Hepatitis C

The Center for Disease Control (CDC) is recommending that all “Baby Boomers,” individuals born between 1945 and 1965, be tested for Hepatitis C virus infection.  Adults who were born between these years make up 75 percent of hepatitis C infected adults.

Hepatitis is the general term used when the liver is inflamed.  There are many causes of liver inflammation ranging from autoimmune disorders to viruses to medications.  Some causes are acute and self-limited; others can lead to permanent and lethal liver damage.

The liver is located in the right upper part of the abdomen, just under the rib cage.  It performs many vital functions for the body including production of proteins and lipids, such as cholesterol and steroids; energy generation; storage of vitamins; detoxification of harmful substances in the blood; production of bile for fat digestion; and recycling old red blood cells’ hemoglobin.  

One of the most common causes of liver damage is excessive alcohol intake.  Alcohol that is absorbed into the blood stream must be metabolized by the liver for removal from the body.  Some of by-products of this metabolism are toxic to liver cells.  Chronic alcohol ingestion can lead to permanent scarring of the liver, or cirrhosis, preventing the cells from regenerating.  

Acetaminophen, a commonly used pain relieving drug, is one of many drugs that can poison the liver when taken at high doses.  Viruses such as hepatitis A, B and C, and the virus that causes mono are other common causes of liver inflammation.  Hepatitis A infection is contracted from contaminated foods; hepatitis B and C infections come from blood and body fluids exposure.           

When the liver is damaged, waste products begin to build up in the blood stream.  One of these products is bilirubin.  Bilirubin comes from the breakdown of hemoglobin, the oxygen carrying molecule in our blood.  When bilirubin levels rise, it deposits in the skin and other tissues.  This causes an orange-yellow discoloration called jaundice.

Symptoms of acute hepatitis can vary somewhat depending on the cause.  Commonly they include malaise, weakness, fever, headache, nausea, vomiting, diarrhea, body aches and abdominal pain.  High levels of bilirubin in the body can also cause itching of the skin.

Some individuals will develop chronic hepatitis, such as with hepatitis C, wherein symptoms can linger indefinitely.  Symptoms of more advanced liver damage are often due to the loss of the liver’s manufacturing capacities.  The liver makes important proteins that keep fluids in the bloodstream.  Without these proteins, fluids leak out of the blood vessels and the individual will develop excessive swelling in their tissues.  Also, clotting proteins are made by the liver.  Without these, there is easy bruising and bleeding.

There are some preventative maneuvers that can help protect us from hepatitis.  The hepatitis A and B vaccinations were developed to immunize individuals from these viruses.  They are now recommended with the other childhood vaccinations.  Proper hand washing, food preparation, and universal blood and body fluid precautions can greatly decrease the chances of contracting hepatitis A, B, and C.  

Check with your doctor to see if you need screening for the hepatitis C virus.  Also, to keep your liver healthy, avoid excess use of alcohol, particularly with medications or supplements that are also metabolized by the liver.  Use over-the-counter drugs and supplements judiciously and always check with your doctor before mixing medications.           

The content in this column is for informational purposes only.  Consult your physician for appropriate individual treatment.  Dr. Reynolds practices Family Medicine in Chesterfield.


Tough road

Tough road ahead in treatment of Hepatitis C, a lurking epidemic that already infects millions. http://www.healthcaretownhall.com/?p=2891

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