Hepatitis C is a viral infection that can be transferred through blood and other bodily fluids. There are six specific types of Hep C that are all related to the genome that is most affected by the illness. This categorization is not related to severity, as all types of Hepatitis C can lead to equally impactful conditions. However, the differences in the genotype varieties are related to how the illness responds to different treatments and interventions.
For the purposes of classification and treatment, Hepatitis C can be viewed as the following possibilities of viral infection:
- Genotype 1a
- Genotype 1b
- Genotype 2a, 2b, 2c, and 2d
- Genotype 3a, 3b, 3c, 3d, 3e, and 3f
- Genotype 4a, 4b, 4c, 4d, 4e, 4f, 4g, 4h, 4i and 4j
- Genotype 5a
- Genotype 6a
These main categories and subcategories are also used to indicate the possible vectors of transmission, as a variety of subtypes are common in specific geographical areas. Although individuals can be infected with more than one type of Hep C, the classification system is mainly utilized to streamline treatments for patients with this illness, since the different genotypes will respond to specific antivirals.
Each of the six genotypes of Hep C can involve both an acute phase and a chronic phase, as these are an expression of the progression of the illness. Although genotype 1 of Hepatitis C is the most commonly found type of the disease within overall populations, it will still correspond to the same phases that are expressed in the other five types. Many treatments for the illness are strongly focused on this genotype, since it is the most prevalent.
What is Hep C?
Regardless of the type of Hep C which a patient may have contracted, the illness follows a fairly distinct progression and impact on health. The virus is thought to have evolved over several thousand years, as is evidenced in the geographical consistency with the Hep C genotypes across the world. The result of the illness is still an inflammation of the liver that can lead to a number of systemic problems that impact health.
The most common outcomes for individuals who have Hepatitis C include:
- Liver damage or liver cancer – which can come as a direct result of the chronic inflammation to the organ.
- Low energy – this arises due to the fact that the virus impedes the liver in processing nutrients and sugars to sustain metabolic actions.
- Low clotting factor – the liver is also responsible for manufacturing proteins that allow the blood to clot. Impaired function can result in comorbid conditions such as anemia and hemophelia.
- Digestive trouble – poor nutrient absorption, nausea and diarrhea, and gastric upset can also be the result of Hep C since the liver is integral to producing enzymes that aid in the digestive process.
Acute Infections and Hep C
Any genotype of Hep C will go through acute and chronic phases. These types of infections refer to the different stages that the virus will go through as it becomes established in the bloodstream. The acute phase will typically denote the first six months after a person has become infected and can often exhibit itself in minimal to nonexistent symptoms. If patients with an acute infection of Hepatitis C do show symptoms, they will generally include:
- Dark urine
These symptoms can typically show at around eight weeks after infection, although many patients will not even realize that they are sick. Although many types of Hep C can be successfully treated in the acute infection phase, most are not diagnosed until the illness has progressed to the chronic stage.
Chronic Infection of Hepatitis C
Chronic Hep C is generally considered to be any infection that has lasted more than six months. At this point, the viral load has built up in the bloodstream and is beginning to cause more noticeable damage to the liver. While some of the symptoms that are experienced can be attributed to toxins building up in the body, these are all as a direct result of a chronic infection of Hep C.
At this stage, patients will begin to recognize a basic feeling of being unwell and can also show other symptoms that are associated with the disease. These can include:
- Feeling sick
- Lack of appetite
- Inability to tolerate alcohol
- Sharp pains over the area of the liver
- Yellowing of the skin
- Depression and mood changes
- Extreme tiredness
- Cognitive and memory problems
- Persistent aches in the joints
Research shows that continued progression of chronic infections of Hepatitis C can also lead to cirrhosis of the liver and liver cancer.
Hep C and Occult Infection
The term of occult infection for Hep C refers to a specific condition in which patients still have the virus in their bloodstream, although it is not immediately expressed. This includes patients who have previously been infected with Hepatitis C, but no longer have viral RNA in their serum although they do have the virus detected through other techniques. This can include finding the virus in certain blood cells, while the overall viral load may be considered insignificant.
The terminology of an occult infection means that the patient still carries the Hep C virus, even though this fact is virtually hidden. As a result, patients with this type of infection will show no symptoms, although they can still pass the virus to others. This type of infection also makes it likely that these patients can develop chronic Hep C at a later stage, since full blown expression of the illness is likely to show as re-infection from the virus that is still present in the body.
Extrahepatic Complications as a Result of Hepatitis C
Extrahepatic infections that are associated with Hep C are not directly related to the effects of the virus on the liver, but are indirect complications that can arise as a result of the liver being compromised. These can impact the following:
- Brain function – a build-up of toxins in the body can lead to cognitive impairment, Alzheimer’s/dementia symptoms, and trouble with coordination.
- Thyroid problems – the disruption of metabolic function can result in hyper or hypo thyroidism.
- Blood sugar issues – the inability to properly process nutrients can lead to imbalance blood sugar which can also give rise to developing type 2 diabetes.