Hepatitis C virus

An infection caused by a virus that attacks the liver and leads to inflammation.
The virus is spread by contact with contaminated blood; for example, from sharing needles or from unsterile tattoo equipment.
Most people have no symptoms. Those who do develop symptoms may have fatigue, nausea, loss of appetite and yellowing of the eyes and skin.
Hepatitis C is treated with antiviral medication. In some people, newer medicines can eradicate the virus.

1. HEPATITIS C

2. Etiology Pathogen - Hepatitis C virus ( HCV : RNA virus , flavivirus ) Transmission Parenteral Needle sharing among IV drug users Needlestick injury (e.g., health care workers) Organ transplantation , dialysis, blood transfusion Sexual: rare (in contrast to HBV and HIV ) Perinatal (vertical) High-risk groups for HCV infection IV drug users (especially long-time users) Hepatitis B virus ( HBV ) or HIV -positive individuals Recipients of blood transfusions or organ transplants

3. Clinical features M ost people remain asymptomatic until progression to cirrhosis occurs, fatigue can complicate chronic infection and is unrelated to the degree of liver damage. If hepatitis C infection is left untreated, progression from chronic hepatitis to cirrhosis occurs over 20–40 years. Risk factors for progression include male gender, immunosuppression (such as co-infection with HIV), prothrombotic states and heavy alcohol misuse. Once cirrhosis is present, 2–5% per year will develop primary hepatocellular carcinoma. Symptoms Malaise, fever , myalgias, arthralgias RUQ pain , tender hepatomegaly Nausea, vomiting, diarrhea Jaundice , possibly pruritus

4. Extrahepatic features Hematological : mixed cryoglobulinemia , monoclonal gammopathies, lymphoma Rheumatological: membranoproliferative glomerulonephritis, polyarteritis nodosa , Sjögren syndrome Dermatologica l: porphyria cutanea tarda , lichen planus Others: diabetes mellitus , thyroiditis, sialadenitis

5. Investigation EIA/ ELISA for anti-HCV antibodies: positive in cases of acute, chronic, and previous HCV infection PCR for HCV RNA if antibodies are positive. Liver function tests ↑ Transaminases with AST/ALT ratio Ratio < 1: acute hepatitis Ratio ≥ 1: chronic hepatitis ↓ Total protein/ albumin , coagulation (particularly ↑ prothrombin time), ↓ cholinesterase Cholestasis parameters: ↑ γ-GT , ↑ alkaline phosphatase , ↑ bilirubin Inflammation markers : leukocytosis , ↑ ferritin Liver biopsy indications If diagnosis is inconclusive For evaluating fibrosis in patients with chronic hepatitis C Evaluation of response to therapy Ultrasound : detection of cirrhosis and neoplasia , e.g., HCC Rule out coinfections : HIV , hepatitis A virus (HAV), hepatitis B virus ( HBV ) serology necessary

6. Treatment