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Hepatitis C

From Mediwikis

Virology

Single stranded RNA "Flaviviridae" family virus, with six genotypes. The rapid drift of the make-up of envelope proteins make it difficult to develop a vaccine.

Transmission

Spread via contaminated blood products and sharps, HCV only infects humans and chimpanzees.

Symptoms

Most are asymptomatic. 10% have mild flu-like symptoms with some jaundice. It often isn't until much later down the line, when chronic liver disease is present, or abnormal transaminase values detected, that a diagnosis is made.

Extrahepatic symptoms

  • Arthritis
  • Cryoglobulinaemia- proteins precipitate from blood at temperatures below 37° (cryo) causing red skin patches. They will dissolve if blood is heated.

Diagnosis

HCV RNA or Anti-HCV in serum, but usually a diagnosis of exclusion, after Hep. A, B and drug causes.

Management

Pegylated-Interferon plus Ribavirin, soon after infection to prevent chronic Hep. C. If chronic, other drugs include Telaprevir and Boceprevir.

Prognosis

About 90% of asymptomatic patients develop chronic liver disease, but those who develop symptoms seem to be "fighting" the disease, and ~50% will develop chronic disease. Other important sequelae include Cirrhosis and Hepatocellular carcinoma.