Hepatitis C - segment of population at greater risk - information, sources, links, discussion

Last Link Check 26 May 2006


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  • Hepatitis C

    In its Disease Prevention Section, the Global Crisis Solution Center will focus on serious diseases which effect a segment of the population many of whom are unaware they are infected.

    The information presented here is not authoritative and is given for informational purposes only. There is no claim or warranty, either express or implied, that the information is correct, error free, complete, valid, or suitable to any particular situation or in general, or that it is the best or only way to solve the problem. The information provided must not be used as the sole basis for education, diagnosis, or for treatment. Other sources, including professional medical opinion, should be consulted before taking any action.

    Page Index
    Current situation and background information
    Hepatitis C - Primary Sites
    Hepatitis C - What you should know, causes, testing
    Hepatitis C Links
    Study of First Responders
    Alternative Treatment
    Additional Hepatitis Sites
    Encyclopedias and General References

    Current situation and background information     
    to index
    It is estimated that there are as many as 200 million worldwide infected with hepatitis C. The CDC estimates that at present there are 3.9 million people in the United States with hepatitis C, 80% of whom show no signs or symptoms. source

    Hepatitis C (HepC or HCV) is a viral infection causing inflammation in the liver was identified in 1988. Before 1988, this type of hepatitis was called non-A, non-B hepatitis, meaning that it was not caused by the viruses that produce hepatitis A or hepatitis B.

    Currently, hepatitis C is responsible for an estimated 8,000-10,000 deaths annually from chronic liver disease. Due to the possible infection by some of those receiving transfusions before 1990, it is estimated that without effective intervention, the number of identified cases will triple in the next 10-20 years.

    Known as the silent disease, many individuals have no symptoms and they do not find out they have it for many years.

    Certain identified portions of the population are at greater risk, but about 10% are infected from unidentified sources. According to the CDC, those at greatest risk and should be tested are injecting drug users and recipients of clotting factors made before 1987.

    At intermediate risk are hemodialysis patients, blood doner recipients or solid organs recipients before 1992 in countries with Hepatitis C screening programs, and intermediate risk for all blood doner recipients now in all other countries. Further at intermediate risk are those with undiagnosed liver problems, and infants born to infected mothers (should be tested when they are 12-18 months old).

    However, risk to child of breastfeeding by infected mother has been determined to be low. An intimate stable relation with an infected partner, or even relations with multiple partners has been determined to be low risk. Healthcare/public safety workers who follow safe practice are also at low risk.

    Everyone should become aware of its causes and methods of protection since it can be transmitted by infected needles, blood transfusion in those countries where screening is not practiced, unsafe tatooing and body piercing, direct blood transfer from one to another (toothbrush, shaving, etc).

    There is currently no vaccine against hepatitis C. A portion of those contracting the disease (15-20%) recover naturally within a short time. Of those not recovering, a large portion may experience no symptoms for 20-30 years although damage to the liver may be occurring slowly. This damage may be minimal or severe. Some never experience problems but in the largest portion of individuals there are problems which impede the proper functioning of the liver, with some eventually developing cirrhosis (scarring), a portion of these having liver failure or liver cancer, and some (less than 3%) dying of liver disease.

    The CDC states that "Interferon can be taken alone or in combination with ribavirin. Combination therapy can get rid of the virus in up to 4 out of 10 persons".

    See below for further details

    Hepatitis C - Primary Sites     to index

    GO TO:

    National Hepatitis C Coalition, Inc.
    A nationwide support system. An up-to-date site including latest news relevant to Hepatitis C, chat room, newsletter, info, traditional & alternative treatments
    American Liver Foundation
    If You Have Hepatitis C Infection source
    Treatment for Hepatitis C source
    Side Effects of Hepatitis C Treatment source
    If you cannot get the above, go to American Liver Foundation homepage and search for hepatitis source
    Hepatitis C Prevention
    CDC guidelines on how to protect yourself from getting Hepatitis C
    For more information from CDC including online training for clinicians and other health professionals
    See the NIDDK site of the National Institute of Health page for very complete treatment of hepatitis C
    Chronic Hepatitis C: Current Disease Management
    Hepatitis Foundation International English French Italian Portuguese Spanish
    For information on Hepatitis A, B and a concise description of Hepatitis C, risks, treatments, plus advice on applying for benefits.
    Also Hepatitis Newsletter for in-depth and current information.
    Ask NOAH About: Hepatitis

