In 1994 I was diagnosed with Chronic Active Hepatitus C (HCV) (which I had been infected with during a surgical procedure that required a Blood Transfusion in the late 70's ) and I was told I would be lucky to see Christmas of 1998.......  Well, I fooled them and just spent Christmas 2002 with my 20month old Great Grand Daughter.   No one can know for sure when you will leave this life and it is how you approach each day that will determine how long you stay here.  

It's always easiest to give up, give in, and let go but easy is not the answer.  You must learn to fight each battle as it comes to you.  Be thankful for each day you are given.  Take pride in yourself and your achievements.  Never, Never, Never give up!!!!

Hepatitis is a silent, quiet, hidden disease that saps your energy, your strength, and most important, your will to do anything!  By knowing what to expect from this disease you are better armed to fight it.  Make it your daily ritual to inform yourself of studies going on and new medicines.   Don't let your doctor blind side you with fancy words, a multitude of prescriptions that don't help, and a lack of understanding of how you feel.  Learn to talk to your doctor.  Make notes before you go in to see him and hand them to him stating "I want to ask you about these".............  He'll listen if he knows you want to talk about something.   I know,.......... I felt the same way,  "My doctor never listens".... Well, I never talked or asked questions like I should have.  Once I learned to participate in my own health care I found the doctors were more than willing to talk to me.......  Get involved!!!!!!!!  If you see something that sounds like it might help you, let your doctor know about it and discuss it with him.  In the case of HCV, your Liver is damaged and a lot of things that will work for others, won't necessarily work for you.  Some foods, minerals, etc. can build up in your liver and become toxic to you so it's important you discuss any new diets, foods, vitamins, etc. with your doctor before you take them.

As a safety precaution please make sure you contact your doctor and get the Hep B Anti-Virus injection.  There is a series of three injections and it is imperative that you follow through with all of them or they won't do you any good.  This deadly disease can be passed so silently and sometimes by the time you find out you have it, it's already too late.

UPDATE:    On January 3, 2003 I was diagnosed with End Stage Liver Cancer and was informed by four (4) different specialists that there is no treatment and  I have only a few months to live.  My Hep C Virus has also added a new friend, Hep B!   I must say that although I knew this could come some day I still had a hard time hearing it.  After the initial shock wore off I thought about how lucky I was to have had the extra years I was granted which enabled me to meet my great-grand-daughter and spend more time with my family and friends.  I honestly feel that the extra years came from my tenacity to never quit trying, never to give up or give in and to be thankful for each day.   Even though they say "a few months" I will continue to fight this disease with the same zest I've always had.  Who knows, perhaps I'll be around to meet my great-great-grand-daughter someday!   Don't count me out yet!!!

Here are some facts about HCV:

You may be at risk and should be routinely tested for hepatitis C if you: 
1,  Ever injected illicit drugs, even if you experimented a few times many years ago 
2,  Received clotting factor concentrates produced before 1987 
3,  Were notified that you received blood from a donor who later tested positive for hepatitis C 
4.  Received a transfusion of blood or blood components before July 1992 
5.  Received an organ transplant before July 1992 
6.  Were ever on long-term kidney dialysis 
7.  Have evidence of liver disease 

Check with your health care provider if you can say yes to any of the above! 


Hepatitis C virus (HCV) infection is the most common chronic bloodborne infection in the United States. CDC staff estimate that during the 1980s, an average of 242,000 new infections occurred each year. Since 1989, the annual number of new infections has declined by >80% to 36,000 by 1996. Data from the Third National Health and Nutrition Examination Survey (NHANES III), conducted during 1988–1994, have indicated that an estimated 3.9 million (1.8%) Americans have been infected with HCV. Most of these persons are chronically infected and might not be aware of their infection because they are not clinically ill. Infected persons serve as a source of transmission to others and are at risk for chronic liver disease or other HCV-related chronic diseases during the first two or more decades following initial infection.

Chronic liver disease is the tenth leading cause of death among adults in the United States, and accounts for approximately 25,000 deaths annually, or approximately 1% of all deaths. Population-based studies indicate that 40% of chronic liver disease is HCV-related, resulting in an estimated 8,000–10,000 deaths each year. Current estimates of medical and work-loss costs of HCV-related acute and chronic liver disease are >$600 million annually, and HCV- associated end-stage liver disease is the most frequent indication for liver transplantation among adults. Because most HCV-infected persons are aged 30–49 years, the number of deaths attributable to HCV- related chronic liver disease could increase substantially during the next 10–20 years as this group of infected persons reaches ages at which complications from chronic liver disease typically occur.

