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Hepatitis C: Born between 1945 and 1965?

Hepatitis C: Born between 1945 and 1965?

Hepatitis C is a liver infection caused by the Hepatitis C Virus (HCV). CDC estimates there were 41,200 acute cases of HCV in 2016. An estimated 3.5 million people in the U.S. have chronic HCV. Although felt to be a conservative estimate, 18,153 U.S. death certificates had HCV recorded as an underlying or contributing cause of death in 2016.

Transmission

High-risk:

·         Exposure to infected blood or body fluids containing blood

·         Can survive outside of the body for up to 3 weeks

Infrequent risk:

·         Sex with an HCV-infected person

·         Sharing personal items contaminated with infectious blood, such as razors or toothbrushes

·         Healthcare procedures, such as injections

·         Unregulated tattooing (HCV can linger in tattoo needles and dye)

No risk:

·         Is not spread by sharing eating utensils, breastfeeding, hugging, kissing, holding hands, coughing, sneezing, or through food or water

Acute Hepatitis C: Newly infected

Symptoms usually appear 2-12 weeks after exposure:

· None or mild

· Fever

· Fatigue

· Dark urine

· Clay-colored stool

· Abdominal pain

· Loss of appetite

· Nausea and vomiting

· Joint pain

· Jaundice (yellowing of the skin or whites of the eyes)

Chronic Hepatitis C

· Becomes chronic in 75%–85% of cases. This occurs when the body’s immune response is unable to fight the rapidly multiplying virus

· Most people have no or few symptoms

· Causes chronic liver disease: cirrhosis (liver scarring), liver failure, and liver cancer

· Chronic liver disease is usually silent, progressing slowly without symptoms for several decades

Who Should Be Tested

· Current or former injection drug users, including those who injected only once many years ago

· Everyone born from 1945 through 1965

· Recipients of clotting factor concentrates made before 1987 (treatment for hemophilia, an inherited bleeding disorder in which the blood does not clot properly)

· Recipients of blood transfusions or solid organ transplants prior to July 1992

· Chronic dialysis patients

· People with known exposures to HCV: healthcare workers after needle sticks; recipients of blood or organs from a donor who tested HCV-positive; children born to HCV-positive mothers

· Incarcerated persons

· People who get an unregulated tattoo (HCV can linger in tattoo needles and dye)

Approximately 15%–25% of people clear the virus from their bodies without treatment and do not develop chronic infection. Prior infection with HCV does not protect against later infection with the same or different genotypes of the virus.

· HCV has 7 genotypes with more than 67 subtypes

· Genotype identification is helpful when making a treatment plan

· In the U.S., HCV genotype 1 is most common, accounting for approximately 70% of cases

Diagnosis: Lab testing

Screening tests for HCV antibody:

· Antibodies are the body’s immune response to fighting the disease: Positive or Negative for HCV antibodies

· If negative, there is no infection or it’s too early after exposure to test (can be detected in >97% of people by 6 months after exposure)

· Once positive, this test is always positive (you always have antibodies in your blood)

HCV RNA

· RNA (ribonucleic acid): genetic material of HCV

· Measures the amount of HCV in the blood (viral load)

· Used to monitor the effectiveness of treatment

Treatment

· Patients with acute HCV are followed and considered for treatment if HCV RNA persists after 6 months

· Greater than 90% of HCV infected persons can be cured of HCV infection with 8-12 weeks of medication

There is no vaccine for HCV.

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