Hepatitis C

Question 1

What is hepatitis C?

Answer 1

A blood - borne RNA virus that infects the liver cells

Question 2

How long is the incubation period for hepatitis C?

Answer 2

6 - 9 weeks

Question 3

What is the most common route of Hepatitis C transmission?

Answer 3

1. 90% of cases via IVDU

Question 4

How is hepatitis C transmitted?

Answer 4

1. Parenteral
2. Sexual
3. Vertical

Question 5

How is acute Hepatitis C diagnosed?

Answer 5

HCV RNA detected in blood 1-3 weeks after initial exposure

Question 6

How does acute Hepatitis C present?

Answer 6

30% of patients will develop features such as ;

1. Jaundice
2. Fatigue
3. Athralgia
4. Rise in liver transaminases

Question 7

What is the significance of anti-HCV antibodies found in blood?

Answer 7

1. Antibodies take 2 - 8 weeks to develop
2. Patients will eventually develop anti-HCV antibodies it should be remembered that patients who spontaneously clear the virus will continue to have anti-HCV antibodies

Question 8

What percentage of patients will clear virus after acute infection?

Answer 8

15 % will clear the infection in the acute phase but majority will end up progressing to chronic disease.

Question 9

How is chronic hepatitis C diagnosed?

Answer 9

Chronic hepatitis C may be defined as the persistence of HCV RNA in the blood for 6 months.

Question 10

What is the natural history of HCV infection?

Answer 10

1. HCV exposure - acute
2. Chronic HCV infection
   - 80% stable disease
   - 20% progress to Hepatitis Cirrhosis
3. Hepatitis Cirrgosis
   - 70% slowely progressive disease
   - 30% progress to Hepatocellular carcinoma
4. Hepatocellular carcinoma

Question 11

Complications of chronic hepatitis C?

Answer 11

1. rheumatological problems: arthralgia, arthritis
2. eye problems: Sjogren’s syndrome
3. cirrhosis (5-20% of those with chronic disease)
   hepatocellular cancer

Question 12

What is the aim of treatment?

Answer 12

the aim of treatment is sustained virological response (SVR), defined as undetectable serum HCV RNA six months after the end of therapy.

Question 13

What is the treatment for Hepatitis C?

Answer 13

Currently a combination of protease inhibitors (e.g. daclatasvir) with or without ribavirin are used