Hepatitis C is a viral disease of the liver, caused by the hepatitis C virus. This disease is usually transmitted via contact with infected blood, although it is also possible to contract it during sexual intercourse. After infection, the virus is cleared out of the organism within six months with little to none complications in about 30 percent of cases. On the other hand, in about 70 percent of patients, hepatitis C takes a chronic form. The chronic form of the disease can last for years and sometimes even be lifelong.
While patients suffering from the acute form of hepatitis C usually show little to no symptoms, the chronic form, which causes a much more serious deterioration of the liver, presents with a number of symptoms, such as:
- Itchy skin
- Joint pain
- Nausea
- Vomiting
- Loss of appetite
- Weight loss
- Jaundice
- Dark urine
- Light, clay colored stool
- Abdominal pain
- Prolonged bleeding time
- Getting bruises easily
These symptoms suggest a gradual loss of liver function. If untreated, hepatitis C can, in time, cause more serious damage to the liver, which can manifest as complications such as fibrosis, cirrhosis and liver cancer. The most common complication of the chronic form of this disease is steatosis, or fatty liver, which affects 55 percent of patients.
What is fatty liver disease?
Fatty liver disease can be caused by a number of reasons — obesity, alcohol abuse, type 2 diabetes, taking certain medical and street drugs, raised blood fat levels, and several infectious (and other) diseases, including hepatitis C. Different causes can contribute to this condition at the same time, so, for instance, an obese hepatitis C patient who regularly drinks alcohol will be more prone to fatty liver disease than other patients.
How are hepatitis C and fatty liver disease connected?
The hepatitis C virus is known to be one of the causes of fatty liver disease. Although the exact molecular mechanism by which hepatitis C causes fatty liver disease is yet to be determined, it is believed that this virus produces certain proteins which interrupt the cell's lipid metabolism. This means that the cell is not able to get rid of the fat it produces, and ends up storing it until the lipids fill the cytoplasm.
Another mechanism, which should also be taken into consideration, is insulin resistance. Hepatitis C is known to cause insulin resistance. In the case of insulin resistance, glucose blood levels are higher than normal. This sets off a chain of events which leads to increased levels of fat in the patient's blood. The excess fat is then taken and stored by the liver cells, resulting in fatty liver.
It should be noted that the risk of steatosis, as well as the severity of the condition, also depends on the genotype of the virus. Although they are considered to be the same species, there are several different types of hepatitis C virus. Out of all genotypes, genotype 3 is believed to cause steatosis most often, with up to 73 percent of patients suffering from fatty liver disease.
How can I know whether I have fatty liver disease?
There are a number of ways in which fatty liver disease can be diagnosed. Ultrasound and other imaging techniques (such as CT and MRI) can be used to diagnose this condition. Unlike the latter two, ultrasound is cheap and accessible, and is generally the first diagnostic procedure your doctor will use if they suspect that you suffer from fatty liver disease. Sadly, ultrasound cannot be used to determine the amount of cells affected by steatosis.
The most precise method of diagnosing fatty liver disease is a liver biopsy. But, since this method is invasive, and a number of things could go wrong during the procedure (plus, it's not cheap, either), the doctors usually opt for other, non-invasive methods.
How can fatty liver disease be treated?
Unfortunately, there is no specific treatment for this condition. The only thing you can — and should — do is to change your diet and lose weight. Also, since alcohol is known to cause and contribute to fatty liver disease, you should stop drinking as well. Studies suggest that a healthy diet and regular exercise can reduce the number cells affected by this condition in only three months. If this condition has affected large parts of the liver, and the damage is irreversible, liver transplantation might be the only option.
Diagnosing the underlying cause of steatosis is essential in determining which type of therapy should be administered. Once the exact cause is known, treating it will, in time, treat the fatty liver disease as well.