Ok - there's a few "random" questions I have and my general theory is if I have these questions then somebody else probably does too.

1. Is there any possible way to look at the person and know how much liver damage there is? For example my husband has literally dozens of spots surrounding his eyes, on his hands and arms - all over. But the brown spots around his eyes are the most alarming. He also bruises very, very easily and if he cuts himself shaving he'll literally bleed for hours.

2. Why doesn't the state HAVE to notify me that I've been exposted to Hepatitis? Had he not told me, I would have never known. If he had syphilis then they are required by law to notify me, yet syphilis is treatable at very, very low cost.

3. When the disease goes from inactive to active, is this a gradual thing or does it happen overnight?

I will probably think of more later. :)

Monica:

1) There is NO WAY to tell how much liver damage has already been wreaked. A person could be in fourth stage fibrosis (fibrosis is scarring of the liver) and they can look and FEEL totally healthy.

What you CAN tell visually sometimes, is how hard their liver is working THIS WEEK! I got so good at "reading" the colour of my husband's skin, that I could take one look at him in the morning, and just judging from the colour, I knew if this week he had to eat less proteins and take a little more milk thistle etc. If he'd do that for a few days, his colour would return to normal, and blood tests would confirm that his liver had been overtaxed that week!

2) This non-notification of spouses, and in some case, of PATIENTS themselves is an atrocity, and another political fight we need to wage! I know of prisons that mass-test all the inmates, and DO NOT INFORM THEM that if are Hep C positive! They are only testing for their own statistical purposes! Also, if two people are not legally married, and only living common-law, in many jurisdictions, the common law spouse has NO RIGHTS AT ALL to medical information. Although, some doctor's will divuge results in private. This is a most strange practice, since A) Hep C is a reportable disease to public health units, AND B) everyone knows how very contagious it is!

3) It is NEVER inactive!!!!! This virus is always replicating and multiplying!! This is evidenced in a lab test called the VIRAL LOAD TEST! A person's viral load fluctuates both UP AND DOWN over the space of time. You can have an alarmingly high viral load one week, then watch your diet,etc. for a few days or weeks, get another viral load test, and it has gone down to more manageable levels again.

Being symptom-free is NOT a sign of being inactive. It just means that the virus is not reproducing at such a fast rate that it produces visible symptoms.

All My Love,
Menolly

Monica,

I will add to what Menolly has said by saying that thankfully, the disease is more or less a gradual progression.

What does start to happen in the advanced stages however is the random start up and shut down of the liver function as the liver is more and more stressed by the disease.

As the disease usually (in the severe cases) becomes cirrhosis, the liver is so scarred and fatty that there is not enough liver tissue to support normal function. This is when you see more symptoms with the patient.

During the disease with my Father, he would always be tired and could not always eat well or focus his mind, but outwardly these symptoms were not evident to most people and they went on for years.

It was unfortunately only in the final stages (end stage liver disease) that the symptoms were visually clear.