When Tiredness is Sign of Liver Disease You Caught Years and Years Ago


Hepatitis C can seem like a disease other people get. The virus is traditionally associated with tattoos and intravenous drug use, and Keith Richards and Pamela Anderson are amongst those who have suffered from it. Imagine, then, how clean-living grandmother-of-two Melanie Dymock felt when she discovered she had it, following blood tests after a heart operation in 2010.

‘My GP was dumbstruck and so was I,’ says Melanie, 50, from Dagenham, east London. ‘I’ve never used drugs or had any tattoos and I had no symptoms – I felt fine. I had no idea where I could have got it from.’ Hepatitis C is contracted by blood to blood contact, and once in the body, the virus causes liver cirrhosis and failure.

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It raises the risk of liver cancer, too, because it kills cells, causing a high turnover of new cells, meaning more chance of mutation. However, it takes 30 years on average after infection for cirrhosis to set in, and frighteningly, it is symptomless until then.

‘My doctor asked if I’d ever had a blood transfusion,’ says Melanie, a GP receptionist who lives with her long-term partner. ‘And I had – I was born with a heart defect and so I’d had an operation on it when I was 16. I also had a transfusion when I had my daughter in 1982 because I lost a lot of blood.

‘He said it must be that because they only started screening blood used in transfusions in 1992. It was pretty scary that I’d had it all that time without realizing it. The doctors said if it hadn’t been picked up, within five years I’d have had cirrhosis of the liver.’

Experts are warning that the UK is about to see an explosion of cases like Melanie’s, where people who caught hepatitis C during its peak in the 1970s and 1980s are only now discovering they have it. New diagnoses of the virus shot up by a third between 2010 and 2012 in England, according to Public Health England.

Intravenous drug use and blood transfusions are the most common causes, but the virus can be caught through medical procedures, including dental work, and tattoos, and piercings. This is less of a risk now in the UK, but it’s still a major threat if you have such procedures in certain countries where sterilization standards are poor.

It can also, more rarely, be passed from one to another through sharing toothbrushes (if the gums bleed) and razors. This summer it was revealed that thousands of women in England were at risk of hepatitis C after it emerged that a retired gynecologist had practiced for years while unknowingly carrying the virus.

Two patients are already confirmed to have been infected although the risk is very low since it would need to involve the doctor scratching him or herself during an operation.

The condition is curable, so doctors are urging those who may be at risk – including anyone who had a blood transfusion before 1992 – to get themselves tested. Although all donated blood is now screened for hepatitis C, it wouldn’t show up if you were having a routine blood test for something else. You’d need to be specifically tested for the hepatitis C virus to find out.

‘The liver has an extraordinary repair capacity, so it can take decades for any problems to develop,’ says Graham Foster, professor of hepatology at the Queen Mary University of London. ‘It’s like the petrol tank in your car – it will run at 100 miles per hour but then when the final drop of petrol goes, it suddenly stops. ‘About 30 percent of people with hepatitis C already have cirrhosis by the time they are diagnosed.’

Hospital admissions for hepatitis C-related end-stage liver disease and liver cancer in England have increased from 574 in 1998 to 2,266 in 2012. ‘The trouble is the earliest symptoms will be feeling unwell and tired,’ says Charles Gore, chief executive of the Hepatitis C Trust. ‘And these people may think, “I’m 50, it’s normal.” ’

Professor Foster says this group could also have unwittingly passed it on to their children and grandchildren – around one in 20 mothers with hepatitis C will infect their baby. Luckily, Melanie’s daughter was not affected. source