Hepatitus C Virus: An Overview

Dr. Michell Shiffman of Bon Secours' Liver Institute of Virginia

Dr. Michell Shiffman of Bon Secours' Liver Institute of Virginia

Hepatitis C virus (HCV) is the most common cause of liver disease, cirrhosis and liver cancer in the USA. HCV is also the most common reason why patients need a liver transplant. The most common reasons why patients acquire HCV is because they utilized illicit injection drugs or inhaled cocaine with a person who was already infected with HCV. Patients may also have received a blood or plasma transfusion prior to 1990 when HCV was first discovered and before donated blood could be tested for this virus. It is extremely rare for HCV to be transmitted through sexual interaction. HCV cannot be transmitted by food or casual interactions with a person with HCV. Approximately 20% of persons with chronic HCV have no obvious source of how they acquired this infection.

Over 80% of persons who are infected with HCV develop chronic disease. This means the virus does not go away.  Many, but not all patients with chronic HCV have elevated liver enzymes in their blood. A blood test can detect these elevated liver enzymes and the amount of this virus (HCV RNA) in the blood of a patient. The level of HCV RNA in the blood does not have any relation to the severity of the liver disease caused by chronic HCV. Tha majority of patients with chronic HCV slowly develop damage to the liver and increasing amounts of scaring until cirrhosis has developed. This process takes 20-30 years.  Patients with cirrhosis are at increased risk to develop liver failure and liver cancer.

The majority of patients with chronic HCV are asymptomatic. Of those patients with symptoms, the most common is fatigue. Some patients develop aches in the joints or a discoloration in the lower legs. HCV can also cause kidney damage and diabetes.

There are several different types of HCV called genotypes. The most common genotype in the USA is type 1 which affects 65% of persons.  Most of the remaining persons in this country have genotypes 2 or 3.

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About Dr.MLShiffman

Dr. Mitchell Shiffman is the Bon Secours expert on liver disease and liver treatments for Virginia. Prior to joining Bon Secours, Dr. Shiffman was a professor of Medicine at Virginia Commonwealth University (VCU) in Richmond, VA. He was the Chief of the Hepatology Section and Medical Director of the Liver Transplant Program at the VCU Medical Center from 1989 until 2009. During his 20 years at the VCU Medical Center Dr. Shiffman built and directed one of the most respected and productive hepatology programs in the United States. Dr. Shiffman is recognized as one of the world’s leaders in the field of Hepatology. His particular area of research is viral hepatitis. He has been involved with and/or directed numerous clinical trials to develop new and better treatments for viral hepatitis B and C. Dr. Shiffman is a regular speaker on the treatment of viral hepatitis, the management of various liver disorders, and issues related to liver transplantation at regional, national and international society meetings. He has published over 200 articles in medical journals related to the treatment of liver diseases and has edited two books on this topic. In addition, he has contributed to various HCV educational resources including an HCV educational kit. Dr. Shiffman is also a widely recognized expert consultant to pharmaceutical companies on the treatment of liver disease. Dr. Shiffman holds a Bachelor of Arts from State University of New York at Buffalo, a Master of Science in physiology from the University of New Mexico School of Medicine in Albuquerque, N.M. and his Doctor of Medicine from State University of New York Upstate Medical Center in Syracuse, N.Y. He completed his internship and residency in internal medicine and fellowship training in gastroenterology and hepatology at the Medical College of Virginia Hospitals in Richmond, VA. Dr. Shiffman is a member of many professional organizations including: the American College of Gastroenterology, American College of Physicians, the American Gastroenterological Association, American Society for the Study of Liver Diseases, American Society of Transplantation, European Association for the Study of the Liver, International Liver Transplantation Society, Richmond Academy of Medicine, Virginia Medical Society and the Virginia Gastrointestinal Society. He was a member of the Board of Trustees with the American College of Gastroenterology from 2003-2009.

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