Hepatitis C and the link to liver cancer

Doctors recommend everyone should have at least one blood screening for hepatitis C in their lifetime.

Detect early

If detected early, it’s easy to cure this viral infection before it progresses further. 

Hepatitis C is an infectious disease caused by the hepatitis C virus that infects the cells of your liver. The virus can remain in your blood for up to 20 years without apparent symptoms, until it causes inflammation and damage to the liver. This could develop into chronic hepatitis, cirrhosis (scarring of the liver), or liver cancer.

Risk factors for infection

“Hepatitis C is not an inherited disease; it is acquired,” explains Dr Lesiba Mashitisho, a physician (internal medicine) at Mediclinic Legae. “It is a blood-borne pathogen, and a person becomes infected when they’re exposed to blood or blood products infected with the hepatitis C virus.”

The risk factors associated with acquiring hepatitis C are:

• Receiving infected blood, blood products or organs
• Being exposed to needle injury
• Having multiple sexual partners.

Patients with kidney disease on haemodialysis are also at risk if exposed to infected dialysis machines that have not been sterilised between patients.

The risk factors for progressing to chronic hepatitis C are:

• Consuming alcohol 
• Being male  
• Being older than 40
• Being co-infected with HIV and/or hepatitis B.

“Those who eventually develop the chronic disease end up with cirrhosis and liver decompensation (acute deterioration in liver functioning). Hepatitis C infection, with or without liver cirrhosis, results in a patient developing hepatocellular carcinoma (liver cancer),” says Dr Mashitisho.

Diagnosis

People at high risk must be tested for hepatitis C infection. The virus is diagnosed by testing for hepatis C antibodies and by doing a hepatitis C polymerase chain reaction (PCR) test. The hepatitis C viral load (HCV RNA) PCR quantitative test measures the amount of hepatitis C virus in the blood.

Symptoms

A person infected with hepatitis C may not show symptoms. Those with symptoms develop within seven weeks and these symptoms may continue for six months. “Chronic hepatitis C occurs when the acute infection continues beyond six months,” says Dr Mashitisho.

The symptoms of hepatitis C infection include, and are not limited to:

• nausea
• vomiting
• loss of appetite
• yellow eyes
• grey-coloured stool
• dark urine
• fatigue
• malaise (feeling ill or uncomfortable)
• abdominal discomfort.

Prevention and treatment

“Hepatitis C is a curable condition,” says Dr Mashitisho, who explains that although no vaccine for hepatitis C exists, it can be treated. “The treatment involves direct-acting antiviral therapy (DAA). Some individuals are co-infected with hepatitis B virus or with HIV, and this category is managed a bit differently.” He adds that the disease can be prevented by:

• Avoiding exposure to infected blood or infected blood products
• Never using unsterilised needles
• Practising safe sex.

“Hepatitis C is a global health problem and it’s advisable to prevention the infection in the first place,” he says. “While the infection can be cured, it can also progress to a chronic infection if left untreated. Hepatitis C is a risk factor for liver cirrhosis and liver cancer and subsequent liver decompensation and death. It’s important to be aware of the disease and have a blood screening test for the virus.”