HEPATITIS (TYPE C)

Hello everyone!, How are you all? I hope you all are fine and I am fine too! So today, we will discuss Hepatitis Type C. Let's begin!!

GENERAL INTRODUCTION

Hepatitis Type C is a liver disease that is caused by the bloodborne Hepatitis C virus (HCV). It can cause acute to chronic hepatitis. The severity can range from a mild illness lasting a few weeks to a life-long illness.

CAUSES

The hepatitis C virus is a bloodborne virus: the most common modes of infection are:-

exposure to small quantities of blood.
injection drug use
unsafe injection practices
unsafe health care
transfusion of unscreened blood and blood products

SYMPTOMS

Hepatitis C virus causes both acute and chronic infection. New HCV infections are usually asymptomatic. The incubation period for hepatitis C ranges from 2 weeks to 6 months. Following initial infection, approximately 80% of people do not exhibit any symptoms. Those who are acutely symptomatic may exhibit:-

fever
fatigue
decreased appetite
nausea
vomiting
abdominal pain
dark urine
grey-colored feces
joint pain
jaundice (yellowing of the skin and the whites of the eyes).

HOW IS IT TRANSMITTED

Early diagnosis can prevent health problems that may result from infection and prevent transmission of the virus. WHO recommends testing people who may be at increased risk of infection.

Populations at increased risk of HCV infection include:

people who inject drugs;
people in prisons and other closed settings;
people who use drugs through other routes of administration (non-injecting)
recipients of infected blood products or invasive procedures in healthcare facilities with inadequate infection control practices
children born to mothers infected with HCV;
people with HIV infection;
prisoners or previously incarcerated persons; and
people who have had tattoos or piercings.

DIAGNOSIS

Because new HCV infections are usually asymptomatic, few people are diagnosed when the infection is recent. In those people who go on to develop chronic HCV infection, the infection is also often undiagnosed because it remains asymptomatic until decades after infection when symptoms develop secondary to serious liver damage.

HCV infection is diagnosed in 2 steps:

Testing for anti-HCV antibodies with a serological test identifies people who have been infected with the virus.
If the test is positive for anti-HCV antibodies, a nucleic acid test for HCV ribonucleic acid (RNA) is needed to confirm chronic infection because about 30% of people infected with HCV spontaneously clear the infection by a strong immune response without the need for treatment. Although no longer infected, they will still test positive for anti-HCV antibodies.

After a person has been diagnosed with chronic HCV infection, he or she should have an assessment of the degree of liver damage (fibrosis and cirrhosis). This can be done by liver biopsy or through a variety of non-invasive tests.

The degree of liver damage is used to guide treatment decisions and management of the disease.

TREATMENT

New infection with HCV does not always require treatment, as the immune response in some people will clear the infection. However, when HCV infection becomes chronic, treatment is necessary. The goal of hepatitis C treatment is the cure.

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.

WHO recommends treating all persons with chronic HCV infection over the age of 12 with pan-genotypic DAAs. Pan-genotypic DAAs remain expensive in many high- and upper-middle-income countries. However, prices have dropped dramatically in many countries (primarily low-income and lower-middle-income countries), due to the introduction of generic versions of these medicines.

Access to HCV treatment is improving but remains too limited. In 2017, of the 71 million persons living with HCV infection globally, an estimated 19% (13.1 million) knew their diagnosis, and of those diagnosed with chronic HCV infection, around 5 million persons had been treated with DAAs by the end of 2017. Much more needs to be done for the world to achieve the 80% HCV treatment target by 2030.

PREVENTION

Primary prevention

There is no effective vaccine against hepatitis C; prevention of HCV infection depends upon reducing the risk of exposure to the virus in healthcare settings and higher-risk populations, for example, people who inject drugs and particularly those infected with HIV or those who are taking pre-exposure prophylaxis against HIV.

The following list provides a limited example of primary prevention interventions recommended by WHO:

safe and appropriate use of health care injections;
safe handling and disposal of sharps and waste;
provision of comprehensive harm-reduction services to people who inject drugs including sterile injecting equipment and effective and evidence-based treatment of dependence;
testing of donated blood for HBV and HCV (as well as HIV and syphilis);
training of health personnel;
Secondary prevention

For people infected with the hepatitis C virus, WHO recommends:

education and counseling on options for care and treatment;
immunization with the hepatitis A and B vaccines to prevent coinfection from these hepatitis viruses and to protect their liver;
early and appropriate medical management including antiviral therapy; and
regular monitoring for early diagnosis of chronic liver disease.

PREVALENCE

Hepatitis C is found worldwide. The most affected regions are the WHO Eastern Mediterranean Region and the WHO European Region, with an estimated prevalence in 2015 of 2.3% and 1.5% respectively. The prevalence of HCV infection in other WHO regions varies from 0.5% to 1.0%. Depending on the country, hepatitis C virus infection can be concentrated in certain populations. For example, 23% of new HCV infections and 33% of HCV mortality are attributable to injecting drug use. Yet, people who inject drugs and people in prisons are not often included in national responses.

In countries where infection control practices are or were historically insufficient, HCV infection is often widely distributed in the general population. There are multiple strains (or genotypes) of the HCV virus and their distribution varies by region. However, in many countries, the genotype distribution remains unknown.

Well, readers, that was it. Hope you liked it and it gave you enough information about Hepatitis type C. If still have any queries, feel free to ask in the comments, and yes! suggestions will be appreciated. Take care and keep you and your family safe. I will write again soon. Till then, bubyeeee.