HCV- Hepatitis and Hepatitis C Infection

Hepatitis C Virus and Infection. History, Source and Mode of Infection, Types of infection, Factors promoting severity, Laboratory Diagnosis of Hepatitis C, ELISA, References.

1. Hepatitis C - Bishwash Poudel Medical Laboratory Technologist LABORATORY DEPARTMENT

2. Contents 01 02 03 04 05 History, Causative Agent Introduction to Hepatitis Structure, History , Mode of Infection Hepatitis C Virus Introduction, Natural History, Source of Infection, Hepatitis C Acute infection, Chronic Infection, Factors promoting Severity Infection History , Methods Applied, -( EIA) Diagnosis and Serological Pattern Bishwash Poudel 06 Conclusion, References At the End

3. History, Distribution, Causative Agent Bishwash Poudel INTRODUCTION TO HEPATITIS

4. Hepatitis Intro: Hepatitis is an inflammation of the Liver Tissue. There are 5 main Hepatitis Virus, referred to as A, B, C, D, and E. In particular, types B and C lead to chronic disease in hundreds of millions of people &, together, are the most common cause of liver cirrhosis and cancer. Bishwash Poudel

5. Causative Agent Hepatitis Virus Excessive Alcohol Consumption CMV EBV Yellow Fever Virus Other Infectious  agents  include viruses,bacteria , and parasites Toxins, drugs (NSAIDs), alcohol and non-alcoholic fatty liver disease are metabolic causes of liver injury and inflammation Bishwash Poudel

6. HEPATITIS C VIRUS Bishwash Poudel

7. INTRODUCTION Member of the Hepacivirus C species Positive-sense single-stranded RNA virus of the family Flaviviridae  Small(60 nm), enveloped ( Icosahedral core) The hepatitis C virus is the cause of Hepatitis C and some cancers such as liver cancer and lymphomas in humans. Bishwash Poudel

8. HISTORY Discovered in 1989 HCV by scientists at CDC, NIH and industry Previously known as non-A,  non -B hepatitis because the virus could not be identified. 1942-1945 1989 Approximately 182,383   service members were hospitalized for HCV during World War II. Drug approved interferon alfa-2B(+ Ribavirin later) , Screening test started 1991-1998 The CDC and Chiron came together to identify the hepatitisC (HCV) virus 2010-2013 Rapid Antibody Test, New Direct-Acting Anti- Virals ( Sofosbuvir -Sovaldi , Olysio )

9. Bishwash Poudel Transmission of Hepatitis C Virus   NOT TRANSMITTED VIA:   Touching Kissing Coughing Sneezing Sharing utensils Breastfeeding

10. CDC recommends you get tested HCV if- You’ve Received blood from donor who later found out they had hepatitis C You’ve ever injected drugs. People who use intranasal drugs. (refer- IDSA) You were born between 1945 and 1965. ( ref.link ) You've had long-term kidney dialysis , and unregulated tattoo. You have HIV or were born to a mother with hepatitis C

11. Hepatitis C infection Bishwash Poudel Contagious liver disease that results from infection with the Hepatitis C virus. A major Public Health problem. It accounts 3% of global Population infected.(180 million) It can range in severity from a mild illness lasting a few weeks to serious life long illness.

12. Chronic in 70-85% of infected individuals. 20-40% of case leads to end stage liver disease. (Liver Cirrhoses, Hepatocellular carcinoma, Liver Failure) Liver failure after chronic infection is common reason for liver transplantation. Alcohol consumption, Lack of anti-oxidant, Gender, Fatty Liver- Promotes Hepatitis. Bishwash Poudel

13. SYMPTOMS SEEN: Fever Fatigue Dark urine Clay-colored stool Abdominal pain Loss of appetite Nausea Vomiting Joint pain Jaundice

14. A short-term viral infection. Carry the infection for a small window of time Most people will experience illness and mild symptoms as fatigue &vomiting on six months after exposure. In many cases, the disease causes no symptoms at all. May improve or resolve without treatment . Acute Infection:

15. CHRONIC INFECTION begins as an acute hepatitis For most people who get it up to 85% the illness moves into a long-lasting stage. If untreated, results in serious health problems Including liver damage Cirrhosis (scarring of the liver) Liver cancer, and even death

16. LABORATORY DIAGNOSIS

17. What blood tests are used to detect HCV infection? Several blood tests are performed to test for HCV infection, including: Screening tests for antibody to HCV (anti-HCV) enzyme immunoassay (EIA) enhanced chemiluminescence immunoassay (CIA) Qualitative tests to detect presence/absence of virus- (HCV RNA polymerase chain reaction [PCR]) Quantitative tests to detect amount (titer) of virus (HCV RNA PCR)

18. ENZYME IMMUNO ASSAY (EIA)

19. Interpretation of Results of Tests for Hepatitis C: TEST OUTCOME INTERPRETATION FURTHER ACTIONS HCV antibody nonreactive No HCV antibody detected Sample can be reported as nonreactive for HCV antibody. No further action required. If recent exposure in person tested is suspected, test for HCV RNA.* HCV antibody reactive Presumptive HCV infection A repeatedly reactive result is consistent with current HCV infection or past HCV infection that has resolved or biologic false positivity for HCV antibody. Test for HCV RNA to identify current infection. HCV antibody reactive, HCV RNA detected Current HCV infection Provide person tested with appropriate counseling and link person tested to care and treatment. HCV antibody reactive, HCV RNA not detected No current HCV infection No further action required in most cases. If distinction between true positivity and biologic false positivity for HCV antibody is desired, and if sample is repeatedly reactive in the initial test, test with another HCV antibody assay. In certain situations, follow up with HCV RNA testing and appropriate counseling Source: CDC Testing for HCV infection

20. REFRENCES

21. Thank you