By John McElligott, MD and Donna Kennedy, Ph.D., MS
During a single month – February in fact – the St. Christopher Fund received applications from 10 drivers with problems due to hepatitis C. Therefore, we decided to take a look at this disease. You may not even know you are infected, but with the demands of your job as a professional truck driver, it will soon be apparent that you are sick.
Hepatitis C is a disease caused by the hepatitis C virus (HCV). Approximately 270-300 million people are infected worldwide, with 3-4 million new cases each year. Because hepatitis C is the most common cause of cirrhosis (scarring of the liver), it is the leading reason for liver transplantation in the U.S.
There are two phases of hepatitis C, the acute phase and chronic phase. The acute phase involves the first six months after the HCV has caused infection.
Symptoms typically appear between two and 24 weeks and are often flu-like (fever, fatigue, loss of appetite, nausea, vomiting). Symptoms may also include having dark urine, clay-colored stool, abdominal pain, joint pain, itching and jaundice (yellowing of the skin). However, 60-70 percent of those infected show no symptoms during the acute phase.
The chronic phase involves infection lasting more than six months. Again, most individuals will have no symptoms and are surprised to learn of the disease when discovered during a routine exam or when being screened for blood donation. Symptoms vary from person to person with chronic hepatitis C, but can include depression, sleep disturbances, appetite changes, joint pains, nausea and the flu-like symptoms listed above.
When hepatitis C has caused cirrhosis, symptoms usually appear and may include an accumulation of fluid in the abdomen, enlarged veins (especially on the stomach and esophagus), jaundice, a tendency to bruise or bleed, and cognitive impairment (hepatic encephalopathy).
Infection can be treated with interferon or ribavirin and has a 51 percent cure rate. However, according to the Center for Disease Control, of every 100 persons infected with hepatitis C, approximately
- 75 to 85 percent will develop chronic infection.
- 60 to 70 percent will develop chronic liver disease.
- 5 to 20 percent will develop cirrhosis over a period of 20 to 30 years.
- 1 to 5 percent will die from the consequences of chronic infection (liver cancer or cirrhosis).
A faster progression of the disease is influenced by a number of factors. If you are an aging male, consume alcohol regularly, have HIV or have a fatty liver, you can expect the disease to progress at a faster rate.
Currently, no vaccine is available for hepatitis C. LL
John McElligot is an MD, Fellow of the American College of Physicians, and medical director of the St. Christopher Trucker Development and Relief Fund. Donna Kennedy, PhD, MS, is executive director of SCF. Jeff Heinrich, who serves as the column’s medical editor, has a Doctor of Education degree and PA-C, which means Physician Assistant Certified.