Hepatitis C: What's it all about?

Hepatitis C (HCV) is a virus that causes chronic inflammation of the liver and liver disease. About 4 million Americans have hepatitis C and more than 150,000 new cases develop each year.


How does hepatitis C affect my whole body?
Hepatitis C is a systemic disease and may cause many symptoms or diseases including:

  • Dry mouth (due to the disease affecting the salivary glands; known as sialadenitis)
  • Rashes on the skin (leukocytoclastic vasculitis, lichen planus)
  • Kidney disease or failure (vasculitis, cryoglobulinemia)
  • Thyroid disease may be increased in patients with hepatitis C
  • Muscle and joint aches
  • Fatigue
  • Depression
  • Decreased platelets
  • Pulmonary disease (fibrosis)

    How many HCV cases become chronic?
    It is estimated that between 75 and 85 percent of HCV cases become chronic--leading to scarring of the liver and possibly cirrhosis, liver cancer and liver failure--but many people are unaware that they are infected. In fact, infection with the virus can persis without noticeable systems for twenty or more years. HCV is currently the leading cause of liver transplantation in the United States. (Fifteen percent or less of those infected do spontaneously recover, however, although we do not know how or why.)


    Why isn't there a vaccine for hepatitis C?
    Unlike the viruses that produce hepatitis A and B, the hepatitis C virus is very unstable. It mutates often, evading the protective antibodies in a person's immune system that might be produced by a vaccine.

    Additionally, there are six genotypes (or clades) of HCV found in different populations around the world (resulting from viral mutations). These genotypes respond to Western drug treatment differently and produce slightly different disease patterns. Genotypes include:

    Genotype 1: Subtype 1a is found most often in the United States, the United Kingdom and Europe. Subtype 1b is found mostly in Japan and Europe. These genotype subsets are the least responsive to Western medical treatments with interferon and ribavirin.

    Genotype 2: Subtypes 2a, 2b, 2c and 2d are found mostly in Japan and China.

    Genotype 3: Subtypes 3a, 3b, 3c, 3d, 3e and 3f are found mostly in Scotland and other parts of the United Kingdom.

    Genotype 4: Subtypes 4a, 4b, 4c, 4d, 4e, 4f, 4g, 4h, 4i and 4j are found mostly in the Middle East and Africa.

    Genotype 5: Subtype 5a is found mostly in Canada and South Africa.

    Genotype 6: Subtype 6a is found mostly in Hong Kong and Macau.

    Those with hepatitis C should make sure they receive vaccines against hepatitis A and B since contracting C along with either of these other diseases can be devastating. (1)






    (1) Cohen, M., Gish, R. Doner, K, "The Hepatitis C Help Book." St. Martin's Press. 2000.