Hepatitis C Transmission

The skin and mucous membrane of the human body form a fairly good barrier against external invaders. Is Hep C Curable? The Hepatitis C virus cannot simply cross this barrier by itself and infections can only occur if this natural barrier

damaged locally. This occurs, for example, with transfusion with contaminated blood or blood products, use of contaminated surgical instruments or needles. 

Before 1991, Hepatitis C infection was a risk for recipients of blood transfusion and for people with hemophilia (bleeding disease) who were treated with a coagulation preparation made from human blood. In 1991 an extensive check of blood and blood products for Hepatitis C virus was introduced by the blood banks in the Netherlands. 

Since that time, the chance of being infected with Hepatitis C when administering blood or blood products, for example for the treatment of hemophilia, has been processed in such a way that the chance of infection is almost completely excluded. 

Another large group of infected people are drug addicts who spray dirty needles or use common straws to sniff cocaine. This also applies to people who, even once, have injected drugs. 

In more than a third of patients with Hep C Curable, however, it is not possible to indicate how the infection has contracted. Possible factors that played a role here include tattoos, common use of razor blades or toothbrushes, contact with contaminated blood in the event of an injury to the skin or mucous membranes, operations. 

Because, as mentioned, the skin and intact mucous membranes form a good barrier against the virus, there is no risk in normal intercourse with Hep C Curable patients, such as in the family, cuddling and kissing and intercourse at work or in the same class for contamination.

What Causes Hepatitis C?

  • Blood transfusion before 1991
  • Infusion of blood products before 1991
  • Drug injection using dirty needles

 Possible risk factors:

  • Operations
  • Interventions in the teeth
  • Puncture with contaminated needles
  • Common use of razor blades or toothbrushes
  • Tattoos
  • Piercing

Very low risk factors:

  • Birth
  • Sexual contact (?)

No risk factors:

  • Being with an infected patient
  • Hugging and kissing

How does a Hepatitis C infection proceed? 

The incubation time is five to 12 weeks. Infection with Hepatitis C only rarely gives rise to disease symptoms, also known as Early Symptoms of Hep C. Symptoms such as jaundice are present in less than 10% of people during acute inflammation. Only in very exceptional cases does the acute phase give rise to life-threatening complications. Although an acute infection generally does not cause any symptoms, it does lead to a chronic liver disease in more than 80% of the cases.

This chronic inflammation often proceeds insidiously with no or very few complaints. It may take 10 to 30 years before any symptoms occur. Sometimes the disease only expresses itself through fatigue; rarely do other symptoms occur such as joint pains, skin abnormalities, or in rare cases jaundice. 

The infection is often discovered by chance, for example during the blood bank examination or during a general examination, whereby the functioning of the liver is often also examined. Increased concentrations of certain liver enzymes are then found in the blood. These are certain proteins that occur in the liver cells and are released to an increased extent in the blood during inflammation of the liver. 

The chronic inflammation can be erratic, with periods of increased virus activity alternating with periods in which there is hardly any inflammation. Nevertheless, after years, most patients develop a scarring of the liver. Fibrosis is the collective name for minimal to severe scarring of the liver, however, the rate of fibrosis may improve with decreasing liver inflammation. 

What are the chances of getting Hep C sexually?

Cirrhosis is an irreversible change in the liver due to scars. Cirrhosis can be present for years without symptoms and can be found by chance. In the end, some of the people who have a liver failure or the effects of blood thrust flowing through the liver, will eventually develop liver cancer after many years. On the other hand, in some patients the Hep C Curable virus may be present for years without giving rise to any form of liver inflammation or complications thereof. 

Cirrhosis can be present for years without symptoms and can be found by chance. In the end, some of the people who have a liver failure or the effects of blood thrust flowing through the liver, will eventually develop liver cancer after many years. On the other hand, in some patients the Hepatitis C virus may be present for years without giving rise to any form of liver inflammation or complications thereof. 

Cirrhosis can be present for years without symptoms and can be found by chance. In the end, some of the people who have a liver failure or the effects of blood thrust flowing through the liver, will eventually develop liver cancer after many years. On the other hand, in some patients the Hepatitis C virus may be present for years without giving rise to any form of liver inflammation or complications thereof.

How does a Hepatitis C infection manifest itself?

In the acute phase or in an advanced disease, Hepatitis C can sometimes manifest itself with signs of liver damage such as jaundice, abdominal fluid, swollen liver and spleen or bleeding from the esophagus veins. In addition, there may be complaints such as fatigue, which, however, also occurs with other diseases. 

However, Hepatitis C is usually found by chance following blood tests that also test liver function. Sometimes a surprise virus is also found in candidate blood donors because the blood is always checked for Hepatitis C

How is Hepatitis C Diagnosed?

Specific or increased levels of liver enzymes in the blood raise the suspicion of a virus hepatitis. Since 1991, it has been possible to detect virus antibodies against the Hepatitis C virus in the blood of patients. Because the screening test is not 100% reliable, a positive test result must always be confirmed. 

A negative result indicates the absence of Hepatitis C. With an acute infection it can sometimes take many weeks for the body to produce antibodies. Then it may be necessary to do a complex additional test for the RNA virus itself. This research can only take place in specialized laboratories.

If an active virus infection is detected, then it must be investigated how severe the inflammation is and to what extent damage to the liver has already occurred. Physical examination assesses the size of the liver and spleen and looks for signs of poor functioning of the liver, such as jaundice. This examination is supplemented by a sound photograph (ultrasound) and blood test. If this is found that although there is Hepatitis C virus in the blood, there is no inflammatory activity in the liver and there is also no liver injury present, it will be decided to wait. 

There may then be a carrier without activity or there may be a quiet phase in the sometimes erratic course of inflammation. For this reason, the blood will be tested again after a few months. If, however, the presence of Hepatitis C is found with active inflammation of the liver, the patient will often be referred to a specialist center. 

Here it will be assessed whether antiviral agents should be started. In this assessment, it will often be necessary to remove a piece of tissue (biopsy) from the liver in order to obtain more certainty about the nature and severity of the condition using a microscope. 

How can Hepatitis C be Prevented?

Unfortunately, there is no vaccine or other medicine that protects against Hepatitis C. However, measures can be taken to prevent the transmission of Hepatitis C.

Medicine: 

  • Screening   of blood for donation for Hepatitis C.
  • Use disposable instruments
  • Sterilization of other medical instruments
  • Virus inactivation of blood products (eg Heat treatment)

The patient: 

Avoiding the joint use of sharp objects (needles, razor blades, toothbrushes, scissors and knives Avoid tattoos)

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