HCV is transmitted primarily through large or repeated direct percutaneous exposures to blood. In the United States, the relative importance of the two most common exposures associated with transmission of HCV, blood transfusion and injecting-drug use, has changed over time. Blood transfusion, which accounted for a substantial proportion of HCV infections acquired >15 years ago, rarely accounts for recently acquired infections. Since 1994, risk for transfusion-transmitted HCV infection has been so low that CDC’s sentinel counties viral hepatitis surveillance system has been unable to detect any transfusion-associated cases of acute hepatitis C, although the risk is not zero. In contrast, injecting-drug use consistently has accounted for a substantial proportion of HCV infections and currently accounts for 60% of HCV transmission in the United States. A high proportion of infections continue to be associated with injecting-drug use, but for reasons that are unclear, the dramatic decline in the incidence of acute hepatitis C since 1989 correlates with a decrease in cases among injecting-drug users.

Persons with acute HCV infection typically are either asymptomatic or have a mild clinical illness; 60%-70% have no discernible symptoms; 20%-30% might have jaundice; and 10%-20% might have non-specific symptoms (e.g., anorexia, malaise, or abdominal pain). Clinical illness in patients with acute hepatitis C who seek medical care is similar to that of other types of viral hepatitis, and serologic testing is necessary to determine the etiology of hepatitis in an individual patient. In <20% of these patients, onset of symptoms might precede anti-HCV seroconversion. Average time period from exposure to symptom onset is 6-7 weeks, whereas average time period from exposure to seroconversion is 8-9 weeks. Anti-HCV can be detected in 80% of patients within 15 weeks after exposure, in >90% within 5 months after exposure, and in >97% by 6 months after exposure. Rarely, seroconversion might be delayed until 9 months after exposure.

The course of acute hepatitis C is variable, although elevations in serum ALT levels, often in a fluctuating pattern, are its most characteristic feature. Normalization of ALT levels might occur and suggests full recovery, but this is frequently followed by ALT elevations that indicate progression to chronic disease. Fulminant hepatic failure following acute hepatitis C is rare.

After acute infection, 15%-25% of persons appear to resolve their infection without sequelae as defined by the sustained absence of HCV RNA in serum and normalization of ALT levels. Chronic HCV infection develops in most persons (75%-85%) with persistent or fluctuating ALT elevations indicating active liver disease developing in 60%-70% of chronically infected persons. In the remaining 30%-40% of chronically infected persons, ALT levels are normal. No clinical or epidemiologic features among patients with acute infection have been found to be predictive of either persistent infection or chronic liver disease. Moreover, various ALT patterns have been observed in these patients during follow-up, and patients might have prolonged periods (>12 months) of normal ALT activity even though they have histologic-confirmed chronic hepatitis. Thus, a single ALT determination cannot be used to exclude ongoing hepatic injury, and long-term follow-up of patients with HCV infection is required to determine their clinical outcome or prognosis.

The course of chronic liver disease is usually insidious, progressing at a slow rate without symptoms or physical signs in the majority of patients during the first two or more decades after infection. Frequently, chronic hepatitis C is not recognized until asymptomatic individuals are identified as HCV-positive during blood donor screening, or elevated ALT levels are detected during routine physical examinations. Most studies have reported that cirrhosis develops in 10%-20% of persons with chronic hepatitis C over a period of 20-30 years, and HCC in 1%-5%, with striking geographic variations in rates of this disease. However, when cirrhosis is established, the rate of development of HCC might be as high as 1%-4% per year. In contrast, a study of > 200 women 17 years after they received HCV-contaminated RH factor IG reported that only 2.4% had evidence of cirrhosis and none had died. Thus, longer term follow-up studies are needed to assess the lifetime consequences of chronic hepatitis C, particularly among those who acquired their infection at young ages.

Although factors predicting severity of liver disease have not been well defined, recent data indicate that increased alcohol intake, being aged >40 years at infection, and being male are associated with more severe liver disease. In particular, among persons with alcoholic liver disease and HCV infection, liver disease progresses more rapidly; among those with cirrhosis, a higher risk for development of HCC exists. Furthermore, even intake of moderate amounts (>10 grams/day) of alcohol in patients with chronic hepatitis C might enhance disease progression. More severe liver injury observed in persons with alcoholic liver disease and HCV infection possibly is attributable to alcohol-induced enhancement of viral replication or increased susceptibility of cells to viral injury. In addition, persons who have chronic liver disease are at increased risk for fulminant hepatitis A. 



