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Hepatitis is a general term used to describe inflammation of the liver. Alcohol, chemicals and drugs can cause hepatitis. It can also be caused by a viral infection, such as hepatitis A, B, C, D and E.These viruses may produce similar symptoms, but are transmitted differently so their prevention and control differ. Medically they are regarded as different diseases.

This pamphlet is concerned with hepatitis C only.

What Are the Symptoms?

In many cases, people infected with hepatitis C virus may not become ill, whilst others may experience a minor "flu" like illness which does not require treatment.

However, when first infected with hepatitis C, some people's urine may become dark and the whites of the eyes and their skin may turn yellow (jaundice). Hepatitis symptoms may disappear within a few weeks but this does not necessarily mean that the infection has also disappeared. A person with hepatitis symptoms should consult their doctor.

Inflammation of the liver can be determined by a blood test measuring two liver enzymes (ALT and AST). Elevation of these enzymes indicates ongoing liver damage.

When liver inflammation persists for longer than six months the illness is called chronic hepatitis C.

The symptoms of chronic hepatitis C may include:

1. mild to severe lethargy;
   
2. loss of appetite;
   
3. nausea and vomiting;
   
4. soreness in the upper right part of the abdomen (under the ribs);
   
5. fever; and
   
6. pain in the joints.

Is Hepatitis C Dangerous?

Those infected may continue to carry the virus in their blood and become long term or chronic carriers. It is believed that at least 20 percent of people who are chronic carriers will develop cirrhosis, which is scarring of the liver. This process may take 20 years to develop. After some years, a certain proportion of patients with cirrhosis may develop liver cancer.

It is believed that carriers of hepatitis C probably remain infectious throughout their lives and may therefore be capable of transmitting the disease to others at any time.



How Is Hepatitis C Transmitted?

Hepatitis C is a blood borne disease, that is, transmission occurs via blood to blood contact. The hepatitis C virus, like hepatitis B and HIV (the virus that causes AIDS), is present in the blood of people infected with hepatitis C. Transmission of the virus most frequently occurs when infected blood enters another person's bloodstream through broken skin or mucous membrane.

The majority of people in Australia with hepatitis C have been infected by the sharing of needles and syringes during injecting drug use. The use of instruments such as tattooing needles that are not sterilized prior to skin penetration can also transmit the virus. Sharing of razor blades or toothbrushes belonging to an infected hepatitis C person may also lead to disease transmission. The virus can also be transmitted in the following ways:

Health Care Workers

Contact with blood on cuts and abrasions, or injuries with contaminated instruments among health care workers can lead to infection.

Mother to Baby

Hepatitis C may be transmitted from mother to baby but appears to occur much less commonly than with hepatitis B. The risk of breast milk transmitting the virus is considered to be very low.

Sexual Intercourse

There is a very small risk that hepatitis C may be spread during heterosexual and homosexual intercourse. The risk is higher if one partner has acute hepatitis C infection and/or also has HIV infection.

Blood donors are not at risk of catching this disease, and the risk for people receiving blood transfusions nowadays is very low, as all donations, since 1990, are screened for hepatitis C.

Who Is at Risk of Infection?

People in the following groups have an increased risk of being infected with hepatitis C.

1. Injecting drug users who share needles and syringes.
   
2. People who received blood transfusions before February 1990.
   
3. Health care workers with occupational exposure to blood.
   
4. People with multiple sexual partners.
   
5. Kidney dialysis patients and people with hemophilia.
   
6. People undergoing skin penetration procedures, such as tattooing, with unsterile equipment.

About 25 per cent of people infected with hepatitis C do not appear to belong to any of the above risk groups.

How Do I Avoid Becoming Infected?

1. For people who inject drugs-never share needles, syringes and other injecting equipment. Always use clean needles and syringes. These are available from some chemists and needle and syringe exchange outlets. For further information on where to obtain clean needles and syringes or, if necessary, on how to clean them, contact DIRECTLINE on 9416 1818 or 008 136 385.
   
2. Do not share personal items such as toothbrushes, razors, nail files or nail scissors, as these can puncture the skin and become contaminated with blood.
   
3. For people performing or receiving ear piercing, tattooing, electrolysis or acupuncture, always ensure that any instrument that pierces the skin has been sterilised since it was last used.
   
4. Health care workers should adhere to universal infection control guidelines.
   
5. Use "safer sex" practices. For sexually active people, the correct and consistent use of condoms for vaginal and oral sex with men and women will reduce the risk of infection. People in long term stable relationships need to discuss condom use with their doctor.

At present there is no vaccine available to prevent a person from being infected with hepatitis C.

What Should I Do If I Already Have Hepatitis C?

1. Consult your doctor who will monitor your condition and, if necessary refer you to a specialist.
   
2. Maintain a nutritious diet which is well balanced and low in fat.
   
3. Avoid drinking alcohol (no more than seven standard drinks per week) as alcohol hastens the development of cirrhosis.
   
4. Rest when you feel unwell.

What Should I Do To Stop The Spread of Hepatitis C?

If you are infected with the hepatitis C virus, you should take the following precautions, in order to prevent its spread.

