Is hypoplastic anaemia linked to Hepatitis C infection?
Q: I am 51 years old. Two years back I was diagnosed with hypoplastic anaemia. While taking packed cell transfusion, the blood given to me was unchecked due to which I got Hepatitis C. My platelets came down to 18,000. I went to Vellore for treatment and consulted other doctors too. I was told that I could be treated only if my platelet is more than 50,000. Initially I took Danazol tablets and later iron capsules. I had to take transfusion every month as my haemoglobin came down to 5. None of the doctors could do much for me. I have being under homeopathic treatment for the last one year. There has been some improvement. This time I have taken transfusion after 70 days (I always take 2 Units of packed cell) and my platelet had gone up to more than a 100,000. But my SGOT and SGPT have gone up. How is HCV linked to hypoplastic anaemia? I know HCV is a silent killer, so what will happen after 20 years? I am tired of being admitted to the hospital. Is there a way out? I need to live for another 5-6 years for my children. I am the sole earning member of the family and cannot afford to be too ill and absent from duties. Please suggest something that will help me live a better life.
A:Hepatitis C is caused by a RNA virus and most patients infected with HCV have chronic liver disease, which can progress to cirrhosis and hepatocellular carcinoma (HCC). The virus is usually transmitted by percutaneous exposure to infected blood (intravenous drug abuse, acupuncture, tattooing, sharing razors). Patient-to-patient transmission can also occur during surgery, use of a contaminated colonoscope or dialysis. No risk factors are can be found in about 10% of patients. The virus targets liver cells and perhaps also B lymphocytes and up to 50% of liver cells may be infected in chronic hepatitis C. Patients are usually asymptomatic or may have non-specific symptoms such as tiredness or malaise. In case of cirrhosis or advanced liver disease, symptoms like itching, altered sleep pattern, swelling of ankle & feet, ascites, bleeding or mental disorientation may develop. Treatments aims to eradicate HCV and prevent progression to cirrhosis or cancer. This is done by using interferon (IFN alfa-2b & IFN alfa-2a) alone or in combination with ribavirin. Unfortunately, side effects are very common with these drugs and they include flu-like symptoms; neutropenia, thrombocytopenia & hemolytic anaemia; disturbance in memory & concentration, headache, depression; metabolic complications, gastrointestinal disturbance etc. HCV is not known to cause aplastic anaemia though other hepatitis viruses are implicated. The treatment of hypoplastic/aplastic anaemia consists of transfusions, antibiotic therapy, use of immunosuppressive agents (ATG alone or combined with CSA) and finally, bone marrow transplant. You need to consult an experienced gastroenterologist along with a clinical haematologist who can advise and guide you.