HCV-positive patients should be evaluated for the presence and severity of chronic liver disease. Initial evaluation for presence of disease should include multiple measurements of ALT at regular intervals, because ALT activity fluctuates in persons with chronic hepatitis C. Patients with chronic hepatitis C should be evaluated for the severity of their liver disease and for possible treatment. 
Antiviral therapy is recommended for patients with chronic hepatitis C who are at greatest risk for progression to cirrhosis. These persons include anti-HCV-positive patients with persistently elevated ALT levels, detectable HCV RNA, and a liver biopsy that indicates either portal or bridging fibrosis or at least moderate degrees of inflammation and necrosis.

In patients with less severe histologic changes, indications for treatment are less clear, and careful clinical follow-up might be an acceptable alternative to treatment with antiviral therapy (e.g., interferon) because progression to cirrhosis is likely to be slow, if it occurs at all. Similarly, patients with compensated cirrhosis (without jaundice, ascites, variceal hemorrhage, or encephalopathy) might not benefit from interferon therapy. Careful assessment should be made, and the risks and benefits of therapy should be thoroughly discussed with the patient.

Patients with persistently normal ALT values should not be treated outside of clinical trials, as treatment might actually induce liver enzyme abnormalities. Patients with advanced cirrhosis who might be at risk for decompensation with therapy and pregnant women also should not be treated. Interferon treatment is not FDA-approved for patients aged <18 years or >60 years. Treatment of patients who are drinking excessive amounts of alcohol or who are injecting illegal drugs should be delayed until these behaviors have been discontinued for > 6 months. Contraindications to treatment with interferon include major depressive illness, cytopenias, hyperthyroidism, renal transplantation, and evidence of autoimmune disease. 

Most clinical trials of treatment for chronic hepatitis C have been conducted using alpha interferon. When the recommended regimen of 3 million units administered subcutaneously 3 times/week for 12 months is used, approximately 50% of treated patients have normalization of serum ALT activity (biochemical response), and 33% have a loss of detectable HCV RNA in serum (virologic response) at the end of therapy. However, > 50% of these patients relapse when therapy is stopped. Thus, 15%-25% have a sustained response as measured by testing for ALT and HCV RNA > 1 years after therapy is stopped, many of whom also have histologic improvement. For patients who do not respond by the end of therapy, retreatment with a standard dose of interferon is rarely effective. Patients who have persistently abnormal ALT levels and detectable HCV RNA in serum after 3 months of interferon are unlikely to respond to treatment, and interferon treatment should be discontinued. These persons might be considered for participation in clinical trials of alternative treatments. Decreased interferon response rates (<15%) have been found in patients with higher serum HCV RNA titers and HCV genotype 1 (the most common strain of HCV in the United States); however, treatment should not be withheld based solely on these findings.

Therapy for hepatitis C is a rapidly changing area of clinical practice. Combination therapy with interferon and ribavirin, a nucleoside analogue, is approved for the naive treatment of patients with chronic hepatitis C. Studies of patients treated with a combination of ribavirin and interferon have demonstrated a substantial increase in sustained response rates, reaching 40%-50%, compared with response rates of 15%-25% with interferon alone. However, as with interferon alone, combination therapy in patients with genotype 1 is not as successful, and sustained response rates among these patients are still <30%. 

Most patients receiving interferon experience flu-like symptoms early in treatment, but these symptoms diminish with continued treatment. Later side effects include fatigue, bone marrow suppression, and neuropsychiatric effects (e.g., apathy, cognitive changes, irritability, and depression). Interferon dosage must be reduced in 10%-40% of patients and discontinued in 5%-15% because of severe side effects. Ribavirin can induce hemolytic anemia and can be problematic for patients with pre-existing anemia, bone marrow suppression, or renal failure. In these patients, combination therapy should be avoided or attempts should be made to correct the anemia. Hemolytic anemia caused by ribavirin also can be life-threatening for patients with ischemic heart disease or cerebral vascular disease. Ribavirin is teratogenic, and female patients should avoid becoming pregnant during therapy.

Other treatments, including corticosteroids, ursodiol, and thymosin, have not been effective. High iron levels in the liver might reduce the efficacy of interferon. Use of iron reduction therapy (phlebotomy or chelation) in combination with interferon has been studied, but results have been inconclusive. Because patients are becoming more interested in alternative therapies (e.g., traditional Chinese medicine, antioxidants, naturopathy, and homeopathy), physicians should be prepared to address questions regarding these topics.

Here are some links that will provide you with additional information:. 

http://www.drugabuse.gov/HepatitisAlert/HepatitisAlert.html 

http://www.cdc.gov/ncidod/diseases/hepatitis/c/fact.htm 

http://www.cdc.gov/ncidod/diseases/hepatitis/b/index.htm 

Never take your health for granted!  Annual check ups and open conversations with your own physician can save you from this deadly disease.