Video:Hepatitis C

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Overview

Hepatitis C is an infectious disease caused by the hepatitis C virus, that primarily affects the liver.[1]

HCV EM picture 2.png

Initial symptoms

During the initial infection, people often have mild or no symptoms.[2] Occasionally they will have a fever, dark urine, abdominal pain, or yellow tinged skin called jaundice.[2]

Jaundice eye.jpg

Failing to fight-off the virus

About 80% of people who get the initial infection, will never completely fight off the hepatitis C virus, and it will persist in their liver.[2]

Liver2.png

Late stage effects

Over many years, the chronic infection of the liver, can lead to complications like a fatty liver, cirrhosis, and liver cancer.[2] Worldwide hepatitis C is the cause of 27% of cirrhosis cases, and 25% of hepatocellular carcinomas.[3]

Liver Cirrhosis es.png

Other effects

Liver failure will also cause other problems, such as confusion, accumulation of fluid in the abdomen, and enlarged blood vessels in the esophagus or stomach that can cause serious bleeding.[1]

Esophageal varices - wale.jpg

Spread

Hepatitis C is spread primarily by blood-to-blood contact, associated with intravenous drug use, poorly sterilized medical equipment, needlestick injuries in healthcare, and transfusions.[2][4] It may also be spread from an infected mother, to her baby during birth.[2]

Sources of Infection for Persons with Hepatitis C (CDC) US.png

Casual contact and blood screening

It is not spread by superficial contact, and the risk of being infected through a blood transfusion, can be reduced to one per two million, with proper blood screening.[2]

Blood bag.jpg

Hepatitis family

It is one of five known hepatitis viruses: A, B, C, D, and E.[5]

Hepatitis B virus 1.jpg

Diagnosis

Diagnosis is by blood testing to look for either antibodies to the virus or its RNA.[2] Testing is recommended in all people who are at risk.[2]

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Prevention

There is no vaccine against hepatitis C[2][6]. Prevention includes harm reduction efforts for intravenous drug users, universal precautions for health care workers, condom use, and proper screening of donated blood.[7]

Heroin needle in the street.jpg

Treatment

About 95% of people can be cured of the chronic infection, with antiviral medications such as sofosbuvir, or simeprevir.[2][7] These drugs are effective but expensive.[7]

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Early generation treatments

Earlier generation treatments such as peginterferon, and ribavirin are more affordable, but have cure rates of less than 50%, and greater side effects.[7][8]

Ribavirin ball-and-stick.png

Treatment of liver failure

Those who develop cirrhosis or liver cancer, may require a liver transplant.[9] Hepatitis C is the leading reason for liver transplantation, though the virus usually recurs after transplantation.[9]

Dr. Ehtuish Performing An Organ Transplant..jpg

Epidemiology

As of 2015, about 2% of the worlds population was infected with the hepatitis C virus, causing 167,000 deaths due to liver cancer, and 326,000 deaths due to cirrhosis.[10][11] It occurs most commonly in Africa, Central, and East Asia.[7]

HCV prevalence 1999.png

History

The existence of hepatitis C (originally identifiable only as a type of non-A, non-B hepatitis) was suggested in the 1970s, and proven in 1989.[12] Hepatitis C infects only humans and chimpanzees.[13]

Schimpanse Zoo Leipzig.jpg

References

  1. 1.0 1.1 Ryan KJ, Ray CG, eds. (2004). Sherris Medical Microbiology (4th ed.). McGraw Hill. pp. 551–2. ISBN 978-0-8385-8529-0.
  2. 2.00 2.01 2.02 2.03 2.04 2.05 2.06 2.07 2.08 2.09 2.10 "Hepatitis C FAQs for Health Professionals". CDC. January 8, 2016. Archived from the original on 21 January 2016. Retrieved 4 February 2016.
  3. Alter, MJ (2007-05-07). "Epidemiology of hepatitis C virus infection". World Journal of Gastroenterology. 13 (17): 2436–41. doi:10.3748/wjg.v13.i17.2436. PMC 4146761. PMID 17552026.[permanent dead link]
  4. Maheshwari, A; Thuluvath, PJ (February 2010). "Management of acute hepatitis C". Clinics in Liver Disease. 14 (1): 169–76, x. doi:10.1016/j.cld.2009.11.007. PMID 20123448.
  5. "Viral Hepatitis: A through E and Beyond". National Institute of Diabetes and Digestive and Kidney Diseases. April 2012. Archived from the original on 2 February 2016. Retrieved 4 February 2016.
  6. Webster, Daniel P; Klenerman, Paul; Dusheiko, Geoffrey M (2015). "Hepatitis C". The Lancet. 385 (9973): 1124–1135. doi:10.1016/S0140-6736(14)62401-6. ISSN 0140-6736. PMC 4878852. PMID 25687730.
  7. 7.0 7.1 7.2 7.3 7.4 "Hepatitis C Fact sheet N°164". WHO. July 2015. Archived from the original on 31 January 2016. Retrieved 4 February 2016.
  8. Kim, A (September 2016). "Hepatitis C Virus". Annals of Internal Medicine (Review). 165 (5): ITC33–ITC48. doi:10.7326/AITC201609060. PMID 27595226.
  9. 9.0 9.1 Rosen, HR (2011-06-23). "Clinical practice. Chronic hepatitis C infection". The New England Journal of Medicine. 364 (25): 2429–38. doi:10.1056/NEJMcp1006613. PMID 21696309.
  10. GBD 2015 Disease and Injury Incidence and Prevalence, Collaborators. (8 October 2016). "Global, regional, and national incidence, prevalence, and years lived with disability for 310 diseases and injuries, 1990-2015: a systematic analysis for the Global Burden of Disease Study 2015". Lancet. 388 (10053): 1545–1602. doi:10.1016/S0140-6736(16)31678-6. PMC 5055577. PMID 27733282.
  11. GBD 2015 Mortality and Causes of Death, Collaborators. (8 October 2016). "Global, regional, and national life expectancy, all-cause mortality, and cause-specific mortality for 249 causes of death, 1980-2015: a systematic analysis for the Global Burden of Disease Study 2015". Lancet. 388 (10053): 1459–1544. doi:10.1016/S0140-6736(16)31012-1. PMC 5388903. PMID 27733281.
  12. Houghton M (November 2009). "The long and winding road leading to the identification of the hepatitis C virus". Journal of Hepatology. 51 (5): 939–48. doi:10.1016/j.jhep.2009.08.004. PMID 19781804.
  13. Shors, Teri (2011-11-08). Understanding viruses (2nd ed.). Burlington, MA: Jones & Bartlett Learning. p. 535. ISBN 978-0-7637-8553-6. Archived from the original on 2016-05-15.