WebMD Medical News
Louise Chang, MD
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.
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.
There are several ways to get infected with hepatitis C:
You cannot get hepatitis C from hugging or shaking hands with an infected
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.
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
"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.
Hepatitis C usually doesn't cause any symptoms. But when symptoms occur, the
CDC says they may include:
"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.
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.
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
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."
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."
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,
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.
There isn't one. "The virus changes very quickly," making it very hard to
create a vaccine, notes Bacon.
SOURCES:Entertainment Tonight.WebMD Medical Reference: "Understanding
Hepatitis C -- the Basics."CDC: "Viral Hepatitis: FAQs for the Public."Bruce R. Bacon, MD, James F. King Endowed Chair in Gastroenterology,
professor of internal medicine, director of the division of gastroenterology
and hepatology, St. Louis University School of Medicine.
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