Julien's Journal May 2016 (Volume 41, Number 5) | Page 32
Did You Know Hepatitis C is
Now Curable?
Poorani Sekar, M.D. was born in the US and raised
in India. She graduated from Marshall University in
2003, finished medical school at UNMC in 2008, did
an internal medicine residency and Infectious Disease
fellowship at the University of Minnesota. She completed her training in 2013 and is Board Certified in
Internal Medicine and Infectious Diseases. Dr. Sekar
has been practicing in Dubuque since November
2014. She is a member of the AMA, ACP, and IDSA.
She enjoys educating the general public on current
medical issues (hepatitis C, Zika, etc.) and is now giving talks in and around Dubuque.
by Dr. Poorani Sekar, M.D.
R
ecently there has been a barrage
of commercials on TV, magazines, and the radio about “the silent killer:” hepatitis C. Hepatitis
means inflammation of the liver
(Greek “hepat” – liver, “itis” – inflammation). This can be caused by viruses, alcohol,
or drugs. The most common viruses that
cause hepatitis are the hepatitis viruses A
through C. The virus uses the patient’s cells
to replicate itself and causes inflammation
of the liver cells in the process. An estimated 3.5 million people in the United States
are infected with the hepatitis C virus
(HCV). This figure is under reported since
incidence/prevalence research doesn’t take
in to account people who are homeless,
in jail, on Native American reservations,
in nursing facilities, etc. About 70% of patients infected with hepatitis C do not know
they have the virus.
HCV is a blood borne virus, which is pri28 ❖ Julien’s Journal ❖ May 2016
marily transmitted by sharing needles
while using injection drugs. Other ways
of acquiring the virus include receiving
unscreened blood, clotting factors, and
organ transplants prior to 1992. The baby
boomers (born 1945-65) are at higher risk
of hepatitis C (five times the risk of the general population) and it is postulated they
might have had unscreened blood products or experimented with drugs and sex.
Hepatitis C spreads less commonly through
unprotected sex, from mother to child, and
sharing personal care items such as razors
or toothbrushes. The virus is not spread
through the sharing of eating utensils, food
or water, hugging, kissing, or coughing.
There have been misconceptions in the
community, as well as with fami ly members of patients with hepatitis C, that the
disease is spread through casual contact
such as hugging, using shared utensils, etc.,
so there has been a lot of discrimination
against patients with hepatitis C.
Almost 70 – 80% of people do not have any
symptoms when they contract this illness.
A minority of people have symptoms of
fevers, jaundice, vomiting, dark urine, or
pale stools. For every 100 people infected
with hepatitis C, 15 – 25 clear the virus
without treatment, 75 – 85 develop chronic
infection, 60 – 70 have changes in the liver,
five to 20 will go on to develop cirrhosis
(scarring and malfunctioning) of the liver,
and one to five people will die from the cirrhosis or liver cancer. About 15,000 people
die from this illness every year in the United
States. There are certain risk factors which
may hasten the progression of liver disease
and cirrhosis such as being male, middle
aged, coinfection with HIV and hepatitis
B, diabetes, obesity, alcohol, and drug use.
Conversely, being female, younger, Caucasian, drinking coffee, and low viral level to
begin with, can predict a slower progression or spontaneously clearing the virus.
Patients should talk to their doctors about
getting tested for hepatitis C if they were
born between 1945 and 1965, used injection drugs (even if only once many years
ago), received any blood products or organ transplants before 1992, have had
abnormal liver tests, had unprotected sex,
or work in the health care field and were
exposed to blood through a needle stick
injury.
The test used initially to screen for this
disease is called HCV serology, which is a
simple blood test that looks for exposure
to hepatitis C by checking for antibodies
in the blood. Antibodies are what the body
makes when exposed to a pathogen as a
self-defense to try and protect us from
getting the illness. Having an antibody to a
specific pathogen in the blood indicates ex-