Monday, January 21, 2008

A Summary of Chronic Hepatitis C Infection

Hepatitis C is a stealthy virus that mutates while hiding in liver cells and other organ cells like the spleen and gall bladder. The fact that the viral cells "hide" makes it very difficult for the body's immune system to eradicate it. Hepatitis C is a slowly progressing disease sometimes taking many years until symptoms are noticeable. It is at this point that the virus has reached advanced chronic stage and becomes difficult to eradicate. Hepatitis C results in 8,000 to 10,000 deaths annually. Hepatitis C is also the leading cause of liver transplants in the U.S.

Hepatitis C infection is caused by blood contact with someone who has the virus infection himself. The transmission of the virus can occur by illicit drug use with needles, sharing toothbrushes or razors with an infected person, by sexual means, by unsanitary tattooing or by exposure to blood at your workplace (like a hospital or blood bank). Some HCV infection may have been caused by receiving blood from a transfusion prior to 1992.

Hepatitis C is diagnosed via a blood test. Usually, the first thing that is noticed is that the liver enzyme levels for ALT and AST are elevated well above normal levels. Further investigation via HCV-RNA testing identifies whether the Hepatitis C virus is in your blood or not. Other tests for HCV include qualitative viral load tests, which measure the RNA particles in your blood. If you are being treated for HCV, your doctor is probably using either a HCV-RNA or viral load test to determine the effectiveness of the treatment.

The symptoms of Hepatitis C infection often do not occur in a person until 20 years after he/she had been infected. Since the HCV infects the liver and the liver is the organ in the body that makes all the energy for our daily activities possible, liver function deterioration often results in fatigue.

Fatigue is the primary complaint or symptom of HCV infection. Other more severe symptoms are jaundice (yellowing of the skin/eyes), bile retention (which can cause jaundice), portal vein hypertension, skin rashes and itching, and autoimmune problems resulting from your body's immune system attacking normal cells.

Long term HCV infection may result in fibrosis or even cirrhosis of the liver. Fibrosis results from unchecked liver inflammation. As the HCV infection progresses, the damage to the liver results in scarring or hardening of the liver cells (fibrosis). Long term fibrosis may lead to cirrhosis which is when the scarring from fibrosis overtakes the normal liver cell structure causing deformity and loss of function in the liver. About 15%-20% of HCV patients end up with cirrhosis. A liver biopsy is currently the most accurate means of determining the amount of inflammation and fibrosis the liver has sustained.

Hepatitis C progression in the body can take several years or even decades to come to chronic stage or to a stage where severe liver damage is evident. This period of time allows a person to determine how to properly treat the disease and to decide on a course of disease management. Currently, the main treatment for HCV infection to eradicate the virus is combo alpha-interferon and Ribavirin. Sometimes a doctor may prescribe interferon alone. Interferon comes in standard form or in pegylated form. Standard form interferon is administered 3 times per week, while the pegylated form is administered only once per week. Your body makes its own interferon, which is a protein that fights viral infection and viral replication.

Hepatitis C may often be managed by taking herbal and vitamin supplements that help your body fight infection and limit inflammation. These supplements help your liver with the inflammation and give it the nutrients it needs to regenerate healthy new cells. Your doctor can recommend alternative or adjunct solutions you may want to try.

Proper treatment of the disease, a healthy and active lifestyle, a good diet, abstinence from alcohol and stress management are important factors in controlling Hepatitis C progression.

Surviving in the Hospital

Being placed in a hospital is not a guarantee that you are going to get the best treatment possible. As a patient, you need to do all you can to make certain you get the best possible care while you are there. If you are unable to do so, your family must handle this for you.

Discuss this with your family before you ever end up in the hospital. Everyone in your family should understand what needs to be done.

If you are receiving any treatments, know what the treatments are for and make certain they are a necessity. Ask if there are any side effects.

Make sure you are in the hospital that is best for your condition. For example, if you have a heart condition and may be in need of a bypass, ask your doctor if this is the best hospital in your area to perform this. Some hospitals have better success rates in different procedures and it is important you are in the correct facility. Your doctor should not be offended if you ask this and, if he or she is, you might want to consider finding another doctor.

If you have medications at home, you can save a lot of money bringing them in. Most hospitals send your medications to the lab to make certain they are what they are supposed to be. The lab then returns them to the nurses area that is taking care of you. They use your medications and return the ones that are left when you leave.

Exercise your right to say no. If you are sleeping good, say no to sleeping pills. If you are not in pain, you can tell them you do not want your pain medication until you actually need it.

If your nurse gives you a pill you are unfamiliar with, ask them what the pill is, why it has been prescribed to you, and what the side effects are. If you are on anti-rejection medications for a kidney transplant you have had, for instance, make certain they contact the hospital that performed that operation and verify the medication does not counteract these medicines.

Insist your bathroom is cleaned and disinfected daily. Make certain doctors and nurses have washed their hands thoroughly before you let them examine you.

If your medications are not taking care of your problem, ask your nurse to contact the physician and have them prescribe a new medication, or up the dose. For example, if you are still in pain after taking a pain medication, let the nurse know you need something else as your pain will not go away.

These steps are important. Remember, the hospital is full of people with different diseases. A high number of patients contract a disease they did not have before they arrived.

Many patients receive operations they did not need. Get a second opinion.

The nursing staff is busy. They may be giving you a morphine shot when you are allergic to morphine. It happens.

Take charge when you are in the hospital and make certain there are family members who can do so if you are unable to. The idea is to receive proper treatment and make a recovery. Do not be concerned you will offend anyone. You have a right to the best care you can receive.