A killer disease could be lurking in your body without your knowledge and not showing any symptoms until it damages your liver.
“Hepatitis C is called the silent killer because many people will never know they have it or when they got infected until it starts affecting the liver,” said Dr. Mariejane Braza, an infectious disease doctor with Cleveland Clinic’s Indian River Hospital. “It might be 10 or 20 years down the road from the time you were infected before you notice any symptoms. The viral infection targets the liver, which is a very resilient organ, yet if left untreated it can lead to severe liver damage.
“Years ago, a patient diagnosed with hepatitis C would have to undergo a lengthy, miserable treatment with injections to be cured. But now hepatitis C is a completely curable disease thanks to advancements in direct acting antiviral medications.”
Dr. Braza has made it her personal mission to encourage everyone to be tested for hepatitis C whether they have symptoms or not.
“The CDC used to advise only those people at high risk to be tested but now they are saying that everyone should be screened with a simple liver enzyme test. It’s not part of your regular blood panel screenings that you get with your yearly physical, so you should ask your primary care physician to request it.”
Hepatitis C is caused by the hepatitis C virus (HCV), a blood-borne pathogen. The primary mode of transmission is through contact with contaminated blood, often occurring during unsafe medical procedures, sharing needles or other drug paraphernalia, and less commonly through sexual contact or from a mother to child during childbirth.
Hepatitis C is a global health issue affecting 71 million people worldwide, according to the World Health Organization. Its prevalence varies across regions, with Egypt having one of the highest reported rates of hepatitis C infections in the world. In the United States approximately 3 million people are known to have the disease, but many more may be infected without knowing it.
“It may be more common than we think because people just don’t check it,” said Dr. Braza.
“We didn’t have a test before 1992 so those people who had blood transfusions before 1990 are at risk. And someone who had unsafe sex or drug use even once before 1990 and has not engaged in any unsafe practices since, still may be carrying the virus. The good news is that it is totally curable with antiviral therapy if caught early. A pill given once a day for three months or three pills once a day for two months, with very limited side effects, can cure it completely.
“Veterans are a high-risk group who should be tested because they are more likely to have had blood transfusions and may have participated in risky behavior while abroad. When I was in training at the Veterans Administration, we tested everyone and now we are striving to test all adults.”
Hepatitis C can be a serious disease resulting in health problems including liver damage, liver failure, liver cirrhosis, liver cancer and death. The Centers for Disease Control reports that hepatitis C is the most common reason for liver transplantation in the United States.
Most people become infected with hepatitis C by sharing needles, syringes or other equipment used to prepare and inject drugs. Sharing glucose monitors, razors, nail clippers, toothbrushes and other personal items is also a way to spread the virus. While uncommon, hepatitis C can also spread during sex. It has been reported more often among men who have sex with men. Even something as simple as having a tattoo or body piercing in an unlicensed facility with non-sterile instruments can expose you to the disease. Healthcare, emergency medical and public safety personnel who have been exposed to the blood of someone with hepatitis C are also at risk.
Before widespread screening of the blood supply in 1992, hepatitis C was also spread through blood transfusions and organ transplants. In the 1970s and ’80s thousands of people were infected with hepatitis C and HIV due to the transfusion of contaminated blood that contained these viruses. Now, thanks to the stringent tests of blood from donors, the risk of transmission to recipients of blood or blood products is extremely low.
Hepatitis C is not spread by sharing eating utensils, breastfeeding, hugging, kissing, holding hands, coughing or sneezing, or through food or water.
New hepatitis C infections are increasing most rapidly among young people, primarily due to increasing injection drug use associated with America’s opioid epidemic. However, about 75 percent of the 3 million Americans already living with hepatitis C are baby boomers who could have gotten infected from tainted blood and blood products before testing of the blood supply began in 1992.
“Because symptoms don’t show up for years, if at all, people can live with hepatitis C without ever feeling sick,” Dr. Braza continued. “Left untreated, however, hepatitis C can cause serious liver damage including liver cancer. The only way for you to know if you have hepatitis C is to get tested. The CDC is now recommending that all adults get tested, so talk to your doctor. It could save your life.”
Dr. Mariejane Braza received her medical degree from Cebu Institute of Medicine in the Philippines. She completed internships at Perpetual Succour Hospital in the Philippines and the University of Tesac Health Science Center in San Antonio, Texas, where she also completed her residency in internal medicine. She went on to finish her fellowship in infectious disease at the University of Texas Health Science Center at San Antonio. She joined Cleveland Clinic’s Indian River Hospital in January of this year. Her office is located in the Health and Wellness Center, 3450 11th Court, Vero Beach: 772-794-5631.