Hepatitis C is a chronic infection. Once exposed through the usual risk factors, there is a better than 85% chance the virus will stick with you, avoiding clearance by the immune system. That's it.
As a reminder, the Centers for Disease Control list the risk factors for hepatitis C:
Some people are at increased risk for hepatitis C, including
- Current injection drug users (currently the most common way hepatitis C virus is spread in the United States)
- Past injection drug users, including those who injected only one time or many years ago
- Recipients of donated blood, blood products, and organs (once a common means of transmission but now rare in the United States since blood screening became available in 1992)
- People who received a blood product for clotting problems made before 1987
- Hemodialysis patients or persons who spent many years on dialysis for kidney failure
- People who received body piercing or tattoos done with non-sterile instruments
- People with known exposures to the hepatitis C virus, such as
- Healthcare workers injured by needlesticks
- Recipients of blood or organs from a donor who tested positive for the hepatitis C virus
- HIV-infected persons
- Children born to mothers infected with the hepatitis C virus
Less common risks include:
- Having sexual contact with a person who is infected with the hepatitis C virus
- Sharing personal care items, such as razors or toothbrushes, that may have come in contact with the blood of an infected person
The misunderstood part is that there is the belief that those newly diagnosed with chronic hepatitis C have been infected recently, but in reality, the vast majority of the patients were exposed the better part of 20 years. Experimentation with IV drugs and blood transfusions are the two major risk factors I see on a daily basis. For all of these years, they have had hepatitis C. The test for hepatitis C is not always part of routine screening. In other words, if it is not specifically requested, it will not be done by your family physician during your annual exam. If you don't look, you won't see it. That simple.
It's incredibally difficult for patients to comprehend how they "could have this for all these years" and not know about it. For many, they are free of symptoms and enjoying life.
Take home message: most patients with HCV have had it for many years. If you have any of the risk factors you must ask to be tested. Amen.
