Saturday, October 15, 2016

Hepatitits C: Symptoms - Screening - Diagnosed

Source: CDC


The incubation period for hepatitis C is 2 weeks to 6 months. Following initial infection, approximately 80% of people do not exhibit any symptoms. 

Those who are acutely symptomatic may exhibit fever, fatigue, decreased appetite, nausea, vomiting, abdominal pain, dark urine, grey-coloured faeces, joint pain and jaundice (yellowing of skin and the whites of the eyes).

Most people do not have any symptoms until the hepatitis C virus causes liver damage, which can take 10 or more years to happen. Others may have one or more of the following symptoms:
  • feeling tired
  • muscle soreness
  • upset stomach
  • stomach pain
  • fever
  • loss of appetite
  • diarrhea
  • dark-yellow urine
  • light-colored stools
  • yellowish eyes and skin, called jaundice
When symptoms of hepatitis C occur, they can begin 1 to 3 months after coming into contact with the virus. See a doctor right away if you or a child in your care has symptoms of hepatitis C.

Getting tested

Early diagnosis can prevent health problems that may result from infection and prevent transmission of the virus. WHO recommends screening for people who may be at increased risk of infection.

Populations at increased risk of HCV infection include:
  • people who inject drugs;
  • people who use intranasal drugs;
  • recipients of infected blood products or invasive procedures in health-care facilities with inadequate infection control practices;
  • children born to mothers infected with HCV;
  • people with sexual partners who are HCV-infected;
  • people with HIV infection;
  • prisoners or previously incarcerated persons; and
  • people who have had tattoos or piercings.

Screening and Diagnosis

Due to the fact that acute HCV infection is usually asymptomatic, few people are diagnosed during the acute phase. In those people who go on to develop chronic HCV infection, the infection is also often undiagnosed because the infection remains asymptomatic until decades after infection when symptoms develop secondary to serious liver damage.

HCV infection is diagnosed in 2 steps:
  1. Screening for anti-HCV antibodies with a serological test identifies people who have been infected with the virus.
  2. If the test is positive for anti-HCV antibodies, a nucleic acid test for HCV ribonucleic acid (RNA) is needed to confirm chronic infection because about 15–45% of people infected with HCV spontaneously clear the infection by a strong immune response without the need for treatment. Although no longer infected, they will still test positive for anti-HCV antibodies.

After a person has been diagnosed with chronic hepatitis C infection, they should have an assessment of the degree of liver damage (fibrosis and cirrhosis). This can be done by liver biopsy or through a variety of non-invasive tests.

In addition, these people should have a laboratory test to identify the genotype of the hepatitis C strain. There are 6 genotypes of the HCV and they respond differently to treatment. Furthermore, it is possible for a person to be infected with more than 1 genotype. The degree of liver damage and virus genotype are used to guide treatment decisions and management of the disease.

How Hepatitis C Diagnosed
A blood test will show if you have hepatitis C. Blood tests are done at a doctor’s office or outpatient facility. A blood sample is taken using a needle inserted into a vein in your arm or hand. The blood sample is sent to a lab to test for hepatitis C.

If you are at higher risk of getting hepatitis C, get tested. Many people with hepatitis C do not know they are infected.

Your doctor may suggest getting a liver biopsy if chronic hepatitis C is suspected. A liver biopsy is a test to take a small piece of your liver to look for liver damage. The doctor may ask you to stop taking certain medicines before the test. You may be asked to fast for 8 hours before the test.

During the test, you lie on a table with your right hand resting above your head. Medicine is applied to numb the area where the biopsy needle will be inserted. If needed, sedatives and pain medicine are also given. The doctor uses a needle to take a small piece of liver tissue. After the test, you must lie on your right side for up to 2 hours. You will stay 2 to 4 hours after the test before being sent home.

A liver biopsy is performed at a hospital or outpatient center by a doctor. The liver sample is sent to a special lab where a doctor looks at the tissue with a microscope and sends a report to your doctor.

What can be done

US government is
  • Working together with many federal agencies to carry out the Strategic Action Plan for Viral Hepatitis.
  • Funding programs that support hepatitis C testing and getting people linked to care and treatment.
  • Educating doctors, nurses, and other health care providers about hepatitis C, developing clinical tools and issuing updated guidance to help carry out recommended testing.
  • Working with states and communities to improve reporting of hepatitis C test results in order to get people needed services.
  • Increasing coverage under the Affordable Care Act so more people will have health insurance for testing and treatment.
State and local public health departments can
  • Let people know where they can get blood tests for hepatitis C.
  • Follow-up with health care providers and laboratories for people who have a positive hepatitis C antibody test but have no record of a follow-up test.
  • Monitor and report people with hepatitis C infection and promote best practices for testing and linking patients to care.
Doctors, nurses, and other health care providers can
  • Set up systems to make to make sure all patients born from 1945 through 1965 are tested for hepatitis C.
  • Test patients with other risks for hepatitis C, including blood transfusions before 1992 or injection drug use.
  • Make sure everyone who has a positive hepatitis C antibody test gets the follow-up blood RNA test and is linked to lifesaving care and treatment if infected.
Baby boomers and all persons at risk can
People living with hepatitis C can
  • Eat a healthy diet, stay physically active, see a doctor on a regular basis and ask if you could benefit from new and better treatments.
  • Talk to your doctor before taking over the counter medicines and avoid alcohol because they can cause liver damage.
  • Reduce the risk of transmission to others by not donating blood or sharing personal items that might come into contact with blood.


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