Hepatitis C

**Hepatitis C** is an infection that mostly affects the liver. The hepatitis C virus (HCV) causes this disease. Often, a person with Hepatitis C does not have any health problems or signs that they have the disease. However, chronic infection can scar the liver. Many years of infection may cause cirrhosis. Sometimes, people with cirrhosis also have liver failure or liver cancer. They can also have very swollen veins of the esophagus and stomach. The blood loss from this can kill. As far as scientists know, this virus does not cause disease in any animals other than humans.

The medications that are normally used to treat Hepatitis C are called peginterferon and ribavirin. Between 50 and 80% of people who are treated are cured. However, if a person's Hepatitis C has got worse so much that the person has cirrhosis or liver cancer, they might need a liver transplant (surgery where they are given another person's liver, or part of another person's liver). This makes it possible for the person to survive, but the Hepatitis C virus usually comes back after the transplant. There is no vaccine that works to prevent people from getting Hepatitis C.
## Signs and symptoms
Hepatitis C causes symptoms that begin quickly or last only a short time in just 15% of people with the disease. More often, infected people have symptoms that are not serious and not very specific, like not feeling like eating, feeling tired, nausea (feeling like throwing up), pain in the muscles or joints, and losing weight. If it is not treated, Hepatitis C goes away by itself in 10-50% of infected people (1 to 5 out of every 10). This happens more often in young women than in other infected people. Because the hepatitis C virus can cause cancer it is official classified as a carcinogen by the World Health Organisation (WHO). Among people in general, 27% of all cases of cirrhosis, and 25% of all cases of liver cancer, are caused by Hepatitis C.

Cirrhosis of the liver can cause many different symptoms. Some of these symptoms are high blood pressure in the veins that travel to the liver; a buildup of fluid in the abdomen, called ascites; easy bruising or bleeding; veins becoming larger than normal, especially in the stomach and esophagus; jaundice (a yellowing of the skin); and brain damage.

### Effects outside the liver 
Hepatitis C can also cause some problems which do not happen very often which affect parts of the body outside of the liver. One rare problem that Hepatitis C can cause is Sjögren's syndrome, an autoimmune disorder where the body's system of defenses attacks itself. Hepatitis C can also cause a lower-than-normal number of blood platelets (the part of the blood which causes blood to clot) without enough platelets, a person can have bleeding problems, or can start bleeding and be unable to stop. Other rare problems that Hepatitis C can cause are long-lasting skin disease; non-Hodgkin's lymphoma (a type of cancer); and diabetes (where a person's body does not make or use enough insulin, an important hormone that controls the level of sugar in the blood).

## Cause
Hepatitis C is caused by the Hepatitis C virus (HCV). There are seven major types of HCV, called "genotypes". In the United States, the first genotype of HCV causes 70% of all cases of Hepatitis C ; the second genotype causes 20%; and each of the other genotypes causes 1% . In 20% of all cases of Hepatitis C, it is not known what caused the infection, but many of these cases are thought to have been caused by intravenous drug use. One study that looked at 77 countries showed that in 25 of these countries (including the United States), between 60% and 80% of all IV drug users had Hepatitis C. and China.

#### Healthcare exposure
Peoples are at risk for getting Hepatitis C if they get blood transfusions (where a person is given blood from another person), blood products (which have blood or parts of blood in them), or organ transplants (where a person who needs a new organ is given an organ from another person), if these things have not been tested for the Hepatitis C virus. since 1992, only one in 10,000 to 10,000,000 units of blood carry the virus.

#### Sexual intercourse
Scientists do not know whether Hepatitis C can be spread through sex. Hepatitis C is more likely in people who have sexual actions which make them much more likely to get Hepatitis C. However, it is not known whether this is because of these people's sexual behavior, or because these people were also using IV drugs.

#### Body piercings 
People who get tattoos are about two to three times more likely to get Hepatitis C. This can be because of tools that are not clean or free of germs, or because the dyes used for tattooing are contaminated (the Hepatitis C virus has gotten inside of them).

#### Contact with blood
Because Hepatitis C is spread by blood-to-blood contact, personal-care tools which come into contact with blood - like razors, toothbrushes, and manicure or pedicure equipment or any other kind of blood to blood contact - can spread the disease if they are shared.

#### Transmission from mother to child
Although this does not happen very often, a pregnant woman who has Hepatitis C can give the disease to her baby when it is born, or to her fetus while she is pregnant. If a pregnant woman has Hepatitis C, nothing can be done to make her less likely to give her baby the disease. or her viral loads (the amount of the Hepatitis C virus in her blood) are high. Because people with chronic Hepatitis C often have no symptoms for decades, Testing everyone is not recommended in the United States.

## Prevention
As of 2012, there is no vaccine that works to prevent Hepatitis C. Researchers are working on vaccines, and some are making progress. The spread of Hepatitis C can be prevented by using a combination of strategies, like needle exchange programs, where IV drug users can get clean needles which will not spread the virus and treatment for drug abuse. If these strategies are used together, the risk of IV drug users getting Hepatitis C drops by about 75%. Within each country screening blood donors is important. So is using universal precautions in healthcare facilities. Although this almost never happens, chronic Hepatitis C can sometimes clear up on its own, without treatment. Side effects with treatment are common; half of people treated get flu-like symptoms, and a third have emotional problems.

Some supporters of alternative medicine say that alternative therapies like milk thistle, ginseng, and colloidal silver can be helpful for Hepatitis C. However, there is no proof that any alternative therapy has any effect on the Hepatitis C virus.

## Likely outcome
People respond differently to treatment, depending on which of the Hepatitis C virus genotypes they have. About 40-50% in people with genotype 1 have a good, stable response with 8–48 weeks of treatment.

## Epidemiology
 for hepatitis C in 2004 per 100,000 inhabitants

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Between 130 and 170 million people, or about 3% of all of the people in the world, are living with chronic Hepatitis C.

Infection rates are higher in some countries in Africa and Asia. Countries with very high rates of infection include Egypt (22%), Pakistan (4.8%) and China (3.2%). The high rate in Egypt is linked to a now-discontinued mass-treatment campaign for schistosomiasis, using improperly sterilized glass syringes. In 1988, Alter confirmed the virus by verifying its presence in a panel of non A non B hepatitis specimens. In April 1989, the discovery of HCV was published in two articles in the journal *Science*. The discovery led to significant improvements in diagnosis and improved antiviral treatment.

Chiron filed for several patents on the virus and its diagnosis. A competing patent application by the CDC was dropped in 1990 after Chiron paid $1.9 million to the CDC and $337,500 to Bradley. In 1994, Bradley sued Chiron, seeking to invalidate the patent, have himself included as a coinventor, and receive damages and royalty income. He dropped the suit in 1998 after losing before an appeals court.

## Society and culture
The World Hepatitis Alliance coordinates World Hepatitis Day, held every year on July 28. The economic costs of hepatitis C are significant both to the individual and to society. In the United States the average lifetime cost of the disease was estimated at US$33,407 in 2003, with the cost of a liver transplant approximately US$200,000 as of 2011. while the United States costs are between 9,200 and 17,600 in 1998 USD.

## Research
As of 2011, about one hundred medications are in development for hepatitis C. These medicines include vaccines to treat hepatitis, immunomodulators, and cyclophilin inhibitors. These potentially new treatments have come about due to a better understanding of the hepatitis C virus.

## References