Dear Dr. Roach: I am a 35-year-old white male who was a drug addict from the age of 14 until 32. You name it, I took it. About three years ago, I quit drugs and have lived a healthy lifestyle since. I do not drink alcohol, and I smoke one or two cigarettes a day. Three years ago, I was tested for hepatitis and was told the results were negative. About two weeks ago, I was tested and found to have hepatitis C. The results were "HCV RNA Quantitative real time PCR 8010 (high) and log 3.90 (high)."
These results were given to me by a nurse without explanation other than to see a specialist. Further physician visits were denied by my insurance. I have no idea what this means, or what I need to do. I have no symptoms or discomfort at this time. What happens if this condition goes untreated?
A: Now you have to deal with a complication of drug use, particularly injection drug use: hepatitis C. Hepatitis C is a slow-acting virus that affects the liver. The course of hepatitis C is variable. Some people have a very aggressive virus, which without treatment can cause permanent liver damage, ultimately leading to cirrhosis and sometimes cancer of the liver. Others have a much more benign course with no evidence of liver damage, even after many years with the virus.
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Your viral load, a measure of how much virus is in the blood, is fairly low. However, you absolutely should still go see a specialist.
Treatment for hepatitis C is so good now (97% or more effective) and the side effects of the new drugs are so mild that most experts treat someone with even very benign disease. Treatment courses are sometimes shorter for people with mild disease and without scarring of the liver.