Hepatitis C

Original article by Tom Leach | Last updated on 28/6/2013
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  • This is unusual as hepatitis viruses go, as it very rarely causes acute infection. People will only become aware of infection when they develop serious liver disease later in life.
  • 80% of those exposed to the virus will develop chronic infection. Spontaneous late clearance of the disease is very rare.
  • Blood transfusion and blood products are a major means of transmission. It is also though that it can be sexually transmitted, but this is not particularly common.
  • Prevalence in the UK is about 0.02%. In Africa it is about 6%, and in Egypt is as high as 19%.
  • About 80% of those in the UK with haemophilia have hepatitis C.
  • Major health problem – 150 million infected. Incubation 6 - 12 wks – however this figure is fairly meaningless, due the fact that acute disease is so rare.
  • 85% anicteric. 10-15% of patients will have jaundice and perhaps other general symptoms suggestive of hepatitis.
  • Jaundice, malaise, abdominal pain, nausea & fever - mild
  • Diagnosis – abnormal LFTs / +ve anti-HCV
  • Acute liver failure rare – < 0.1%
  • Chronic infection very common – 85% & 1 – 4 % ® HCC
  • Antiviral therapy for chronic infection
  • No vaccine available
  • 30% of chronic HCV develop cirrhosis within 20 – 30 years
  • Worldwide it is the leading cause of liver disease.
  • 95% of new cases in UK are due to IV drug use. Sexual transmission is also possible but less common.
  • Male patients are more likely to develop fibrosis with chronic infection.
  • Interferon is the most common treatment for chronic infection.
  • Progression from chronic hepatitis to cirrhosis takes 20-40 years. This happens more quickly in male patients, immunosupressed patients, and those who drink a lot of alcohol.
  • About 20% of Hep C patients will develop cirrhosis within 20 years.
    • 5 year survival once cirrhosis has set in is 95%. 10-year is 81%
    • ¼ of patients will develop complications, such as ascites. Once these have developed, 5-year survival drops to 50%
    • 2-5% of cirrotic patients will develop hepatocarcinoma.