Q. What is Hepatitis C?
Hepatitis C is one of several types of hepatitis viruses that infect the liver. This virus can cause liver disease in some people.
Q. Could I have Hepatitis C?
Hepatitis C is usually caused by a blood or platelet transfusion from a donor who is infected with the hepatitis C virus. Testing for hepatitis C in blood donors was started in 1991. Blood is not used if the tests show that the donor is infected with the hepatitis C virus. This testing can now prevent most hepatitis C infections associated with transfusions.
Anyone who received a transfusion before the early 1990s could have been infected with hepatitis C. Infection with hepatitis C has been found in about 1 out of every 3 patients who have survived more than 20 years after a transplant.
Q. Would I know if I am infected?
The only way to know for sure whether you have hepatitis C is to have a blood test that detects this virus. Many patients do not know that they are infected, because there are no specific symptoms. During the first 10 years after infection, hepatitis C usually does not cause serious damage to the liver. Some patients who have the infection for 10-30 years develop inflammation of the liver or cirrhosis (scarring of the liver). Hepatitis C can also cause liver cancer in some patients.
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Q. Have I already been tested?
Many patients have not been tested for hepatitis C. Testing for the hepatitis C virus requires a special blood test. Some patients have been tested for another type of hepatitis virus (hepatitis B). Since hepatitis B and C are different, you should ask your doctor if you have been tested for hepatitis C.
Q. What test should I get?
A special blood test must be done to find out if you have hepatitis C. We recommend an antibody test as the first step. If the antibody test is positive or if you are taking immune suppressive medications, you should also have a test for the virus itself. The test for the virus itself is called HCV RNA, PCR, branched-chain DNA, Amplicor and other names. Ask your doctor to order these tests for you. Please call the FHCRC Long-Term Follow-Up department (206-667-4415) to tell us about the results of any testing that is done.
Q. What if I am infected?
If your blood tests show that you are infected by the hepatitis C virus, you should see a liver specialist (a hepatologist or a gastroenterologist who is experienced in the care of patients with liver disease). The liver specialist will want to answer three questions: 1) Has the virus infection caused any damage to your liver? 2) Are there other causes of liver damage, for example, from alcohol, medications, chronic graft-versus-host disease, too much iron in your body, or the hepatitis B virus? 3) Should you be treated with medications for this virus?
These are complicated and difficult questions. The liver specialist might need to talk to a specialist here at the Fred Hutchinson Cancer Center to get help. You can find out more about the hepatitis C virus by contacting the American Liver Foundation (a patient support group) (www.liverfoundation.org) or the American Association for the Study of Liver Diseases (the organization of liver doctors and researchers) (www.aasld.org).
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