Sept. 10, 2008 -- Singer Natalie Cole, who has hepatitis C, says she's getting chemotherapy and will cut off all her hair next week because it's starting to fall out due to the chemo.
"What I have is treated with chemotherapy. I have chemo every week," Cole said in an interview shown yesterday on Entertainment Tonight. She told her interviewer, Paula Abdul of American Idol, that the chemotherapy makes her tired and nauseous, and that she's lost a lot of weight due to her illness, but that she has a "great group of people" rallying around her.
What is hepatitis C? How do you get it, how is it treated, and can you prevent it? And is chemotherapy a common treatment for hepatitis C? Here are answers to those and other question about hepatitis C.
What is hepatitis C?
Hepatitis C is a liver disease caused by an infection with a virus. It is a serious disease because the liver is needed to remove toxins that build up in the blood. Hepatitis C can cause cirrhosis and destroy the liver. It is a main cause of liver transplants worldwide.
How do you get hepatitis C?
There are several ways to get infected with hepatitis C:
- Sharing needles for injection drug use. Drug use may be how Cole got hepatitis C. She told Entertainment Tonight that she used heroin in the early 1980s. Cole wrote about her drug use in her 2000 autobiography, Angel on My Shoulder; saying her drug use is long over.
- Accidentally getting pricked by a needle contaminated by infected blood. This sometimes happens to hospital workers.
- Being born to a mother with hepatitis C infection.
- Getting a blood transfusion from someone with hepatitis C infection. Before 1992, blood could not be tested for hepatitis C. Since 1992, all blood donated in the U.S. gets tested for the virus. If you had a blood transfusion or organ transplant before June 1992, ask your doctor about being tested for hepatitis C.
- Some people on kidney dialysis have gotten hepatitis C from contamination of the equipment.
- It's possible to get hepatitis C from someone you live with if you share items such as razors or toothbrushes that might have had his or her blood on them.
- A person can get hepatitis C from getting a tattoo or body piercing with dirty tools.
- Rarely, a person can get hepatitis C from having unprotected sex with an infected person. This is more likely to happen if the infected person also has another sexually transmitted disease.
You cannot get hepatitis C from hugging or shaking hands with an infected person.
How common is hepatitis C?
The CDC estimates that 3.2 million people in the U.S have chronic hepatitis C infection, a long-term illness that happens when the virus remains in a person's body. Most of those people don't know that they have it because they don't look or feel sick, the CDC's web site states.
An estimated 19,000 people in the U.S. have acute hepatitis C infection, which is a short-term illness that happens within six months of being exposed to the hepatitis C virus.
Does hepatitis C make you sick right away?
Not usually. Natalie Cole told Entertainment Tonight that the hepatitis C virus had been "dormant" in her body for 25 years. And that's not rare.
"Patients can be without symptoms and even with normal liver tests for 25 or 30 years. That's very common, in fact," Bruce R. Bacon, MD, director of the division of gastroenterology and hepatology at St. Louis University School of Medicine, tells WebMD.
Bacon, who isn't treating Cole, prefers the word "inactive" rather than "dormant" to describe the virus when it's not causing obvious symptoms.
What are the symptoms of hepatitis C?
Hepatitis C usually doesn't cause any symptoms. But when symptoms occur, the CDC says they may include:
- Appetite loss
- Abdominal pain
- Dark urine
- Clay-colored bowel movements
- Joint pain
- Jaundice (yellow color in the skin or eyes)
"The most common symptom is probably no symptoms. But the next most common symptom would be fatigue. People just feel tired and worn out," says Bacon.
How is hepatitis C diagnosed?
Hepatitis C is diagnosed by a blood test.
If you have any risk factors for hepatitis C, get tested, and if you find out you have hepatitis C, see a specialist, Bacon suggests.
Don't let stigma about drug use or other risk factors stand in your way. "We just need to move beyond that and find out what's going on," says Bacon.
How is hepatitis C treated?
Hepatitis C is treated with two drugs: long-acting interferon (called pegylated interferon or peginterferon) and ribavirin.
Pegintereferon "gets the immune system to handle the virus a little more effectively," says Bacon. Ribavirin is an antiviral medicine, "but it doesn't work against hepatitis C alone; it only works in conjunction with interferon."
New treatments are in the works. "Those new treatments are a class of drugs called protease inhibitors," says Bacon, singling out two protease inhibitors -- telapravir and boceprevir -- as being "far along in development."
Is Natalie Cole really getting chemotherapy for hepatitis C?
The chemotherapy that you'd get for cancer isn't used to treat hepatitis C. But Bacon says hepatitis C treatment can have side effects "that are akin to what patients experience when they receive cancer chemotherapy." That includes temporary hair loss.
The peginterferon-ribavirin combination is "sometimes loosely called chemotherapy," says Bacon. "I don't like to give it that negative connotation, to try to keep things positive for patients. So I call it treatment for their viral infection or antiviral therapy."
How long does treatment take?
That depends on the strain, or genotype, of the virus. Those genotypes vary around the world. The most common genotype in the U.S. takes 48 weeks to treat, says Bacon.
Can hepatitis C be cured?
The combination of peginterferon and ribavirin cures hepatitis C in 50% to 60% of cases, according to Bacon. He predicts that the protease inhibitors that are being developed will boost the cure rate to 70% to 80%.
"So often people say, 'Oh, there's no cure; I'm not going to do anything about it.' But there is a cure. You can have the virus eradicated up to 50%-60% of the time," says Bacon.
What about a hepatitis C vaccine?
There isn't one. "The virus changes very quickly," making it very hard to create a vaccine, notes Bacon.