Glossary

anaemia: very low red blood cell count.

albumin: a protein made by the liver. It carries drugs, hormones and waste products through the blood and maintains fluid levels within the body. An abnormally low level of albumin is a sign of serious liver damage.

ALT (alanine transaminase, also called serum glutamate pyruvate transaminase; SGPT): a key liver enzyme produced in liver cells. ALT is routinely monitored in HIVpositive people on ARVs to detect liver toxicity from HIV drugs (or other medications). Elevated ALT signals liver injury, but does not indicate how serious liver damage is. antioxidant: a substance that reduces oxidative damage (damage due to oxygen) such as that caused by free radicals

ascites: an abnormal accumulation of fluid in the abdomen, a sign of serious liver damage in people with hepatitis C.

AST (aspartate aminotransferase; serum glutamicoxaloacetic transaminase; SGOT): an enzyme that is made in many places throughout the body (heart, intestines, muscle) , which is monitored (as with ALT) routinely in HIV-positive people on ARVs to detect liver toxicity from HIV drugs (or other medications). Elevated AST that is specifically made in the liver signals liver injury, but does not indicate how serious liver damage is. autoantibody: Abnormal antibodies produced against the body’s own tissues

bile duct: a tube that carries bile from the liver to the gallbladder and then to the small intestine biopsy: taking a small sample of body tissue for examination and testing in the laboratory

bilirubin: a liver enzyme. Increased levels of bilirubin lead to a yellowing of the skin or eyes

BMI (body mass index): a calculation from your height and weight that is used to determine if someone is over or under weight. There are many online calculators.

cirrhosis: severe scarring of the liver (see fibrosis) that makes it difficult for the liver to carry out its functions

coinfection: infection with more than one virus

cryoglobulinemia: increased blood levels of abnormal proteins called cryoglobulins that can inflame blood vessels and thicken blood

encephalopathy: degenerative brain function or disease.

epoetin-alpha (EPO): a treatment for anaemia, administered by injection.

enzyme: a protein produced in the body that speeds-up other chemical reactions

ETR (end of treatment response): having an undetectable HCV viral load at the end of HCV treatment (see SVR)

EVR (early virological response): a 99% (or 2-log ) drop in HCV viral load after 12 weeks of HCV treatment

fibrosis: mild to moderate scarring of the liver (see cirrhosis)

Fibrotest: a test which uses results from blood tests to predict liver damage and which may become an alternative option to liver biopsy in some patients

Fibroscan: non-invasive ultrasound scan that measures the 'elasticity' or stiffness of the liver

free radical: a chemical produced after a molecular reaction, often containing oxygen, that has one 'free' unpaired electron on its outer surface. This makes it able to react and damage other cells, and perhaps increase progression of cardiovascular disease, cancers and aging.

fulminant liver disease: sudden, rapid disease progression related to liver failure

genotype: a category for different types of similar hepatitis C viruses. The HCV genotype is the strongest predictor of respnse to hepatitis C treatment.

grade/grading: The grade of hepatitis infection refers to the amount of inflammation in liver tissue, found by a biopsy. It is usually measured on the Ishak scale from 1-18) where 0 is none and 18 is the maximum.

GGT (gamma glutamyl transferase): enzyme involved in metabolism that is produced in the bile ducts. Any type of liver disease, heavy drinking, and some medications can increase levels of GGT.

HCV: hepatitis C virus

hepatic encephalopathy: brain disease that occurs when serious liver damage prevents toxic substances from being flitered out of the blood, and they enter the brain.

hepatotoxicity: the medical term for liver-related side effects

IDU: injecting drug user

jaundice: a common symptom of hepatitis where increased levels of bilirubin lead to a yellowing of the skin or eyes

monoinfection: infection with one virus

neutropenia: very low amount of neutrophils (neutrophils are white blood cells that fight bacterial infections).

NNRTI: Non-nucleoside reverse transcriptase inhibitor, a type of HIV drug – also called non-nuke

pegylated interferon (PEG interferon): Main treatment for hepatitis C, given in combination with ribavirin. Given as a onceweekly injection.

PI (protease inhibitor): a type of HIV drug. HCV protease inhibitors are indevelopment.

portal hypertension: increased blood pressure (hypertension) in the vein carrying blood to the liver

PT (prothrombin time; pro-time): PT testing measures the amount of time it takes for blood to clot. When the liver is damaged, its ability to make clotting factors is impaired. If this time increases – referred to as a prolonged PT interval – it shows that the liver is not working so well.

ribavirin: drug used to boost the efficacy of pegylated interferon in combination therapy for hepatitis C. Given as twice-daily capsules.

RTI (reverse transcriptase inhibitor): a type of HIV drug – also called nucleoside or nuke

RVR (rapid virological response): meaning that hepatitis C virus is undetectable after 4 weeks of treatment. Currently, RVR is used in research, not everyday clinical practice. An RVR is a good sign, but HCV treatment should not be stopped in people who do not have one.

stage/staging: The stage of hepatitis infection refers to the amount of scaring (fibrosis), from results from a biposy. It is usually measured on the Metavir scale of 0 to 4, where 0 represents no scarring and 4 cirrhosis, or on the Knodell scale of 0 to 6, where 0 is no scarring and 6 cirrhosis.

steatosis: fatty liver. Build up of fat in the liver worsens liver damage and makse hepatitis C harder to treat.

SVR (sustained virological response): having a negative HCV viral load test 6 months after stopping HCV treatment. The response, 6 months after treatment is stopped, determines whether treatment has been effective in terms of clearing HCV. SVR is the most important result from an HCV treatment trial.

thrombocytopenia: low platelet count (platelets help stop bleeding by clotting blood).

toxicity: the term for the degree to which a substance harms a person

varices: extended or swollen veins that can burst, a complication of cirrhosis.