-The hepatitis C virus (HCV) is a single-stranded RNA virus (hepacivirus)
-HIV leads to more rapid progression of chronic hepatitis C to cirrhosis
-the most common chronic bloodborne infection in the United States
-The incubation period averages 6–7 weeks
Transmission: Primarily transmitted by parenteral route usually through use of injected drugs with needle sharing accounting for more than 40% of the cases; rarely sexually transmitted
-Transmission via breastfeeding has not been documented.
-HCV pathogenesis (average incubation period 6-12 weeks) is mainly immune mediated, in which the liver damage is caused by cytotoxic CD8 T cells and proinflammatory cytokines.
-No immunizations are currently available for HCV infections.
Symptoms & Signs:
-Most primary infections are asymptomatic or clinically mild
-can present with jaundice, anorexia, malaise, and abdominal pain
Two types of diagnostic tests are available to detect HCV infection; HCV antibodies (ELISA) and confirming by HCV RNA (RT-PCR)
-Testing for antibodies to HCV (anti-HCV) is recommended for screening of asymptomatic persons based on risk factors or exposure.
-Waxing and waning aminotransferase elevations
-No effective treatment for acute disease
-Treatment for chronic disease includes interferon, pegylated interferon, ribavirin, or HCV direct-acting antiviral agents.
-There are four current classes of direct-acting antiviral agents (DAAs): nonstructural protein (NS) 3/4A protease inhibitors, NS5B nucleoside polymerase inhibitors, NS5B non-nucleoside polymerase inhibitors, and NS5A inhibitors.
-Alcohol abuse and smoking can influence hepatitis severity.
-HCV is a pathogenic factor in mixed cryoglobulinemia and membranoproliferative glomerulonephritis.
-In most patients, clinical recovery is complete in 3–6 months
-Vertical transmission is around 5% in mothers who are positive for HCV RNA.
-In contrast to HAV and HBV, most people infected with HCV (85%) develop a chronic infection. Of these, up to 70% will develop chronic liver disease; Cirrhosis occurs in up to 50% of chronically infected patients.
-Prevention consists mainly of reduction of risk factors, including screening of blood and blood products, preventing percutaneous injuries, and reducing intravenous drug use.
- What is the most sensitive indicator to detect HCV infection? HCV RNA by the polymerase chain reaction (PCR)
- Is breastfeeding contraindicated in women infected with hepatitis C? No
|IV drug use with needle sharing + Single-stranded RNA virus + Chronic liver disease = Hepatitis C|