What is Hepatitis C from a Medical Perspective?
- Acute Hepatitis C: 15-25% of cases resolve spontaneously within 6 months.
- Chronic Hepatitis C: 75-85% progress to persistent infection, increasing risk of cirrhosis, liver cancer, and liver failure.
- Genotypes: 6 major genotypes (1-6) with varying geographic prevalence and treatment responses.
Over 58 million people globally live with chronic HCV. It is a major cause of liver transplants and cancer-related deaths.
Symptoms of Hepatitis C
Acute Hepatitis C:
- Often asymptomatic or mild flu-like symptoms.
- Fatigue, nausea, abdominal pain, and dark urine.
- Jaundice (yellowing of skin/eyes) in ~20% of cases.
Chronic Hepatitis C:
- May remain asymptomatic for decades.
- Advanced stages present with:
- Ascites, variceal bleeding, and encephalopathy (cirrhosis).
- Fatigue, itching, and spider angiomas.
- Hepatocellular carcinoma (HCC) in 1-5% of cases over 20 years.
Hepatitis C Diagnostic Methods
Testing involves a two-step process:
- Screening Test:
- Anti-HCV antibody test: Detects past/present infection.
- Confirmatory Test:
- HCV RNA PCR test: Confirms active infection and quantifies viral load.
- Genotyping:
- Determines genotype to guide treatment duration and drug selection.
- Liver Assessment:
- Ultrasound, FibroScan, or biopsy to evaluate fibrosis/cirrhosis.
Medical Management of Hepatitis C
Acute Hepatitis C:
- No routine antiviral therapy unless rapid progression occurs.
- Monitor for spontaneous clearance (6-month HCV RNA test).
Chronic Hepatitis C:
- Direct-Acting Antivirals (DAAs):
- 95-99% cure rate with 8-12 week regimens (e.g., Sofosbuvir + Velpatasvir).
- Genotype-specific regimens (e.g., genotype 3 may require longer treatment).
- Liver Monitoring:
- Biannual ultrasounds for HCC screening post-cure.
Frequently Asked Questions (FAQ)
Can Hepatitis C be cured?
Yes. Modern DAAs achieve cure (SVR12) in over 95% of cases. Treatment eliminates the virus permanently.
What is the window period for testing?
Antibodies appear 2-12 weeks post-infection. HCV RNA can be detected within 1-2 weeks. Confirmatory testing recommended 6 months post-exposure.
Is Hepatitis C transmitted through sex?
Low risk in monogamous relationships. Higher risk in HIV-positive individuals, those with multiple partners, or during anal sex. Condom use advised.
Can HCV recur after cure?
No. A sustained virologic response (SVR) means complete cure. However, re-infection is possible through re-exposure to HCV.
Does HCV affect life expectancy?
Untreated chronic HCV reduces life expectancy by 10-15 years. Early DAA treatment restores normal life expectancy.
Preventing Hepatitis C Transmission
- Avoid Blood Contact:
- Never share needles, razors, or toothbrushes.
- Use sterile equipment for tattoos/piercings.
- Blood Safety:
- Ensure all blood donations are HCV-screened.
- Needle Exchange Programs:
- Reduce transmission among people who inject drugs.
- Universal Precautions:
- Healthcare workers must follow strict infection control protocols.
