What type of virus is hepatitis C virus?
Single-stranded RNA virus in the Flaviviridae family.
What are the major transmission routes of hepatitis C?
Percutaneous exposure (especially injection drug use), sexual transmission
What is the incubation period of HCV infection?
14–160 days.
Types of HCV
Acute and chronic
What proportion of HCV infections become chronic?
60–85%.
What laboratory test indicates HCV infection?
Anti-HCV antibodies and detection of HCV RNA.
Does hepatitis C have an available vaccine?
No vaccine currently exists.
Why is hepatitis C often diagnosed late?
Chronic infection is frequently asymptomatic for decades.
Prognosis of HAV
Older in age = worse prognosis
Acute HCV duration?
Initial six months after exposure
Chronic HCV duration?
More than six months
Risk factors for HCV
Percutaneous exposure:
- injection drugs
- blood tranfussions withour propper screening
- unsafe medical procedures
- accidental occupational exposures
Does vertical transmission occur?
Yes but less common, usually HIV infection added to HCV makes it more likely
Clinical manifestations of acute HCV
Usually asymptomatic (80% of cases)
First symptoms: RUQ pain, flu-like symptoms, nausea and vomit
Advanced cases: jaundice, dark color pee, acolia
Clinical manifestations of chronic HCV
Non specific, liver cirrhosis (within 20 years of infection)
High-yield clinical features for chronic hepatitis C
Mixed cyoglobulinemia (immune complex deposits)
Membranoproliferative glomerulonephritis
B-cell non-Hodgkin lymphoma
Mixed cyoglobulinemia triad
Palpable purpura + athralgia + weakness
Gold standard for HCV
Positive PCR: ARN HCV
What long-term complications occur with chronic HCV infection?
Liver fibrosis, cirrhosis and hepatocellular carcinoma.
Ideal screening time after exposure
within 48 hours of exposure , repeat six months after exposure if initial test is negative
When should pregnant women screen for HCV?
Once per pregnancy
Who sould have annual screening?
People who recreationally inject drugs
Men with HIV infection who have unprotected sex with men
Men who have sex with men and take HIV preexposure prophylaxis
The most characteristic biopsy finding in chronic hepatitis C is:
Portal lymphoid aggregates/follicles
HCV treatment for both acute and chronic
Multidrug approach: direct acting antivirals for 8 to 12 weeks
