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Hepatitis C
The hepatitis C virus (HCV) was discovered in 1989 and was initially
referred to as a "non-A-non-B" hepatitis virus. The virus is a
single-stranded, enveloped, positive sense RNA virus in the flavivirus
family.
Hepatitis C infects an estimated 170 million persons worldwide and 4
million persons in the United States. Co-infection with HIV is common
and rates among HIV positive populations are higher.
Transmission
The infection is spread by blood exchange and, less commonly, sexual
contact. Before serological tests became available, it was often
caused by the use of medical products derived from blood and by blood
transfusion.
Although it can be spread sexually, and vertically (from mother to
child), transmission by these routes is not as likely as with
hepatitis B. hepatitis C is not considered an Sexually Transmitted
Disease (STD). The CDC reports that only 1.5% of partners of hepatitis
C carriers test positive for the disease. In most developed countries,
it is usually seen primarily in intravenous drug users.
Symptoms
In most cases, acute hepatitis C infection has no symptoms and becomes
chronic, and can cause long term damage to the liver, including
cirrhosis and
hepatocellular carcinoma. Severe liver damage may not
develop for 10-40 years after infection.
Diagnosis
Currently, serological tests are available to check for infection. In
addition, PCR can be used for more sensitivity and to elucidate a
genotype for the infection. There are 6 major known genotypes.
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Treatment
Treatment is mainly based on interferon, combined with other drugs;
though this action does not guarantee results. Currently, the
preferred treatment is pegylated interferon together with ribavirin.
Studies have shown sustained cure rates of 75% or better in people
with genotypes 2 or 3 HCV (which is easier to treat) and about 50% in
those with genotype 1.
It is well known that alcohol makes HCV virus proliferate faster, and
makes interferon treatment less effective.
Unlike hepatitis A and B, there is no vaccine for
hepatitis C.
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