Hepatitis C

Hepatitis C is a form of inflammatory disease of the liver caused by a virus, the hepatitis C virus (HCV). Almost always, Hepatitis C is spread by contact with an infected person's blood. The majority of the people with HCV infections have no symptoms. Therefore, they are unaware of the need to seek treatment. more...

Hepatitis C infected 150 to 200 million people around the world and is now the leading cause of liver transplants, and a frequent cause of liver cancer. Co-infection with HCV is common for people with HIV/AIDS and often causes their death.

Signs and symptoms

Acute Hepatitis C

Hepatitis C is one of 6 viruses, called hepatitis A, B, C, D, E and G, that can cause an acute disease lasting several weeks. Most cases (between 60% and 70%), even those that develop chronic infection, are asymptomatic.

For persons with acute symptoms, abdominal pain, jaundice, itching and flu-like symptoms are the most prominent causes for seeking medical attention.

Chronic Hepatitis C

For persons with silent disease, some are diagnosed because of certain medical phenomena associated with the presence of hepatitis C virus, such as thyroiditis (inflammation of the thyroid), cryoglobulinemia (a form of vasculitis) and glomerulonephritis (inflammation of the kidney), specifically membranoproliferative glomerulonephritis (MPGN). Carriers of the virus may begin to develop symptoms after only a few years. Symptoms, when developed, are variable and dependent on individual carrier. They may include prolonged flu-like symptoms and any combination of the following: body aches, headaches, night sweats, loss of appetite, diarrhea, fatigue, nausea, mild abdominal pain, typically located in the upper right quadrant.

Diagnosis

Hepatitis C may be suspected on the basis of the medical history and symptoms, because of abnormal liver function tests or as part of routine blood tests in many situations. Occasionally, people are diagnosed as a result of targeted screening such as blood donation (for which every donor is screened for numerous blood-borne diseases) or as a result of contact tracing.

Presence of HCV is generally screened with serological blood tests, all based on ELISA testing (ELISA-1, 2 and 3 are in use). These tests have a strong positive predictive value for the presence of the virus, but may take 6 months to become positive (seroconversion); in the meanwhile, a patient may have a false-negative result. Confirmation of the presence of the virus is by reverse transcriptase-polymerase chain reaction (rtPCR). This test is more expensive and hence avoided when risk of infection is deemed low. It may come up positive much earlier after infection (sometimes several weeks). rtPCR can also confirm which genomic type (see below) of the virus is present, which may determine the treatment regimen best suited for the patient.

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