hepatitis C virus

see also:

• viruses
• hepatitis B virus
• HIV / AIDS
• hepatitis
• cirrhosis
• hepatocellular carcinoma

• a single-stranded ribonucleic acid (RNA) hepacivirus, a member of the flaviviridae viruses
• the most frequent cause of parenteral non-A, non-B hepatitis worldwide.
• causes 20% of acute viral hepatitis cases in USA.
• mainly spread by blood transmission, primarily from sharing needles between intravenous drug users (IVDU) or injection drug use (IDU)
• risk from needlestick injury from a hep C +ve source is approximately 3%
• no vaccination available
• no antiviral prophylactics available
• most cases develop chronic hep C infection and hepatitis
  • 50% of pts with hep C develop cirrhosis - most within 5-10yrs
  • confers 15-20x risk of hepatocellular carcinoma
  • chronic infection also associated with sporadic form of porphyria cutanea tarda.
  • may develop cryoglobulinaemia

• see hepatocellular carcinoma
• HCV infection confers a 15-20x risk of hepatocellular carcinoma (but most of this risk is limited to those with advanced hepatic fibrosis or cirrhosis)
  • HCV epidemics: Japan 1920's; southern Europe 1940's; Nth America 1960's-70's;
  • in patients with hepatocellular carcinoma, HCV markers are found in 80-90% if Japanese, 44-66% if Italian, 30-50% if USA.
  • risk factors of hepatocellular carcinoma with HCV infection include:
    • older age at time of infection
    • males
    • coinfection with HIV or HBV
    • possibly diabetes or obesity
    • chronic heavy alcohol intake