Hepatitis C is a virus of the liver, causing inflammation and scar formation. The liver has a multitude of functions, including creating albumin (a blood protein) and globin (the oxygen carrying substance in the blood), cholesterol and bile, removing and excreting toxins from our bloodstream, and storing or releasing glycogen for energy.
The initial signs of hepatitis are a flu-like illness with joint ache, fatigue and sometimes yellow skin and eyes. Hepatitis C and B may, in some cases, become disabling or fatal. As the virus harms the liver, it stops functioning, and the brain and other organs toxify. Or hepatitis may be chronically persistent, causing only slight joint aches, fatigue and other flu-like symptoms.
At the Hawkins Center, we must use the signs and symptoms of hepatitis to help clients obtain disability benefits when they are incapacitated by hepatitis C. In establishing disability, tests documenting the manifestations of the disease are essential.
But what kind of tests are the most useful? Once the hepatitis virus is identified by blood test, the surest way to detect inflammation (hepatitis) or fibrosis (scarring) of the liver is to take a liver sample with a hollow needle (biopsy). Liver enzymes (noted at ALT, SGOT, SGPT and AST on lab reports) are released into the bloodstream when it is hurt by the virus.
However, low enzymes do not mean lack of harm. Enzymes can be low because the liver is too damaged to still release them. Only the biopsy will reveal this. Lastly, testing for prothrombin (blood clotting) time (PTT on lab reports) is important. Abnormal PTT is a sign of a very damaged liver. You may have to ask for PTT testing, as it is not routinely given.
Those who have hepatitis C from transfusion should be notified. A long life with little compromise is possible, especially if the liver is protected from damage by stopping drinking alcohol or preventing exposure to toxins.
Failure to protect the liver and persistent active hepatitis C can result
in: skin rashes; muscle and joint aches; kidney disease; profound fatigue;
decreased platelets; depression; liver cancer; and liver failure with hepatic
encephalopathy, resulting in confusion, memory loss and eventual coma and
death because of the loss of the liver's ability to remove toxins from
the bloodstream. Clients with these symptoms may qualify for social security
benefits, if proper lab documentation exists.
So, get hip. Keep your follow-up visits if you have hepatitis C. Ask
the doctor at what stage of the disease you are, and if any medications
(such as interferon or ribavirin) might help you. Have your lab work done
routinely, and love your liver by treating it gently. Seek help from legal
professionals who understand the complexities of the liver and the hepatitis
C virus if it becomes disabling.
Thanks to Dr. Robert Gish, Director of California Pacific Medical Center,
Liver Transplant Program for his assistance with this article.