Hepatitis C

(HCV)

  • single-stranded RNA togavirus

  • transmitted by blood or ? sexual contact

  • chronicity in 50% of patients

  • 20% progress to cirrhosis

Symptoms

  • incubation 2-4 months

  • sub-clinical / mild disease in 10%

Risk Factors

  • Needle sharing
    • Tattoos
    • IV drug use
  • Unprotected sex
    • homosexuals
    • prostitutes
  • Haemophiliacs
  • Health workers
  • Haemodialysis
  • Babies of infected mothers

Investigations

  • cDNA can be tested for

Treatment

  • interferon alpha

  • ribavirin

Complications

  • Chronic infection (50%)

  • Cirrhosis

  • Fibrosis

  • Chronic Liver Disease

Hep C

            Spread: blood, blood by-products

  • No vaccine.
  • Avoidance (needle exchange, blood transfusions).
  • Cirrhosis in 20% within 5-30 years, 15% of those will develop hepatocellular carcinoma(course adversely affected by alcohol).
  • Interferon alfa (3M units´3 a week for 12/12)-used with some success (depending on viral genotype, poor on genptype 1) in combination with ribavirin (1000mg OD). Very expensive. New slow release versions. 
  • Use of the 2 together have higher rate of success (15-20% for interferon alfa alone vs. 40-77% when used together)
  • Ribavirin S/E – highly teratogenic, haemolytic anaemia, reticulosis.
 

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