1. Discuss you condition with your health care provider when undergoing any medical or dental procedure.
   
2. Wipe up any blood spills carefully using gloves with household bleach and disposable paper towels.
   
3. Completely cover any cut or wound with a dressing or bandaid.
   
4. Place bloodstained tissues, sanitary towels or other bloodstained dressings in a plastic bag before disposal.
   
5. Practice safer sex.

You should not:

1. donate blood or other body organs;
   
2. share injecting equipment; and
   
3. share personal items such as toothbrushes or razors.

Is There Treatment for Chronic Hepatitis C Infection?

Treatment with antiviral medicines has been used to decrease inflammation in the liver. There are some major side effects and the results of Australian and overseas studies suggest that about one in five people may have benefited in the long term. You should talk to your doctor about treatment options.

Is There a Test for Hepatitis C?

A blood test for hepatitis C became available in 1990. It may take two to three months from the time of infection before a blood test can detect evidence of infection (that is, the presence of antibodies in the blood). This test can only show that you have been infected at some time in the past but it cannot determine if an infected person has become a carrier.

Specialised laboratories can undertake a test which may help to establish if the virus is still present in a person's blood or liver, but this type of test is not routinely performed and is expensive.

For Further Information Contact:

Hepatitis C Helpline
Telephone: (03) 9349 1111.
OR
The Hepatitis C Foundation Victoria Inc
Hepatitis C Support Line
C/O Fairfield Hospital
Yarra Bend Road
FAIRFIELD VIC 3078
Telephone: (03) 9280 2317

Jonathan Wright, M.D. recommends a diet low in protein to minimize stress on the liver. Whole foods diet that follows a hypoglycemic regime, of small meals throughout the day, avoiding stressor foods such as refined sugars, alcohol, and caffeine. Consume plenty of filtered water. Drinking fresh lemon juice water every morning and evening followed by vegetable juice is one of the most therapeutic regimes for the liver. Do this consistently for two to four weeks and then several mornings a week for several months and whenever liver symptoms reoccur. Have lots of vegetables each day. Ideal is at least one salad and one meal of steamed or lightly sauteed vegetables per day. Grains that are easily digestible, such as millet, buckwheat, and quinoa are very good.

According to the Encyclopedia of Natural Medicine:

A natural diet, low in natural and synthetically saturated fats, simple carbohydrates (sugar, white flour, fruit juice, honey, etc), oxidised fatty acids (fried oils) and animal fat, and high in fibre is recommended.

Here is some info on the Transplant-Go-Round

Hi all, I ordered this book and with it I received a book called "Best Kept Secrets in America". In it was the following that I will pass on to you all:

Who Get organ transplants and who doesn't

Because the stakes are so high, rumors about favoritism or "buying a miracle" in the transplant world are common. What isn't true abouth the way organs are allocated"

The more money you have, the better your chances. Reality: If you can pay for the transplant and meet the medical criteria, you'll be listed with everyone else waiting at a specific center. It's not that the organs are expensive, they're not available at any price.

Problem - If you have neither adequate insurance coverage nor sufficient funds, you willl have difficulty getting a transplant center to list you. And if you're not listed, you're not in line for available organs.

Well-publicized patients have a better chance of getting an organ. Although publicity can certainly help in a fundraising effort, it won't necessarily save a life.

Example" Ronnie DeSillersm the seven year old boy who died while awaiting a fourth liver transplant, was brought into the national news spotlight because President Reagan contributed money for his medical costs after initially raised funds were stolen. Three days before the young boy died, the capatible liver became available, but doctors decided that a child in Dallas needed it more desperately.

Rich foreign nationals can buy their way into the American transplant network. Most centers have a limit of no more than 5-10% of American organs available for foreigners.

Moving to a transplant center will improve your chances. It may make sense to move your loved one to a major hospital if he or she is to sick to be at home, but moving to a major transplant center can't really help you chances. If an organ becomes available and you are the best recipient, it doen't matter where you are in the continental U.S. --you'll get it.

To get on an organ waiting list, you must prove that you can pay for it with your own funds or with insurance. Exceptions: Kidneys and sometimes hearts. Medicare covers kidney transplants(or dialysis) for those eligible for S.S. benefits, and heart transplants are covered for Medicare patients over age 65.

Once you have met medical and fiancial criteria, you can be listed with a transplant center. There are over 125 centers in the country, many of which are affiliated with hospitals. Kidney transplants are performed throughout the country and heart transplants are becoming more common, but liver and heart-lung transplants are done less often.

After you have been listed, you must wait for the proper organ to become availabe-and matched to a pool of recipients. Note: Kidney transplants (which are life improving, not lifesaving are available to anyone in need.)

Improving you chances:

1. List with several organ procurement centers. It's best to list with centers that often perform the type of operation you need. Ask the center's transplant coordinator for the center's success rate.
   

2. Review the credentials of the doctors on a transplant team carefully. They should be members of the American Society of Transplant Surgeons, which quarantees that they are board certified with a fellowship in transplant surgery and at least six months of service with a transplant team.
   
   

3. Contact transplant support group. To find a group nearby, check your phone book, ask transplant coordinators at the centers where you are listed or contact the American Council on Transplantation.

(the source for this is Brian Broznick, procurement director for the Pittsburg Transplant Foundation, 5743 Centrek Ave., Pittsburgh 15206)
JO