Question on Hepatitis C

Dear Spence,
Should I be screened for hepatitis C? I know that it can result in liver cirrhosis and I want to make sure I’m not infected.
Signed,
Ura Medic

Dear Ura,
Hepatitis C is a virus that is generally transmitted through blood or blood products or via sexual contact. It ranks second in the United States behind alcohol as a cause of liver disease and is the leading indication for liver transplantation. Fifteen to twenty percent of those infected will clear the virus without consequence whereas the remaining 80% will suffer from chronic hepatitis C. Twenty to fifty percent of those may ultimately develop liver cirrhosis within 10-20 years. Liver cancer or liver failure occurs in one-half of those who developed cirrhosis. Unlike hepatitis A and B, there is no vaccine to prevent the disease. Most people with the virus were contaminated as a result of blood transfusions given prior to 1992 when blood products were not adequately screened for the virus. Most people remain asymptomatic for years and are diagnosed "accidentally" after having been found to have abnormal liver function testing. Treatment is directed at trying to prevent viral replication. The most common used agent is interferon alpha, an injectable drug that is given three times a week. Unfortunately, only 1/5 who take it may show a clinical response. Side effects include depression, flu-like symptoms and suppression of white blood cell counts. Data suggests that interferon may be more effective if taken for at least one year. On top of the interferon therapy, lifestyle changes are extremely important. Patients should avoid alcohol consumption and medications that may contribute to or accelerate liver damage (i.e. Tylenol). They must be cautioned about the potential exposure to others. Wounds should be covered, sharing of toothbrushes and razors should be discouraged, and care should be taken with regards to sexual contact. So, should you be screened? The following risks should prompt immediate evaluation for hepatitis C as formal symptoms maybe lacking. 1) exposure to blood 2) received an organ transplant prior to 1992 3) had dialysis for kidney failure 4) received a blood transfusion or clotting factors prior to 1992 5) had tattoos, piercings or acupuncture using unsterile equipment 6) used illicit intravenous or intranasal drugs.