercial tattoo artists shouldn’t pose a threat as they use properly sterilized equipment. But informal, unregulated settings like tattooing in prisons do pose a significant risk of infection. It is also possible to get hepatitis C through sexual contact, but this is less common, and more dangerous with rough sexual contact that might cause bleeding (not recommended for many reasons). Also uncommon, it can spread in households by sharing items that might have contacted an infected person’s blood, e.g. toothbrushes or razors. It is not spread by hugging, kissing, sharing silverware, coughing, or sneezing.
Why should Baby Boomers (people born between 1945-1965) be concerned? Most of the people with hepatitis C don’t know they have it, and 75 percent of the people with it are in their 50s and 60s (Baby Boomers). The CDC now recommends that all Baby Boomers be tested for hepatitis C. One reason is because there are treatments, and these are improving. Your primary care provider should suggest testing you for hepatitis C as part of a routine annual physical if you have risk factors, including simply being in the high-risk age group. If tests suggest that the virus is active, you will likely be referred to a gastroenterologist (digestive physician) or hepatologist (liver specialist) for evaluation for treatment.
Cirrhosis of the liver is a serious scarring condition of the liver that can be caused by many things, most commonly heavy alcohol drinking. However, there is a link between cirrhosis and hepatitis C, along with alcohol, HIV, and certain drugs. Unfortunately, the risk for liver cancer (hepatocellular carcinoma) is increased in the presence of these risk factors.
So Baby Boomers, and others that might fit one of the above risk categories, expect that your PCP will test you for hepatitis C as part of your regular health maintenance check. You do get one each year, right? If insurance is a problem, be sure to look into the new Healthcare Marketplace made possible by the Affordable Care Act when it reopens again in November.
Dr. Fleming is the Medical Director of The Jane Pauley Community Health Center (closely affiliated with Community Health Network). Ideas for this column can be e-mailed to Dr. Fleming at AskDrFleming@gmail.com. Or you can write your medical questions to Dr, Fleming at AskDrFleming, 8931 E. 30th Street, Indianapolis, IN 46218. On written correspondence, please include your name and city (names will not be published).