Hepatitis C

What is Hepatitis C?

The Hepatitis C virus is a liver infection that causes liver inflammation.  The causative agent of hepatitis C is the hepatitis C virus (HCV) RNA virus.

Hepatitis C virus can cause both acute and chronic hepatitis, it ranging in severity from a mild illness.

The hepatitis C virus HCV) is a blood-borne virus that can lead to serious liver damage and is a major cause of liver cancer.

Check out here what is viral hepatitis?

Epidemiological Triad of Hepatitis C

Epidemiological Triad of Hepatitis C

Agent – The causative agent of hepatitis C is the hepatitis C virus (RNA virus).

Host factor – The people with HCV infection are  30-49 years of age. Hepatitis C virus infection has become the most important cause of chronic hepatitis infection in children.

Environment – Contaminated blood or other body fluid from an infected person. The contaminated blood or secretion on the environmental surface is a source of infection.

Mode of Transmission of Hepatitis C

Hepatitis C infection is more commonly spread through the use of contaminated needles used to inject drugs. Infection transmitted by unclean needles (through skin puncture).

Hepatitis C usually only spreads through the blood-to-blood contact of an infected person with the Hepatitis C virus.

Read here the mode of transmission of hepatitis A and the mode of transmission of hepatitis C.

Source of Infection of Hepatitis C

1. Blood, semen, or other body fluids from an infected person

2. Sexual contact

3. Sharing needles, syringes

4. Needlestick injury

5. Drug injection equipment

6. Infected mother to child at birth (spread from mother to child during birth)  

7. Receiving a blood transfusion or organ transplant

8. Post–transfusion hepatitis- transmitted by blood transfusion

9. Intravenous drug user – sharing of injection equipment

10. Reuse or inadequate sterilization of medical equipment, especially syringes and needles in healthcare settings

11. Transfusion of unscreened blood and blood products

Note– Hepatitis A and Hepatitis B can be prevented by vaccination, but not hepatitis C means no vaccine available for hepatitis C infection.

Hepatitis C virus can’t be transmitted through-

1. Casual contact

2. Hugging

3. Holding hands

4. Coughing and Sneezing

5. Sharing food or drink

6. Sharing eating utensils

7. Mosquito bites

8. Breastfeeding (unless nipples are cracked and bleeding)

Incubation Period of Hepatitis C

The incubation period of hepatitis is 6-7 weeks (2 weeks to 6 months) 

Pathophysiology of Hepatitis C

1. Exposure to HCV Infection

2. Virus causes inflammation of Liver

3. Liver Parenchyma cell degeneration

4. Necrosis of Hepatocytes

5. Cause a diffuse lobular inflammatory reaction

6. Disruption of liver cell cord

7. Accumulation of macrophages near degenerating Hepatocytes

8. Lead to Chronic Hepatitis C, Liver Cirrhosis, Hepatocellular Carcinoma (HCC)

9. Liver failure

Clinical Manifestation of Hepatitis C

1. Acute hepatitis C 

Short-term illness that lasts for the first 6 months after the virus exposure to the body.

2. Chronic hepatitis C 

lllness moves into a long-lasting stage (longer than 6 months). Hepatitis C virus (HCV) is a major cause of chronic viral hepatitis that can lead to liver cirrhosis and hepatocellular carcinoma or Liver cancer.

