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Glossary of terms

Acute - the term acute when applied to hepatitis C refers to the 6 month period after the virus has first entered the body; it is not related to acuteness of symptoms or severity of the disease

Albumin - produced by the liver and the main protein in human blood; low levels indicate liver damage

ALT - alanine aminotransferase - a liver enzyme that enters the blood when there has been liver damage; ALT tests monitor degree of damage

Antigen - substance seen by the body as foreign, therefore causing it to produce antibodies

Antibody - protein produced by the body as a defensive reaction against an antigen (see above)

Ascites - collection of fluid in the bowel cavity, causing swollen abdomen; can be a symptom of advanced liver disease

AST - aspartate aminotransferase – a liver enzyme released when liver cells are damaged; raised AST levels may indicate liver disease (but muscle damage can also cause elevated AST levels)

Autoimmune - describes a disorder which causes the body’s immune system to attack another part of the body

Bile- fluid made by the liver to help digest foods

Bilirubin - product of haemoglobin (red blood cells); when increased levels are found in the blood, this can indicate liver disease, and can result in jaundice (see below)

Cholestasis - reduction in the flow of bile (see above) from the liver

Cirrhosis - permanent cell damage caused by inflammation and fibrosis which have developed to the stage where the liver function and structure is adversely altered; see compensated cirrhosis and decompensate cirrhosis below

Chronic - describes the phase of hepatitis C after the acute phase (see above)

Co-infection - having more than one virus at the same time

Compensated - when the liver is coping with or compensating for the damage cause by cirrhosis (see above)

Decompensated - when cirrhosis (see above) is so extensive that the liver can no longer cope with the damage and can no longer carry out its essential functions

Encephalopathy - disrupted brain function, causing memory loss and confusion; hepatic encephalopathy occurs when a damaged liver is no longer able to filter toxins from the bloodstream

Enzyme - a product of the body that speeds up chemical reaction

EPO - erythropoietin – a hormone used to treat certain types of anaemia; anaemia can be caused by certain medications used to treat hepatitis C

ESLD - end stage liver disease (see HCC below)

Fibroscan - a non-invasive machine using a sound wave to measure the elasticity of the liver; as damage to the liver increases, so it becomes stiffer - the stiffer or less elastic the liver, the faster the sound wave travels

Fibrosis - forming of scar tissue in an inflamed liver, the build up of which can lead to cirrhosis (see above)

Gastroenterologist - doctor who specialises in treatment of digestive diseases

Glycogen - product stored in muscles and the liver

HCC - hepatocellular carcinoma, i.e. liver cancer (also called hepatoma); classified as ESLD (see above)

HCV - hepatitis C virus

Haemoglobin - red blood cells

Hepatic - relating to the liver

Hepatic artery - carries the blood to the liver, pancreas, gallbladder, stomach and the small intestine

Hepatic encephalopathy - see encephalopathy above

Hepatitis - inflammation of the liver (whether caused by a virus or not)

Hepatocyte - liver cell

Hepatologist - doctor who specialises in liver diseases

Hepatomegaly - enlarged and tender liver

Immunoglobulins - large proteins in body designed to bind with invading organisms (such as viruses) to destroy them

Inflammation - swelling caused by the first response of the immune system to infection

Jaundice - yellowing of skin and whites of eyes caused by a build-up of bilirubin (see above)

Log drop - a term used in relationship to the measurement of viral load; the term is usually used in relation to response to treatment at 12 weeks. If treatment is working at least a hundred-fold drop (often referred to as a 2 log drop) in viral load has to be achieved, so for example if a patient has a viral load of 2 million parts per mil at start of treatment, for treatment to be effective a drop of 20,000 should be achieved (or lower, certainly less than 100,000 - see partial responder below)

Neutrophil - an immune system white blood cell; neutrophils destroy, e.g., bacteria and fungi

Null Responder - a patient who does not achieve a 2 log drop (see log drop above) at 12 weeks of treatment

Oesophagus - part of the digestive system, also known as the gullet – a tube through which food and liquid travels from mouth to stomach

Oncologist - doctor who specialises in cancer

PCR - polymerase chain reaction; a PCR test determines whether you currently have hepatitis C by detecting the presence of the genetic material of the virus in the blood

Partial Responder - a patient who achieves a 2 log drop (see log drop above) in viral load but does not attain undetectable, i.e. there is still evidence of the virus

Platelet - also know as a thrombocyte, a blood cell responsible for blood clotting; a reduced platelet count may indicate advanced liver disease and result in ‘easy bleeding’

Portal Hypertension - high blood pressure in the portal vein (which carries blood to the liver, see below), caused by cirrhosis (see above)of the liver; can cause varices (see below)

Portal Vein - carries blood from bowel to spleen to liver

Relapser - patient in whom the virus was undetectable after treatment, but in whom it is detected six months after treatment see also null responder and partial responder)

Responder - see null and partial above

Resection - process where part of the liver affected by cancer is cut away

SVR - sustained viral response - virus remains undetectable after treatment

Thrombocyte - see platelet above

Varices - dilated (expanded) blood vessels along the lining of the upper part of the stomach and lower end of the gullet; can be caused by portal hypertension (see above)

Viral load - amount of virus in blood

Virus - microscopic particle infecting living cells; a virus gets inside cells and replicates