Often the main problem is variable bowel habit - there is sometimes diarrhoea and other days constipation. This is the main symptoms of irritable bowel syndrome (IBS)...

Hepatitis C

Hepatitis C

Worldwide 300 million people are infected with Hepatitis C.

In NZ population 0.45% of the population is positive for Hepatitis C antibodies

  • The infection affects ethnic groups in NZ in equal proportions (in contrast to Hepatitis B). Hepatitis C is usually acquired without any symptoms (no hepatitis illness). A "carrier state" does not exist (in contrast to Hepatitis B)
  • >75% have a history of intravenous drug use.
    • This may be only 1-2 episodes of use at a teenage party.
  • 5%  have a history of blood transfusion prior to 1992 (before routine testing of blood was commenced).
  • 5-10% have other risk factors.
    • Unsterile tattooing.
    • There are high rates in prison inmates (presumably related to i.v drug use).
    • Migrants from countries with high rates due to re-using unsterilised needles - e.g Egypt.
  • 5-10% have no identifiable risk factors.

Lifestyle Issues

  • If you are considering treatment you will need to prepare for the possible impact on your lifestyle and relationships.
  • You could also require time off work to deal with side effects and/or need to arrange a flexible work schedule with your employer.
  • Personal relationships may come under pressure from mood altering side effects and disruptions to routine. A big part of preparing for treatment is preparing those who will support you so they can help you through this time.

What about alternative / complementary treatments?

  • There is much interest in alternative treatments such as homeopathy, herbal medicine, dietary changes, and various therapies to decrease stress. Overall the results are disappointing.
  • It is important to be open and frank with your GP or specialist so that appropriate decisions are made.
  • Some people with hepatitis C have very mild disease and do not need to consider medical treatment. In this situation a more holistic approach may be acceptable.
  • The best “alternative” treatment is to:
    • Stop alcohol.
    • Lose weight.
    • Have a balanced diet (low fat, fresh fruit and vegetables).
    • However there is minimal evidence to support any other sort of dietary restriction and no evidence for any herbal treatment.
  • Fatty liver is has a negative influence on the outcome of Hepatitis C.  Therefore weight loss, a low fat diet and regular exercise and minimal or nil alcohol intake are all helpful measures in a more holistic approach probably because of a reduction in the degree of fatty liver.

  • What about a liver biopsy?

    • Liver function tests measure specific enzymes in your blood. Unfortunately, these tests do not accurately reflect the extent of inflammatory change and/or damage to the liver that can result from HCV infection.
    • Liver damage may be present even when these tests are normal.
    • There is little correlation between the severity of the symptoms and the extent of liver damage.
    • Therefore the only way to determine whether there is any damage to the liver is to physically examine a small section under a microscope (liver biopsy) although a new scanning technique called a Fibroscan may be helpful and decrease the need for liver biopsy.
    • Treatment can proceed without a biopsy - and indeed is unchanged reagrdless of the degree of fibrosis, but there may be some uncertainty about te severity of te underlying disease


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