Early Signs and Symptoms of Acute Hepatitis C

1. Clay-colored feces (poop)

2. Dark urine

3. Fever

4. Fatigue

5. Jaundice (causes yellow eyes and skin)

6. Joint pain

7. Loss of appetite

8. Nausea

9. Stomach pain

10. Vomiting

Chronic Hepatitis C Symptoms

1. Ascites – fluid buildup in the abdomen

2. Easy bleeding and bruising; skin discoloration

3. Hepatic encephalopathy; damage or disease that affects the brain- causes drowsiness, confusion, and slurred speech

4. Jaundice

5. Hives or rashes

6. Itchy skin

7. Spider angiomas – spidery blood vessels under the skin

8. Swollen legs

9. Weight loss

Check out here signs and symptoms of hepatitis B and hepatitis C

Complications of Hepatitis C

1. Liver disease

2. Liver cirrhosis, or scarring of the liver

3. Hepatocellular carcinoma or Liver cancer

4. Liver failure

Hepatitis C Testing and Diagnosis

1. Anti-HCV antibodies

2. HCV RNA – number of viral RNA (genetic material from the hepatitis virus) particles in the blood.

3. Liver function tests- measure proteins and enzyme levels

Treatment of Hepatitis C

If an individual has acute hepatitis C, get supportive care to treat signs and symptoms. If hepatitis C turns into a chronic hepatitis C infection, there are antiviral medications are recommended and treatment is necessary.

Antiviral drugs such as Interferon, Peginterferon, Harvoni, and Ribavirin used to be the main treatments for chronic hepatitis C.

Prevention and Control of Hepatitis C

There is no vaccine available against hepatitis C. Antiviral drugs can cure more than 95% of persons with chronic hepatitis C infection, reducing the risk of death from liver cirrhosis liver failure, and liver cancer.

Primary prevention

Recommended by WHO; The following list provides primary prevention interventions for hepatitis C –

1. Safe and appropriate use of health care injections

2. Safe handling and disposal of sharps and waste

3. Use sterile injecting equipment

4. Screening of donated blood for HBV and HCV (including HIV and syphilis)

5. Prevention of exposure to blood during sexual intercourse

6. Prevent needlestick injury

7. Provide Training for health personnel

Secondary prevention

For individuals infected with the hepatitis C virus, WHO recommends-

 1. Regular monitoring for early diagnosis of chronic liver disease

2. Screening, diagnosis, care, and treatment of persons with hepatitis C infection

3. Early and appropriate medical management including antiviral therapy

4. Immunization with the hepatitis A and B vaccines to prevent confection of these hepatitis viruses infection and to protect the liver

5. Health education, counseling for care, and treatment

Hepatitis C – FAQs

1. What is hepatitis C?

Hepatitis C is an infection of the liver caused by the hepatitis C virus, often described as lasting a few weeks illness “acute Hepatitis C” and long-term infection “chronic Hepatitis C”.  Hepatitis C can begin from mild illness lasting a few weeks to progress to a serious, long-term illness.

Acute hepatitis C – Hepatitis C can be a short-term illness.  It occurs within the first 6 months after exposure to the hepatitis C virus. acute hepatitis C infection leads to chronic liver infection.

Chronic hepatitis C – It can be a lifelong infection if left untreated. Chronic hepatitis C can lead to serious health illness, including liver damage, scarring of the liver (cirrhosis), liver cancer.

2. How is hepatitis C spread?

1. The hepatitis C virus is usually spread when uninfected people come into contact with blood from an infected person

2. Sharing drug-injection equipment

3. Sharing needles, syringes and inject drugs

4. Infected mothers to infants born

5. Health care exposures, infected from sharing glucose monitors

6. Sex with an infected person

7. Hepatitis C can spread when getting tattoos or body and non-sterile instruments and Sharing personal items razors

8. Blood transfusions and organ transplants

3. Can a person be infected with both HIV and the hepatitis C virus?

Yes, people get coinfected with both HIV and hepatitis C virus infection. People who are coinfected with chronic hepatitis C infection are more possibly to get cirrhosis; scarring of the liver.

4. What is the difference between hepatitis A, hepatitis B, and hepatitis C?

Hepatitis occurs from three different viruses and causes liver infections. Its route of entry and spread in different ways and affect the liver differently at a different levels.

Hepatitis B and hepatitis C infections are short-term infections if left untreated can cause chronic (long-term) infection. There are For hepatitis A and hepatitis B, vaccines are available to prevent,  but there is no vaccine for hepatitis C.

5. Can the hepatitis C virus be spread through sexual contact?

Yes, higher risk when sexual contact with those who have multiple sex partners, engages in sexual activity/acts, have a sexually transmitted disease, or are infected with HIV infection.

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