Epidemiology and transmission
HCV is the most common cause of chronic hepatitis, cirrhosis and hepatocellular cancer in the world.
• IV drug use is the most important risk factor for HCV infection.
• Incubation period is 15-160 (average 50) days.
Clinical and laboratory
• Most of the cases are asymptomatic.
• In symptomatic cases, the clinic is typical acute viral hepatitis.
About 85% of acute HCV cases become chronic.
• The most common type is genotype lb.
• Anti-HCV:
It becomes positive after ALT elevation.
Indicates exposure to the virus. It does not indicate viral replication or immunity to the virus.
HCV-RNA:
It can be found positive in the blood before the ALT elevation.
HCV-RNA positivity generally indicates that viral replication continues.
Detection of HCV-RNA in serum is the first biochemical finding that develops within a few days after virus ingestion.
Extrahepatic findings:
hematological
Essential mixed cryoglobulinemia (most common cause)
aplastic anemia
Lymphoma (Diffuse large B-cell, splenic marginal zone lymphoma, lymphoplasmocytic lymphoma)
autoimmune
Autoantibody positivity (ANA, RF, thyroid autoantibodies, anticardiolipin antibody, anti LKM-1)
autoimmune thyroid disease
lymphocytic sialadenitis
Skin
lichen planus
Porphyria cutanea tarda
Leukocytoclastic vasculitis
necrolytic acral erythema
Kidney
MPGN type 1
Other
Diabetes mellitus and metabolic syndrome
Sjogren's syndrome (sicca syndrome)
idiopathic lung fibrosis
myocarditis
Treatment:
• In acute hepatitis C, the patient should receive antiviral therapy.
Establishment
• There is no vaccine and immunoglobulin.X