HEPATITS C

Etiology

HCV is a spherical, encapsulated, positive-strand ribonucleic acid (RNA) virus with a diameter of around
55 nm. It is a member of the Flaviviridae family. However, it is unique enough to be recognized as a new
genus, Hepacivirus. The genome is around 9.6 kb in length. It generates a polyprotein, which is
transformed into at least 10 proteins. Contact with the blood of an infected individual distributes the
hepatitis C virus. Sharing or unintentionally inserting drug needles with an infected individual, having
contact with the blood or open sores of an infected person, and/or being born to a mother with hepatitis
C can all result in transmission.

Prognosis

When persons do have hepatitis C, the symptoms are generally moderate. When people experience fever,
exhaustion, bodily pains, and a loss of appetite, they frequently believe they have the flu. The symptoms
of acute hepatitis C might continue for months. Some individuals will develop chronic hepatitis C if they
do not receive treatment. Chronic hepatitis C, on the other hand, is a long-term condition that can cause
liver damage. Such as fibrosis and, finally, cirrhosis. Older hepatitis C medications were difficult to tolerate
and only cured roughly half of those who took them. Many patients were forced to discontinue therapy
owing to unpleasant adverse effects. Standard treatment consists of two antiviral medications. Chronic
hepatitis C, if left untreated, can lead to cirrhosis, or irreversible damage to the liver. This can eventually
progress to end-stage liver failure, in which the liver stops functioning.

Medical Intervention, Laboratory and Diagnostic Studies

Medical Intervention

• Administer medicine most appropriate for the type of hepatitis C

• During treatment, patient should have blood tests to check if the medicine is working.
• Physician will also assess the liver for damage (scarring), either with a blood test or a scan called
a fibroscan.
• Patient will advise not to become pregnant while taking treatment as it could be harmful to
unborn babies.
• Women taking ribavirin should use contraception during treatment and for another 4 months
after the end of treatment.
• Men taking ribavirin should use a condom during treatment and for another 7 months after the
end of treatment. This is because semen can contain ribavirin.

Laboratory

• Screening: Screening for hepatitis C virus (HCV) is done with a serologic test for the HCV antibody
(Ab).
• Confirmatory: Diagnosis of chronic hepatitis C requires the presence of HCV RNA, commonly
called hepatitis C viral load.
 • Genotype: Once it is determined that HCV RNA is present, the specific genotype and subtype of
the virus can be determined with a genotype test.
• Drug resistance: Mutations of some proteins in HCV can allow the virus to have resistance to
direct-acting antivirals (DAAs), commonly referred to as resistance-associated variants (RAVs) or
resistance-associated polymorphisms (RAPs).

Diagnosis

• Negative (non-reactive). This is when the blood shows no signs of HCV antibodies. Most of the
time, that’s because the patient never came in contact with the virus and do not have hepatitis C.
• Positive (reactive). This means patient have been infected with HCV. However, false positives
are surprisingly common, possible reasons includes, new born to mothers with hep C probably
have HCV antibodies. But most newborns aren’t actually infected.