Hepatitis C: Should You Be Tested?

For at-risk people, the answer is yes, and soon!

The hepatitis C virus (HCV) is the leading cause of liver failure, liver cancer, and liver transplantation in the U.S. Estimates are that HVC kills more than 10,000 Americans each year.

So, who's at-risk?

  • Those who inject or have injected illicit drugs--even once
  • Those with sexual exposure to a partner infected with HCV or with multiple sexual partners
  • People with HIV/AIDS
  • Patients undergoing hemodialysis for chronic renal failure
  • Those whose liver transaminase enzymes are elevated for no known reason
  • Recipients of organ transplants or blood transfusions or both before 1992, when sensitive tests for HCV first became widely available
  • People who come into contact with blood or body fluids from an HCV-infected person
  • More rarely, HCV can be transmitted when the needles used in tattooing or acupuncture have not been properly sterilized.

How can you tell if you have HCV?

Chronic HCV is not associated with any symptoms until it has produced significant liver disease. When symptoms do start to show--which can take years--they may range from fatigue and stiff joints to dark urine and jaundice (where the skin, the whites of the eyes, and the mucus membranes are stained orange-yellow by excess bilirubin in the blood). The diagnosis is made by testing the patient's blood for the presence of antibodies to HCV and HCV's RNA, tiny molecules of HCV's genetic material.

Seek treatment early

A recently published study showed that the 2 standard treatments for HCV are equally effective. Those treated early, however, had success rates that were double those of the people treated at more advanced stages of the disease. So, if you fall into the at-risk group designated above, get your blood tested at once.

An early diagnosis of course improves the likelihood of an early and successful treatment. Success is defined as the absence of HCV RNA 24 weeks after treatment has been completed, but it is not really known whether this insures that no further liver damage will occur. Standard treatment lasts for 48 weeks.

Knowledge is key

The key to preventing the virus from infecting others is for the infected person to become well informed about hepatitis C and to understand how it is spread. Simple precautions such as not sharing toothbrushes or shaving equipment, or being sure to cover bleeding wounds can help stop its spread. These measures are in addition to avoiding the at-risk behaviors in the bulleted list above.

For further information about blood and body-fluid precautions for HCV, visit the website of the Centers for Disease Control and Prevention.

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