JAMA PATIENT PAGE | Infectious Diseases
Hepatitis C Hepatitis C virus (HCV) is an infection that affects the liver. Hepatitis C is contagious and is usually transmitted through blood. People with acute HCV, a short-term illness, usually do not have symptoms. In rare cases, acute HCV may cause fever, nausea and vomiting, and jaundice (yellowing of skin or eyes). Most people with acute HCV infection do not know they are infected, and most eventually develop chronic HCV, a long-term illness. Over time, 20% to 30% develop severe liver disease, such as cirrhosis or cancer, which can be fatal. Currently, most cases of hepatitis are newly diagnosed cases of chronic HCV among baby boomers (people born between 1945 and 1965). As a result, some health organizations have recommended that everyone in this age group be screened for HCV. The August 13, 2014, issue of JAMA contains a review article about HCV treatment.
Who should be tested for hepatitis C infection? Persons who are current or former injection drug users
Persons who received blood products for clotting problems before 1987 or a blood transfusion or organ transplant before 1992
Health care workers who are exposed to blood through a needlestick or other sharp object
Risks for HCV Hepatitis C can be transmitted in the following ways, among others. Baby boomers may have been exposed many years ago by • Injecting drugs • Having had a blood transfusion before 1992 • Being on dialysis • Being exposed as a health care worker • Having sexual contact with someone who has HCV • Getting a tattoo or body piercing with an unclean tool Fewer people are being infected with HCV than previously, in part because the blood supply for transfusions is safer. Also, fewer people are injecting drugs, and those who do so are less likely to share needles.
Symptoms If you have chronic HCV infection, you may not have any symptoms. The most common symptom is feeling tired. However, the virus can affect the kidneys, skin, and other organs.
Screening A blood test is used to screen for HCV. If you are found to have chronic HCV infection, your doctor may perform other tests to determine the degree of liver damage. Tests may include a liver biopsy (using a special needle, taking a small sample of cells from the liver) to help make decisions about treatment. Baby boomers are 5 times more likely to have HCV infection than people who are younger or older. As a result, 2 government health organizations recommend that everyone in this age group receive a one-time screening for HCV, even if they have no risk factors. Talk to your doctor about your need for screening. Author: Deborah Tolmach Sugerman, MSW ConflictofInterestDisclosures: TheauthorhascompletedandsubmittedtheICMJE Form for Disclosure of Potential Conflicts of Interest and none were reported. Sources: Centers for Disease Control and Prevention, US Preventive Services Task Force, National Library of Medicine Rutherford A, Dienstag JL. Viral hepatitis. In: Greenberger NJ, et al. Current Diagnosis and Treatment: Gastroenterology, Hepatology, and Endoscopy. 2nd ed. New York, NY: McGraw-Hill Companies Inc; 2012:chap 39. 664
Persons born from 1945 through 1965
Others who should be tested include Persons with HIV infection Persons with abnormal liver test results or liver disease Persons who have been receiving long-term hemodialysis treatment
Treatment Treatment for the most common type of chronic HCV is a combination of the drugs peginterferon; ribavirin; and boceprevir, telaprevir, or sofosbuvir. A number of additional new treatments are currently in development.
FOR MORE INFORMATION
• Centers for Disease Control and Prevention www.cdc.gov/hepatitis/c • US Preventive Services Task Force www.uspreventiveservicestaskforce.org/uspstf/uspshepc.htm • National Library of Medicine www.nlm.nih.gov/medlineplus/hepatitisc.html To find this and previous JAMA Patient Pages, go to the Patient Page link on JAMA’s website at jama.com. Many are available in English and Spanish.
The JAMA Patient Page is a public service of JAMA. The information and recommendations appearing on this page are appropriate in most instances, but they are not a substitute for medical diagnosis. For specific information concerning your personal medical condition, JAMA suggests that you consult your physician. This page may be photocopied noncommercially by physicians and other health care professionals to share with patients. To purchase bulk reprints, call 312/464-0776.
JAMA August 13, 2014 Volume 312, Number 6
Copyright 2014 American Medical Association. All rights reserved.
