Hepatitis C virus (HCV)

Hepatitis C virus (HCV) infection is a condition in which the individual develops inflammation of liver due to infection with the RNA virus Hepatitis C. The infection was first identified in 1988, and the term Hepatitis C was initially utilized to describe non-A and non-B hepatitis infections that were transmitted through the blood (Miriam J. Alter. 1998, pp. 2013). It is usually transmitted from one individual to another through contaminated blood or blood products (most common), sharing needles or needle-stick injuries, organ transplantation, unsafe sex, or from infected mother to the developing baby (CDC.

2006). During the 1980’s and the 1990’s, the incidence of HCV infection was high as blood and blood products were not routinely screened for the virus. During the years 1982 to 1995, about 15 % of all cases of acute viral hepatitis were caused due to HCV infection. In the early 1990’s, about 120, 000 cases of HCV infection occurred every year in the US. Scandinavia and UK have the lowest HCV infection rates. The infection rates are the highest in Egypt (Miriam J.

Alter. 1998, pp. 2015). Presently, about four million are infected with the HCV in the US (Jenifer K. Lehrer, 2006). About 170 million people throughout the world are affected with chronic HCV infection (Keyur Patel. 2006), and about 3 % population of the World silently suffer from the disease (Mayo Clinic Staff. 2006). The virus that causes HCV is an RNA virus, belonging to the family Flaviviridae and the genus Hepacivirus.

It may be heterogeneous due to mutations developing during the replication of the virus. The virus is one of the six viruses that are recognized as hepatitis viruses (primarily cause infection in the liver) (Miriam J. Alter. 1998, pp. 2014). The incubation period of the virus may range from two to twenty six weeks (usually 6 to 7 weeks) (Miriam J. Alter. 1998, pp. 2018). During the initial stages of the infection, the individual usually develops little or no symptoms.

Some individuals develop a flu-like illness with symptoms such as low-grade fever, tiredness, body pain, anorexia, slight pain in the abdomen, etc. Individuals with the acute version of the disease develop similar symptoms as other viral hepatitis. Individuals with chronic version of the disease also do not have any symptoms, but sometimes develop jaundice, abdominal pain, nausea, vomiting, pale stools, dark urine, itching, ascitis, bleeding varices, etc (Jenifer K. Lehrer, 2006).

The diagnosis of HCV infection is made based on the history, symptoms, signs, physical examination (especially abdominal examination), blood tests (such as ELISA to determine the presence of the HCV antigen), liver function tests (may show higher enzyme levels for longer periods in chronic infection), liver biopsy (to study chronic infection or other complications), imaging techniques (such as X-rays, CT scans and ultrasound), viral studies (such as PCR to know the genetic makeup of the virus), etc (Jenifer K. Lehrer, 2006).

Ribavirin and/or interferon help in the acute sates of the disease by destroying the virus (in about 50 to 80 % of all cases), improving the liver enzyme levels and slowing down the development of chronic liver disease (CDC. 2006). As the liver function is compromised, consumption of drugs, alcohol, nutritional supplements and certain foods should be monitored. Liver transplantation may be required in end stage liver disease. The individual has to get vaccinated against Hepatitis A and Hepatitis B. No vaccine is currently available for HCV because the virus is genetically diverse (Miriam J. Alter. 1998, pp.2020).

The infection can be prevented by have safe sex, avoiding use of contaminated needles during drug use, carefully screening blood during transfusion, etc (Mayo Clinic Staff. 2006). Several long-term complications can develop with HCV infection including cancer of the liver, liver failure, liver cirrhosis (irreversible damage and scarring of the liver), chronic liver diseases (70 % of all cases), long-standing infection following acute hepatitis (55 to 85 % of all cases), fatal outcomes (1 to 5 % of all cases), and requirements of liver transplants (most common cause for transplantation) (CDC.2006, and Jenifer K. Lehrer, 2006).


CDC. “Viral Hepatitis C. ” 2006. CDC. 7 Apr. 2007 http://www. cdc. gov/ncidod/diseases/hepatitis/c/fact. htm Jenifer K. Lehrer. “Hepatitis C. ” Medical Encyclopedia. 2006. Medline Plus. 7 Apr. 2007 http://www. nlm. nih. gov/medlineplus/ency/article/000284. htm Keyur Patel, Andrew J Muir, and John G McHutchison. “Diagnosis and treatment of chronic hepatitis C infection. ” BMJ 332 (2006): 1013-1017. http://www. bmj. com/cgi/content/extract/332/7548/1013 Mayo Clinic Staff. “Hepatitis C. ” Diseases and Conditions. 2006.

Mayo Clinic. 7 Apr. 2007 http://www. mayoclinic. com/health/hepatitis-c/DS00097/DSECTION=1 Miriam J. Alter. , Eric E. Mast and Harold S. Margolis. “Hepatitis C Infection. ” Textbook of Pediatric Infectious Diseases. Ed. Ralph D. Feigin, and James J. Cherry. Philadelphia: W. B. Saunders Company, 1998. 2013-2023. N. D. C Finlayson, and I. A. D Bouchier. “Diseases of the Liver and the Biliary System. ” Davidson’s Principles and Practice of Medicine. Ed. Edwards, C. R. W. , Bouchier, I. A. D. , and Chilvers, E. R. Edinburgh: Churchill Livingstone, 1996. 514-515.

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