    July 18, 2001 Researched by Erica Burnham, MLIS Regional Medical Library, The New York Academy of Medicine Library Up-to-date categorized listings on over 100 sites related to hepatitis C
    The Hepatitis C Resource Center "The Department of Veterans Affairs (VA) leads the country in hepatitis C screening, testing, treatment, research and prevention. VA is the largest single provider of medical care to people with hepatitis C infection in the United States." source General Resources for Providers, General Resources for Patients, Hepatitis C Web Sites, VA and Affiliated Resources, Other Resources of Interest [ ]
    National CDC Hepatitis C Prevention Strategy 2001
    Concise overall coverage of topic plus current state of prevention, counseling, testing capabilities, and national strategy

    Hepatitis C - What you should know, causes, symptoms     to index

    Hepatitis C is an infection of the liver caused by the hepatitis C virus and is easily transmitted through contact with infected blood.

    You may not know you have it but if you are in one of the following groups, you may be at risk and should have a blood test. Besides the regular blood test conducted by a physician or a certified lab, see below for a home test kit which is approved by the Federal Drug Administration (FDA).

    You are at risk if you:

  • have ever injected illegal drugs (even experimentally a few times many years ago)
  • received medical care, injections, or transfusions in countries where Hepatitis C has a high prevalence or where blood is not tested prior to transfusion
  • received a blood transfusion before july 1992. Since then, hepatitis C from transfusion has virtually disappeared in countries where blood is tested for hepatitis C
  • are a war veteran who received blood transfusions before July 1992
  • have undiagnosed liver problems.
  • were notified you received blood from donor who later tested positive for hepatitis C
  • received a solid organ transplant before July, 1992
  • received a blood product for clotting problems produced before 1987
  • have ever been on long-term kidney dialysis

    Note that there are a certain percentage of cases for which the precipitating cause has not been determined.

    What You Should Know In Any Case
    Since hepatitis C is transmitted through contact with the blood of an individual who is infected, there are certain precautions which should be taken which will protect you.

    First, the activities which are NOT considered to be a risk. In general, it is generally accepted that you can not get the disease through everyday contact between individuals, intimate contact (most sexual contact, nursing of baby, kissing, holding hands, sneezing, hugging, coughing, sharing eating utensils or drinking glasses, food or water, casual contact and food and beverage handling, as well as living in constant contact. None of the above appear to cause transmission of hepatitis C.

    However, any activity which causes the transfer of blood from one person to the other (even in very small amounts) should be avoided - sharing toothbrushes, shaving gear, pierced earrings, drug sniffing apparatus, scissors, nail clippers, etc. should be avoided. Do not use unsteralized needles (tattooing, body piercing) and be sure good health practices (washing hands, using disposable gloves) are followed by person doing it. In drug use, do not share needles, syringes, water, or "works", etc.
    Individuals who come into contact with blood as part of their occupation (first responders, health care workers, etc.) should take extra precautions, but current evidence does not suggest that this group is normally at a substantially higher risk than other segment of the population although vaccination against B is advised. Note: there is no vaccination against hepatitis C.

    Protect Yourself If you think that you have hepatitis C, protect yourself by not drinking alcohol and get a test. A test will also indicate if you have liver problems, and how to avoid causing more harm to your liver, There is no vaccine against hepatitis C but there are several drugs which according to the U.S. Center for Disease control can, when used in combination, remove the virus for about 30-40% of infected individuals. If you have more than one steady relationship, get vaccinated for hepatitis B. Also get a vaccination against hepatitis A to further protect your liver. In any case, use safe sex, both to protect yourself from A and B, and to protect the other person. Do not take over-the-counter drugs without first consulting your health care provider since there are some medications which have ingredients harmful to a potentially damaged liver.

    Protect Others
    If you think or know that you have hepatitis, to repeat above, do not let others borrow anything of yours which may have traces of blood - shaving equipment, toothbrush, needles, pierced earrings (this should not be done in any case). Keep covered any cuts or sores you may have. Use safe sex methods if you have more than one permanent relationship. Do not donate blood, organs or tissue. Pregnancy does not have to be avoided since only 5% of children, of mothers with hepatitis C, contract the disease unavoidably at the time of birth. And in many instances, the child's immune system gets rid of it within a two year period. However, the child should be tested at the end of that period just to be sure that it is not still carrying the virus. Breast feeding is considered safe. The U.S. CDC indicates that persons should not be excluded from work, school, play, child-care or other settings on the basis of their infection status.

