Acetaminophen
component of many over-the-counter pain killers (such as Tylenol*) and cold medications. It reduces fever and sensitivity to pain.
Acute
short-term infection. Acute hepatitis C infection should resolve within 6 months of initial infection.
ALT
alanine aminotransferase. This is a type of enzyme normally found in the liver. When liver cells are injured this enzyme leaks into the blood. Therefore, persistently abnormal levels of this enzyme in the blood indicate that the liver may be inflamed or damaged.
Amino acids
nitrogen-containing molecules. Proteins, both in food and in human tissue, are made up of chains of various amino acids. There are 22 known amino acids and the sequence of these amino acids accounts for the distinctive characteristics of each protein.
Analogue
in chemistry, a compound with a structure similar to that of another compound but differing from it with respect to certain components or structural makeup, which may have a similar or opposite action metabolically.
Anemia
decreased ability of the blood to carry oxygen from the lungs throughout the body. This is measured as hemoglobin or red blood cell count.
Antibody
a type of immune protein molecule that is produced when bacteria, a virus or a foreign protein substance, enters your body. A specific antibody is produced against each invader.
Antigen
any substance that stimulates the immune system to produce antibodies. The hepatitis C virus is an example of an antigen.
Anti-HCV test
a blood test which looks for and measures antibodies to the hepatitis C virus. A positive anti-HCV result does NOT indicate immunity to hepatitis C. Rather it indicates that you have been exposed to the hepatitis C virus and likely still have the infection.
Antiviral drugs
drugs that work against a virus, such as the hepatitis C virus.
Antiviral
a substance or process that destroys a virus or prevents it from reproducing.
Ascites
swelling of the abdomen due to an accumulation of fluid.
AST
aspartate aminotransferase. An enzyme that is normally found in liver cells, that can leak out of these cells and make its way to the blood when liver cells are injured. The ALT is felt to be a more specific indicator of liver inflammation, as AST is also found in other organs such as the heart and skeletal muscle.
Autoimmune
directed against the body’s own tissue, e.g. autoimmune hepatitis.
Autologus blood donation
predonation and storage of a patient’s own blood a few weeks before elective surgery. This way, if the patient needs a transfusion during surgery they can receive their own blood and not someone else’s.
Bile
a substance secreted by the liver that helps in the digestion of fats. It is stored in the gall bladder until required.
Bilirubin
a yellow substance formed when red blood cells age and break down. The liver normally breaks down bilirubin for excretion. However, if the liver is not functioning properly bilirubin may accumulate in the blood stream causing jaundice.
Body fluids
any liquid in the body such as blood, urine, saliva, sputum, tears, semen, breast milk or vaginal secretions.
Bone marrow
the inside of bone where blood cells are formed.
Carrier
a person who has a virus in his/her system but who may not necessarily have symptoms or show signs of illness. This person can, however, pass the virus on to other people and make them sick.
CAT scan
computerized axial tomography. A special kind of x-ray for looking at the soft organs in the body, such as the liver. A three-dimensional image of a body structure is constructed by computer from a series of cross-sectional images made along an axis. Also referred to as a CT scan.
Cholestasis
blockage or suppression of bile flow, from either intrahepatic or extrahepatic causes.
Chronic
long-term infection. Chronic hepatitis C infection persists longer than 6 months and usually for years.
Cirrhosis
scarring of the liver as it attempts to protect itself from inflammation. Blood cannot flow freely through scarred liver tissue and thus the liver cannot perform its normal functions.
Clinical trial
a scientifically controlled study done with human subjects to investigate the effectiveness, safety and ideal dosage of a new drug or treatment.
Combination therapy
use of two or more medications at once. For hepatitis C, combination therapy with interferon and ribavirin is now the standard treatment.
Contraindication
a specific circumstance when the use of certain treatments could be harmful.
Cryptogenic cirrhosis
cirrhosis of unknown or hidden origin.
CT scan
computerized tomography scan. This is a special kind of three-dimensional x-ray used for looking at the soft organs in your body, such as the liver. Also referred to as a CAT scan.
Decompensation
failure of the liver to compensate for damage or injury, resulting in a decrease in liver functions.
Diagnosis
determining the presence of a specific disease or infection, usually based on evaluating a patient’s symptoms and results from laboratory tests.
Dialysis
a treatment for kidney disease that removes waste from blood. Used when the kidneys cannot perform their normal waste removal function. (Also called hemodialysis.)
Edema
abnormal accumulation of fluid in your arms, hands, legs, feet and face.
EIA
enzyme immunoassay. A test that detects the presence of antibodies to the hepatitis C virus, EIA is used for initial testing. Because false positive results are possible, supplementary tests (such as RIBA) are needed to confirm diagnosis.
ELISA
enzyme-linked immunosorbent assay – another name for the EIA test.
Enzyme
a cellular protein whose shape allows it to hold together several other molecules in close proximity to each other. In this way, enzymes are able to induce chemical reactions in other substances with little expenditure of energy and without being changed themselves. Basically, an enzyme acts as a catalyst.
Esophagus
a muscle lined tube extending from your throat to your stomach.
