Hepatitis C

Hepatitis C

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Last edited and updated on: by Sagar Aryal

Hepatitis is a liver infection. It is caused by the Hepatitis C virus which is a blood-borne virus. It is a short term illness but it can be asymptomatic until decades after the infection. Chronic Hepatitis C is a serious disease that can result in long term health problems and even death.

Hepatitis C

Image Source: DEUTSCHE APOTHEKER ZEITUNG

Structure

  • Its genome is positive-sense single-stranded RNA.
  • consists of lipid membrane envelope which is 55-65 nm in diameter
  • two viral envelope glycoproteins, E1 and E2 are embedded in the lipid envelope
  • within the envelope, the icosahedral core is present which is 33-40 nm in diameter
  • inside the core RNA is present

Mode of infection

  • sharing of injection
  • blood transfusion from an infected person
  • unsafe sex
  • infected mother to child
  • doesn’t spread from breast milk, food, water, and casual contact

Risk group

  • drug users
  • people with tattoos
  • prisoners or people in closed settings
  • child whose mother is infected
  • people with a sexual partner infected with HCV

Symptoms

The incubation period ranges from 2 weeks to 6 months. About 80 % of people are asymptomatic. Acutely symptomatic may exhibit

  • fever
  • fatigue
  • decreased appetite
  • nausea
  • vomiting
  • abdominal pain
  • dark urine
  • grey-colored feces
  • joint pain
  • jaundice

Testing and diagnosis

  • Screening tests for antibody to HCV (anti- HCV)
  • enzyme immunoassay (EIA)
  • enhanced chemiluminescence immunoassay ( CIA )
  • Qualitative tests to detect the presence or absence of virus (HCV RNA Polymerase Chain Reaction
  • Quantitative tests to detect amount (titer) of virus (HCV RNA PCR)
  • Viral genotyping

HCV Ab rapid test card kit is used for the screening of Hepatitis C virus infection. Since this rapid test card method is not confirmatory test other test needs to be done further. The presence of antibodies against the HCV virus suggests that it may be due to active infection or due to past infection. HCV RNA tests can be qualitative as well as quantitative. Viral genotyping is used to determine the kind or genotype of the HCV present which helps to guide the treatment. There are 5 major types of HCV and more than 50 subtypes identified. The most common genotype is 1 and 3 which accounts for more than 75% cases in Nepal. The drugs selected for the treatment depend in part on the genotype of HCV infecting a person

NOTE : (RAPID TEST KIT )

  • If the purple-pink colored band is not formed in the control region, it is considered invalid and the test need to be repeated in the next kit

Treatment

  • Currently, the vaccine is not available though various research are going on for its formulation
  • Chronic HCV is treated with the combination of drugs
  • WHO’s updated 2018 guidelines recommend therapy with pan-genotypic direct-acting antivirals (DAAs). DAAs can cure most persons with HCV infection, and treatment duration is short (usually 12 to 24 weeks), depending on the absence or presence of cirrhosis.

REFERENCES 

  1. https://www.cdc.gov › hepatitis › hcv › cfaq
  2. https://dgrc.com.np/hepatitis-C/
  3. https://www.who.int/news-room/fact-sheets/detail/hepatitis-C

Hepatitis C

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