    Get A Test
    If you fall into one of the above groups or think you may have contracted it, contact your health care provider and request to be tested for hepatitis C. Hepatitis C is not yet a test which is automatically given. Do not donate blood to test whether or not you have the disease. There are often no definitive signs or symptoms of the disease. Check out the NIDDK site below for a list of possible symptoms when the disease becomes severe or cirrhosis has developed. A home test, authorized by the FDA, may be used as a first step. The home test site offers a self administered and confidential questionnaire which you can take to help you make the decision as to whether or not to take the test.
    Check out the following for clinical symptoms and signs.

    When To Test
    The virus incubation period is from 2 weeks to 6 months from the time of exposure. Therefore, if you receive a not infected result before the end of the period, you cannot be sure that you are clear of the disease. Check the NIDDK site below for information on the sensitivity of different tests.
    If you decide to take the home test, they have the following statement: "...your sample is tested with an Enzyme-Linked Immunoassay (ELISA). In some cases, a more specific test called Recombinant Immunoblot Assay (RIBA) may also be used to determine your final result. It can take up to six months for your blood to develop antibodies to the hepatitis C virus. Hepatitis C CheckSM Test Service may not detect more recent infections. We recommend you take the test six months or more AFTER you have been exposed to hepatitis C virus."

    Excerpts from several authoritative sources:
    What are the symptoms of hepatitis C?
    American Liver Foundation http://www.liverfoundation.org/
    Hepatitis C is a slowly progressing disease that may gradually advance over time and can lead to cirrhosis, liver cancer and even death... One third of [those infected] do not know that they are infected with the hepatitis C virus. However, when symptoms do occur with hepatitis C, they are usually mild and intermittent, with the most commonly reported being fatigue, abdominal pain, and fever.

    Most new cases of hepatitis C occur in young adults, aged 25 to 40, who may not learn for years or even decades that they are infected. Undiagnosed, they risk serious liver damage and may unknowingly infect others. Once cirrhosis and the other complications of hepatitis C set in, the symptoms of the disease are much more severe and, in some cases, even disabling.

    Hepatitis C is an emerging infectious disease in this country. Each year, up to 10,000 people die as a result of the complications of hepatitis C. Hepatitis C, accompanied by cirrhosis and liver failure, is the leading cause of liver transplantation in the United States. It is estimated that, without improved prevention and intervention, the death rate associated with hepatitis C likely will triple in the next 20 years.

    The test kit
    Manufactured by Home Access Health Corporation, the test kit is an FDA-approved, at-home test for hepatitis C. With the easy-to-use test, a person collects a small finger-stick blood sample and mails it for processing. A call to a toll-free number using a personal identification number guaranteeing confidentiality, gives results within 10 business days. On home page, click on our tests and then on hepatitis C.
    Also available is a confidential risk assessment test of 8 questions to determine if it is probable that you may have hepatitis C to help you make the decision as to whether or not to order the home test.

    Hepatitis C - Links     to index

    Hepatitis C links
    The Hepatitis Information Network (Canadian)
    International as well as country links to papers, news, research results, conferences, advances in treatment, etc. as well as general information on Hepatitis C (also Hepatitis General) http://www.hepnet.com/hepc.html

    Hepatitis C in English and German
    One of the best sites with many links, recent studies, individual's stories, very impressive archive of abstracts of English articles which are also translated into German, patient experiences, alternatives, literature, liver transplant info, Hepatitis Art, forum http://www.hepatitis-c.de/

