Understanding Hepatitis C
Wednesday, July 16, 2014

Dr. Jacqueline Riedel

One of the main goals of primary care physicians is to practice preventive medicine: that is, preventing onset of disease, or identifying disease early so as to avoid poor health outcomes in the future.

To that end, your doctor may request that you undergo screening tests on a routine basis. You may be familiar with many of these procedures; mammograms, pap smears, prostate exams and colonoscopies all fall under the “screening” umbrella. One of the newer recommended screening tests is a one-time blood test for hepatitis C in patients born between 1945 and 1965. This recommendation -- supported by the Centers for Disease Control and Prevention (CDD), and the U.S. Preventive Services Task Force -- is advised for all members of the Baby Boomer generation without regard to risk factors. According to the USPSTF’s findings, 75% of all current Hepatitis C infections are in this age group.

So, you may be asking, What is Hepatitis C?  Why be screened? What are the long-term effects of untreated infection? Is there a vaccine that could help me? Read on for more information, then speak to your healthcare provider.

Hepatitis is a general term for inflammation of the liver, which can occur for a variety of reasons: fatty infiltration, autoimmune damage, and viral illnesses. Some of the more common viral causes are infections you may have heard of: Hepatitis A, B and C.  Hepatitis A is typically a foodborne illness caused by poor hand hygiene; there is a vaccine available, but the virus tends to resolve itself without treatment. Hepatitis B is transmitted through contact with bodily fluids of an infected person; a vaccine is available.

Hepatitis C is transmitted through contact with the blood of an infected person. This most commonly occurs through injection drug use; other known routes of transmission include receipt of blood transfusion prior to 1992, birth to an infected mother, and needle stick injuries. Persons who are infected often have no signs of acute illness, so the infection goes undetected until symptoms develop – often many years after the illness was first contracted. Hepatitis C tends to “smolder,” slowly damaging the liver over decades.  I have personally diagnosed a number of patients after an abnormal liver enzyme test; they usually have no complaints, and cannot identify any exposure to the virus.

Unfortunately, there is no vaccine available to prevent contracting hepatitis C. Traditional treatment regimens have required months of medications, with often intolerable side effects and varying efficacy. However, recent pharmaceutical advances have greatly improved the tolerability of treatment regimens.

The new screening recommendations I mentioned earlier in this column attempt to encompass people most likely to have been exposed to the virus during the 1970s and 1980s,  when the incidence of new infection was highest. Even if you don’t believe you have any risk for the virus, please discuss the screening test with your doctor – it could save your liver, and your life.

Dr. Jacqueline Riedel is a Family Medicine physician and a member of the Kennedy Health Alliance. She practices in West Deptford, NJ, and can be reached by calling 856-384-0210