Downloaded From: http://jama.jamanetwork.com/ by a University of North Dakota User on 05/29/2015
jama.com
Hepatitis C Hepatitis C virus (HCV) is an infection that affects the liver. Hepatitis C is contagious and is usually transmitted through blood. People with acute HCV, a short-term illness, usually do not have symptoms. In rare cases, acute HCV may cause fever, nausea and vomiting, and jaundice (yellowing of skin or eyes). Most people with acute HCV infection do not know they are infected, and most eventually develop chronic HCV, a long-term illness. Over time, 20% to 30% develop severe liver disease, such as cirrhosis or cancer, which can be fatal. Currently, most cases of hepatitis are newly diagnosed cases of chronic HCV among baby boomers (people born between 1945 and 1965). As a result, some health organizations have recommended that everyone in this age group be screened for HCV. The August 13, 2014, issue of JAMA contains a review article about HCV treatment.
Who should be tested for hepatitis C infection? Persons who are current or former injection drug users
Persons who received blood products for clotting problems before 1987 or a blood transfusion or organ transplant before 1992
Health care workers who are exposed to blood through a needlestick or other sharp object
Risks for HCV Hepatitis C can be transmitted in the following ways, among others. Baby boomers may have been exposed many years ago by • Injecting drugs • Having had a blood transfusion before 1992 • Being on dialysis • Being exposed as a health care worker • Having sexual contact with someone who has HCV • Getting a tattoo or body piercing with an unclean tool Fewer people are being infected with HCV than previously, in part because the blood supply for transfusions is safer. Also, fewer people are injecting drugs, and those who do so are less likely to share needles.
Symptoms If you have chronic HCV infection, you may not have any symptoms. The most common symptom is feeling tired. However, the virus can affect the kidneys, skin, and other organs.
Screening A blood test is used to screen for HCV. If you are found to have chronic HCV infection, your doctor may perform other tests to determine the degree of liver damage. Tests may include a liver biopsy (using a special needle, taking a small sample of cells from the liver) to help make decisions about treatment. Baby boomers are 5 times more likely to have HCV infection than people who are younger or older. As a result, 2 government health organizations recommend that everyone in this age group receive a one-time screening for HCV, even if they have no risk factors. Talk to your doctor about your need for screening. Author: Deborah Tolmach Sugerman, MSW ConflictofInterestDisclosures: TheauthorhascompletedandsubmittedtheICMJE Form for Disclosure of Potential Conflicts of Interest and none were reported. Sources: Centers for Disease Control and Prevention, US Preventive Services Task Force, National Library of Medicine Rutherford A, Dienstag JL. Viral hepatitis. In: Greenberger NJ, et al. Current Diagnosis and Treatment: Gastroenterology, Hepatology, and Endoscopy. 2nd ed. New York, NY: McGraw-Hill Companies Inc; 2012:chap 39. 664
Persons born from 1945 through 1965
Others who should be tested include Persons with HIV infection Persons with abnormal liver test results or liver disease Persons who have been receiving long-term hemodialysis treatment
Treatment Treatment for the most common type of chronic HCV is a combination of the drugs peginterferon; ribavirin; and boceprevir, telaprevir, or sofosbuvir. A number of additional new treatments are currently in development.
FOR MORE INFORMATION
• Centers for Disease Control and Prevention www.cdc.gov/hepatitis/c • US Preventive Services Task Force www.uspreventiveservicestaskforce.org/uspstf/uspshepc.htm • National Library of Medicine www.nlm.nih.gov/medlineplus/hepatitisc.html To find this and previous JAMA Patient Pages, go to the Patient Page link on JAMA’s website at jama.com. Many are available in English and Spanish.
The JAMA Patient Page is a public service of JAMA. The information and recommendations appearing on this page are appropriate in most instances, but they are not a substitute for medical diagnosis. For specific information concerning your personal medical condition, JAMA suggests that you consult your physician. This page may be photocopied noncommercially by physicians and other health care professionals to share with patients. To purchase bulk reprints, call 312/464-0776.
JAMA August 13, 2014 Volume 312, Number 6
Copyright 2014 American Medical Association. All rights reserved.
Downloaded From: http://jama.jamanetwork.com/ by a University of North Dakota User on 05/29/2015
jama.com