    For a very easy to read discussion on most topics: Are you positive? History, diagnosis, definitions, research, prevention, HCV & other diseases, symptoms, Patients talk, links, alternative medicine & nutrition, Centers/Institutes/Labs, Societies, Orgs
    For listing of Links http://www.hepatitis-c.de/linkse.htm
    Medlineplus Health Information - a service of the National Library of Medicine
    Hepatitis C source Covers many topics including latest news, research, overviews, treatments, etc. Includes links in Spanish
    Hepatitis Central hepatitis-central Over 2,000 pages about Hepatitis and Hepatitis C.
    Combines support plus bulletin boards and recommendations on alternatives, support groups, symptoms & side effects
    Hepatitis C - An Epidemic For Everyone
    Sponsored by the C. Everett Koop Institute at Dartmouth College and one of the most well thought out sites on the net.
    Complete source including videos by those with Hepatitis C and campaigns, full political action links, and what is being done to alert the public and to find a vaccine, expert sites, research centers, patient support
    National Digestive Diseases Information Clearinghouse
    Chronic Hepatitis C: Current Disease Management
    Risk Factors and Transmission, Clinical Symptoms and Signs, Serologic Tests, Liver Biopsy, Immunostaining, Diagnosis, Treatment, The Future of Hepatitis C Research, Selected Review Articles and References http://www.niddk.nih.gov/health/digest/pubs/chrnhepc/chrnhepc.htm
    Hepatitis Foundation International
    English French Italian Portuguese Spanish
    Hep C Connection
    General links, U.S. support groups, newsletter, and emphasis on Colorado (counseling, employment, health care, insurance, legal help, transportation, etc.
    National Hepatitis C Coalition, Inc. http://www.nationalhepatitis-c.org/
    WebMD Health
    In home page, input the word hepatitis into Quick Search at the top to receive all information contained on A B and C.

    Study of First Responders     to index

    Summary of studies regarding first responders
    Routine HCV testing is not recommended for populations with a low prevalence of HCV infection, including first responders, unless they have a history indicating an increased risk for infection (e.g., transfusion before July 1992 or injecting-drug use)... Testing is recommended in first responders for post exposure management after a percutaneous or permucosal exposure to HCV-positive blood..., and testing could be considered for these types of exposures when the HCV status of the source is unknown.... To reduce workplace exposure to blood borne pathogens, standard precautions continue to apply; first responders should be educated about transmission of blood borne pathogens, trained in proper safety measures, and provided with appropriate protective equipment.... First responders also should be vaccinated against HBV, and informed of protocols if percutaneous or permucosal exposures to blood occur....

    Hepatitis C Virus Infection Among Firefighters, Emergency Medical Technicians, and Paramedics --- Selected Locations, United States, 1991--2000 MMWR July 28 2000 49(29)660-5 http://www.cdc.gov/mmwr/preview/mmwrhtml/mm4929a3.htm

    Alternative Treatment     to index

    For discussion of some alternative approaches:
    NCCAM National Center for Complementary and Alternative Medicine
    You should get an accurate medical diagnosis, and should not try to treat the illness yourself. Further, "No complementary medicine or alternative medicine therapies have been scientifically proven to cure or even ease symptoms of hepatitis C." source Among other topics, covers: Alternative Care, Milk Thistle Studies of Milk Thistle in People, Other Herbs That May Help, Herbs That May Ease Interferon's Effects
    or go to homepage and do a search for hepatitis C source
    Coping with Hepatitis C: Diet and Nutrition The US Department of Veterans Affairs (VA) source What to do, how to eat, what to eat and why, how to overcome barriers to eating well

    Additional Hepatitis C Sites     to index

    One of the best overall treatments of the subject:
    Recommendations for Prevention and Control of Hepatitis C Virus (HCV) Infection and HCV-Related Chronic Disease, MMWR Recommendations and Reports October 16, 1998 / Vol. 47 / No. RR-19 U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES Centers for Disease Control and Prevention (CDC)

    "Hepatitis C is a viral disease of which most people have very little knowledge. Even physicians have trouble answering questions about the disease. Yet, HCV (Hepatitis C Virus) affects more people worldwide than the AIDS virus. In 1997, 20 million people were infected with HIV/AIDS compared to 40 million that were infected with HCV. After observing these staggering statistics, it is hard to believe that HCV is virtually non-existent in the public eye. Hopefully, after a clear and informative overview of hepatitis, some of the public ignorance surrounding this "silent epidemic" will be replaced with the inspiration to inquire further about this disease..."
    National Hepatitis C Coalition, Inc. source "coalition of patients and families dedicated to providing education and support through online communications, Hep C Hotline, and grassroots support groups across America." "We are advocates for increased awareness and recognition of the seriousness of hepatitis C, and our purpose is to help others learn how to live with it, while we all fight for stepped up research to find effective treatments, cures and vaccines."
    Jackson Gastroenterology Hepatitis C
    short but complete discussion (bed side manner but very thorough)

    Encyclopedias and General References     to index

    Your Online Hepatitis Encyclopedia
    Hepatitis-Central.com source covering Hepatitis A, Hepatitis B, Hepatitis C, Hepatitis D, Hepatitis E, Hepatitis G, Autoimmune Hepatitis, Hepatitis C Genotypes, etc. Over 2,000 searchable pages of hepatitis information.

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