Fatigue
feeling extremely tired and lacking energy.
Fibrosis
the formation of fibrous tissue or scarring.
Fulminant
running a speedy course with rapid worsening.
Gallstones
solid lumps of cholesterol crystals or pigment material that form in the gall bladder or bile ducts. They may obstruct the flow of bile and cause pain.
Gamma-globulin
a type of protein in blood plasma that provides immunity to certain viruses, such as hepatitis A and hepatitis B (also called immune globulin or immunoglobulin).
Gastrointestinal (GI)
relating to the stomach and intestines.
Genotype
an identifiable strain of the hepatitis C virus. There are 11 major hepatitis C genotypes and more than 90 subtypes.
HCV
hepatitis C virus – the virus that causes hepatitis C.
HCV RNA
the actual viral material of hepatitis C.
Hemochromatosis
a disease in which too much iron is absorbed from the intestine and the excess iron accumulates in various organs. The liver is the first organ to store iron but when its storage capacity is exhausted, iron may accumulate in the heart, pituitary gland and elsewhere in the body. If untreated, damage to the liver, heart and pancreas may eventually cause death.
Hemoglobin
the component of red blood cells that carries oxygen.
Hemophilia
an inherited disease that affects mostly males and prevents normal blood clotting. It is treated by lifelong injections of a synthetic version of the clotting factor lacking in persons with the disease. The new recombinant clotting factor replaces the natural product, which was extracted from people’s blood.
Hemophiliac
a person who has hemophilia.
Hepatitis
inflammation (or swelling) of the liver.
Hepatitis A
a liver disease caused by the hepatitis A virus and spread through contaminated food and water.
Hepatitis B
a liver disease caused by the hepatitis B virus and spread through direct contact with blood or body fluids or sexual contact with an infected person.
Hepatitis C
a liver disease caused by the hepatitis C virus (HCV) and spread through direct blood-to-blood contact with an infected person.
Hepatocellular carcinoma
liver cancer.
Hepatocycte
liver cells.
Hepatomegaly
enlarged liver.
HIV
a disease in which the human immunodeficiency virus (HIV) weakens the person’s immune system. HIV is the virus that causes AIDS (acquired immune deficiency syndrome).
Hyperglycemia
an abnormally high level of sugars in the blood.
Hypoglycemia
an abnormally low level of sugars in the blood.
Immune system
the natural defence mechanism in the body that reduces susceptibility to a disease.
Immunity
a body’s resistance to the effects of a deleterious agent, such as a virus. A person may have developed immunity to one virus but not another.
Immunization
an injection with a vaccine that causes the body to develop immunity against a certain virus or bacterial infection.
Immunocompromised
used to describe people who lack normal natural levels of immunity. This could include people with HIV infection or people who are taking immunosuppressive drugs (such as transplant patients).
Immunoglobulin
a type of protein in blood plasma that provides immunity to certain viruses, such as hepatitis A and hepatitis B (also called gamma-globulin).
Incidence
the number of new cases of a disease occurring in a given population over a certain period of time.
Incubation period
the time it takes for the virus to develop sufficient copies of itself in a body before symptoms and signs of the disease occur and before it can be detected through blood tests.
In vitro
outside the living body and in an artificial environment.
In vivo
in the living body of a plant or animal.
Interferon
one of a number of antiviral proteins that modulate immune response. Interferon alpha (IFNa) is secreted by an infected cell and strengthens the defenses of nearby uninfected cells. A manufactured version of IFNa (trade names: Roferon, Intron A) is an HPB approved treatment for Kaposi’s sarcoma, the hepatitis B virus and the hepatitis C virus.
Irritable bowel syndrome
(spastic colon) a motility disorder involving the entire gastrointestinal tract, causing variable degrees of abdominal pain, constipation and/or diarrhea and abdominal bloating.
Jaundice
yellow discolouration of the skin and eyes as a result of a build-up of bilirubin in the blood. May be a symptom of many liver diseases.
Kayser-Fleischer rings
golden-brown rings in the corneas due to copper disposition in Wilson disease.
Kupffer cells
“scavenger” cells that remove foreign matter, worn-out blood cells and bacteria from the liver.
Lipid
any of a heterogeneous group of fats and fat-like substances characterized by being water-insoluble.
Liver biopsy
a diagnostic procedure used to obtain a small amount of liver tissue, which can be examined under a microscope to help identify the cause or stage of liver disease. Under local anesthetic, a needle is inserted and a small piece of liver is removed.
Liver function tests
blood tests used to assess the general state of the liver or biliary system and to reflect the presence of damage or inflammation. Common LFTs include ALT, AST and bilirubin.
Liver Transplant
a life-saving operation to replace a diseased liver with a healthy, donated liver.
Mutation
the ability of a virus to change its outer coating and to therefore not be recognized and attacked by antibodies.
NAT
nucleic acid testing. Testing that allows direct detection of specific HCV RNA in serum, plasma or tissues, independent of the host’s immune response. Viral nucleic acid detected in the plasma or serum reflects active HCV replication in the liver. NAT-based detection of HCV RNA is performed in two major ways. The most common is target amplification, an example of which is the polymerase chain reaction (PCR). The other major approach involves signal amplification and includes the branched chain DNA technique.
