In our country, it is estimated that 90 percent of persons with chronic hepatitis C virus (HCV) infection were infected through transfusion of unscreened blood or blood products or via injectable drug use.

Hepatitis C usually produces no early symptoms. The disease can go unrecognised for decades. This is why HCV is termed a "silent killer". During the period, the virus can continue to destroy liver cells slowly.

How does it spread?
HCV spreads primarily by exposure to human blood. People may be affected by hepatitis C by:

• Sharing needles with injectable drug users
• Treatment with a blood or blood product for Thalassaemia, Hemophilia or other blood disorders from an infected donor
• Receiving blood transfusion or organ transplant like kidney, liver, heart from an infected donor
• Being a healthcare professional and having frequent contact with blood in the work place, especially accidental needle pricks
• The infected mother to her child
• Sex with a person infected with HCV
• Sharing razors or toothbrushes that might have had blood on them

How can it be prevented?

• Before receiving blood transfusion be sure that the blood is screened properly for HCV. It is most important for persons with blood disorders (like thalassaemia, hemophilia etc.) who need frequent transfusion of blood or blood products.
• Keep aside form drug abuse. If you can not stop, never reuse or share drugs, syringes.
• Do not share toothbrushes, razors, pierced earrings or other personal items.
• Be sure that your barbers are not reusing same blades or razors.
• Do not share chewing gum or pre-chew food for a baby.
• If you are a health worker, always follow routine barrier precautions and safely handle needles and other sharps. Use gloves when touching or cleaning up blood on personal items, tissues, tampons or other items. Cleaning up spilled blood with a strong disinfectant, and keep skin injuries bandaged is strongly recommended.
• Consider the health risks if you are thinking about getting a tattoo or body piercing or any dental procedures. You can get infected if the used tools have someone's blood on them or the artist and dental surgeon do not follow good health practices, such as washing hands and using disposable gloves.
• Avoid multiple sex partners. You should consult with doctor about having your partner tested if one of you is already infected.
• If you feel that you or another family member is at risk for being infected with hepatitis C or any other form of hepatitis, get tested. A simple blood test can put your mind at ease and protect the health of your family.

Taking care of your liver

• Consult with doctor regularly.
• Do not drink alcohol.
• Tell the doctor about all medicine that you are taking, even over-the-counter and herbal medicine.

What are the treatment options?
Drugs are available for the treatment of persons with chronic hepatitis C although there is not yet a proven cure for hepatitis C. Combination drug therapy, using pegylated interferon and ribavirin can work against the virus in up to 5 out of 10 persons with genotype 1 and 8 out of 10 persons with genotype 2 or 3. Liver transplantation is needed in patients with life-threatening cirrhosis or hepato cellular carcinoma (HCC) - a cancer of the liver.

What if you are pregnant?
Transmission can occur at the time of delivery. Infants infected with HCV at birth seem to do well in the first few years of life. HCV RNA test can be performed between the ages of 2 and 6 months, with a repeat test done independent of the first test result. If a later diagnosis is preferred, an anti-HCV test can be performed after 15 months of age.

There is no evidence that breastfeeding spreads HCV infection. To be cautious, an infected mother can avoid breastfeeding if her nipples are cracked and bleeding.

The writer is a medical officer of Dhaka Shishu Hospital, Sher-E-Banglanagor, Dhaka. E-mail: bipul_304957@yahoo.com