Jan 12 - 18, 2004



According to many clinical studies, between 4 to 7 percent of the Pakistani population (or 6 to 10 million people) may be suffering from Hepatitis-C. The liver is a vital organ, located on the right side of your abdomen. Each day, your liver performs more than 500 different vital functions including:

* Storing vitamins, minerals, iron and sugars
* Acting as filter for cleaning the blood and removing toxins
* Producing proteins,bile and blood clotting agents
* Regulating cholesterol and any chemical or medication that enters the bloodstream
* Converting food into chemicals necessary for energy
* Maintaining hormonal balance

If the liver becomes damaged due to chronic infection with hepatitis C, all of its functions can be affected. Hepatitis C (HCV) is a viral infection of the liver, transmitted primarily through infected blood and blood products. It is one of a family of six hepatitis viruses (A, B, C, D, E, and G) that cause liver inflammation, and it accounts for the majority of cases of viral hepatitis. Hepatitis-C is described as a "silent" virus as patients can appear and feel healthy for ten to twenty years before they develop symptoms, while some never experience any symptoms. No vaccine exists for Hepatitis-C, but approximately 15 percent of people with Hepatitis-C develop an acute infection and recover completely within six months without medication. The remaining 85 percent go on to develop chronic hepatitis C and may experience fatigue, loss of appetite, nausea, vomiting, muscle and joint aches, and soreness in the abdomen.

Extreme fatigue is very common, causing many Hepatitis-C patients to reduce their daily activities, and a well balanced diet is essential. However, over the counter medications, vitamins and nutritional supplements should not be taken without consulting a physician. Moreover, it is critical for people with Hepatitis-C to avoid the consumption of any alcohol. Two of the most serious complications of chronic hepatitis C are cirrhosis and liver cancer (hepatocellular carcinoma), both of which may eventually lead to the need for a liver transplant, although this progression can take decades to develop.



Cirrhosis is a scarring of the liver, decreasing the amount of normal liver tissue and liver functions. Within 10 to 20 years of infection, 25 percent of people with chronic Hepatitis-C develop cirrhosis. Liver cancer occurs when malignant cells begin to grow in the tissues of the liver. It can be part of the progression from cirrhosis, and approximately 3-5 percent of those infected with Hepatitis-C may eventually develop hepatocellular carcinoma. Liver transplant may be a last resort for some patients whose liver is failing due to cirrhosis or liver cancer.

Pakistan is said to be one of the countries, where injection usage is highest. Therefore, disposiable syringes should be used they should not be recapped and glass syringes should be avoided. Moreover, screening of blood should be done before transfusion.

Hepatitis C patients now have a remarkable new treatment option: Peg interferon alfa 2a (40 KD), which is injected only once a week. A recently developed process called PEGYLATION now helps interferon to last longer in the body. As a result, a PEGYLATED INTERFERON improves the chances that the molecule will reach and kill the hepatitis C infected cells. 87 percent of Pakistani population that are suffering from Hepatitis-C are of genotype 3, which has a best chance of cure and requires treatment for six months.

Spend a few moments to think, recall and answer the following questions:

1. Did you get a blood transfusion without Hepatitis C Screening?
2. Were you injected with a glass syringe/injected with used syringe?
3. Do you experience chronic fatigue/tiredness for which your doctor is unable to find any explanation?
4. Were your Liver enzymes (ALT) ever raised?
5. Do you have any tattoos?
6. Do you have any body piercing ?
7. Do you have contact with blood in the workplace (e.g. healthcare worker, police personnel and firefighter)?
8. Do you live with a person who is infected with Hepatitis C and have shared items such as nail clippers, razors or toothbrush that might have had blood on them?
9. Have you ever been on haemodialysis?
10. Did you get an organ transplant?
11. Did you have a haircut/shave where you suspected the scissors/comb/razor were not sterilized properly?
12. Has a member of your immediate family been diagnosed with Hepatitis B or Hepatitis C?

If any of the responses to the worksheet were YES Your Doctor will review the worksheet with you and probably ask some additional questions. A simple blood test to determine presence of Hepatitis C might be recommended.

In view of the possible serious complication of Hepatitis-C it is better to know and simple precaution can play important role in protection against this silent killer.