Nausea
feeling sick to your stomach and wanting to vomit.
Nucleic acid
molecules in living cells, which carry hereditary information. The presence of DNA and RNA, the chief types of nucleic acid, allow cells to replicate themselves.
Nucleoside analogue
an artificial copy of a nucleoside. When incorporated into a virus DNA or RNA during viral replication, the nucleoside analogue acts to prevent production of a new virus. An example of a nucleoside analogue is ribavirin, the drug used in combination with interferon to treat hepatitis C.
Nucleoside
a building block of nucleic acids. Nucleosides are nucleotides without the phosphate group.
PCR
polymerase chain reaction. PCR is a method to test for HCV RNA, the actual viral material of hepatitis C. There are two types of test for HCV RNA by PCR. Qualitative tests give a positive or negative result and are recommended for patients who are anti-HCV positive with normal ALT levels and to determine response to treatment. Quantitative tests give the viral concentration or viral load and are not routinely recommended for patients.
Pegylated interferon
a form of interferon that stays in the body longer. Pegylated interferon is created by attaching polymers to interferon. This allows the interferon to become more water-soluble and to remain inside the body longer, accounting for its enhanced activity. This reduces the frequency of injections. Pegylated interferon is under review for approval in Canada.
Platelet
fragments of blood cells that are necessary for blood clotting (coagulation). Platelets are released when damage occurs to a blood vessel. By forming into clots, they stem the flow of blood from the damaged blood vessel.
Polymerase
any of several enzymes that catalyze the formation of DNA or RNA using preexisting DNA or RNA as a template (pattern).
Porphyria
the inability of cells to convert porphyrins to heme in a normal manner. Porphyrins are chemical compounds that are stepping stones along the pathway that leads to the formation of heme in humans and to chlorophyll in plants.
Prognosis
prediction as to the probable outcome of a disease.
Protease inhibitor
a type of antiviral drug that acts by inhibiting the virus’ protease enzyme. This prevents the virus from replicating itself.
Protease
an enzyme that breaks down proteins, including viral proteins.
Pruritus
itching.
Quasispecies
closely related variants of a single genotype within a single individual, which arise from mutations that occur during viral replication. The quasispecies may have an impact on how the virus reacts in an individual and on the natural history of the infection.
Radioisotope scan
a special test that tags blood cells with radioactivity so that they can be tracked as they move throughout the body.
RIBA
recombinant immunoblot assay is a supplementary test used to confirm findings when an EIA test is positive. Measures the presence of various antibodies to hepatitis C in the blood.
Ribavirin
one of a group of drugs called nucleoside analogues that prevent viruses from multiplying. Ribavirin is used in combination with interferon alfa-2b in the treatment of hepatitis C.
Seroconversion
the development of antibodies to a particular antigen.
Serologic test
any of a number of tests done using the clear portion of blood. Often refers to a test that determines the presence of antibodies to antigens such as viruses.
Spider nevi
asymptomatic, spider-like marks that may develop in patients with advanced cirrhosis of the liver. The mark consists of a central arteriole, radiating from which are numerous small vessels resembling a spider’s legs. Common sites are the necklace area, face, forearms and the back of the hands. (Also called vascular spiders, arterial spiders, spider telangiectasis or spider angioma.)
Spleen
a large organ situated in the upper part of the abdominal cavity on the left side. The spleen breaks down red blood cells and sets free hemoglobin, which the liver then converts into bilirubin. In addition, the spleen performs many more important functions.
Splenomegaly
an enlarged spleen.
Steatorrhea
decreased absorption of dietary fats, resulting in their passage to the distal bowel which causes foul-smelling and floating stool; can be caused by deficiency of bile salts.
Steroid
a member of a large family of structurally-similar lipid molecules. Different classes of steroids perform different functions. Anti-inflammatory steroids can reduce swelling, pain and inflammation.
Teratogenicity
tendency to produce birth defects. Teratogenicity is a potential side effect of some drugs, including ribavirin.
Titre
a laboratory measurement of the concentration of a given compound in solution. (Also spelled “titer”.)
Ultrasound
a non-invasive way to examine soft organs that uses sound waves rather than light rays. Ultrasounds of the abdominal cavity are one way to examine the size and state of the liver.
Vaccine
a solution of killed or inactive viruses or bacteria or synthetically, genetically engineered antigenic material. Usually administered by injection, a vaccine can stimulate an immune response and thus give a person protection against contracting a disease. Currently there is no vaccine against hepatitis C.
Varices
large, swollen blood vessels in the stomach and esophagus. In people with severe liver damage the normal flow of blood through the liver is blocked. Blood from the intestines is then rerouted around the liver, primarily through the small blood vessels in the stomach and esophagus. These can become enlarged and swollen (varices) and eventually rupture, causing internal bleeding.
Virus
a tiny microorganism, smaller than bacteria, which cannot replicate itself without a host and can cause sickness in humans that cannot be treated with antibiotics.
