Hepatitis C is caused by an RNA virus, which is transmitted frequently parenterally. It sometimes causes typical symptoms of viral hepatitis, including anorexia, nausea and jaundice, but may be asymptomatic. Fulminant hepatitis and death are rare. A cronische hepatitis develops in about 75% of cases and can lead to cirrhosis and rarely also to a hepatocellular carcinoma Diagnosis is made serologically. The treatment is symptomatic. There is no vaccine available.
See also causes of hepatitis, Overview of the acute viral hepatitis, and chronic hepatitis C.)
Hepatitis C is caused by an RNA virus, which is transmitted frequently parenterally. It sometimes causes typical symptoms of viral hepatitis, including anorexia, nausea and jaundice, but may be asymptomatic. Fulminant hepatitis and death are rare. A cronische hepatitis develops in about 75% of cases and can lead to cirrhosis and rarely also to a hepatocellular carcinoma Diagnosis is made serologically. The treatment is symptomatic. There is no vaccine available. See also causes of hepatitis, Overview of the acute viral hepatitis, and chronic hepatitis C.) In the US, about 2,000 cases of acute hepatitis C infection are diagnosed annually. However, since many cases are not recognized or not reported by these estimates, the CDC that the actual number of new infections is nearly 30,000 a year (see CDC Hepatitis C FAQs). Hepatitis C virus (HCV) is a single-stranded RNA flavivirus, which causes acute viral hepatitis and is a common cause of chronic viral hepatitis. There are six different HCV subtypes with different amino acid sequence (genotypes). These genotypes occur geographically diverse and differ in virulence and response to therapy. The HCV change its amino acid sequence in an infected individual and produced numerous variants (quasispecies). Sometimes HCV infection occurs simultaneously with specific systemic diseases on, including the following: essential mixed cryoglobulinemia Porphyria cutanea tarda (about 60-80% of patients with porphyria have HCV infection, but few HCV infected patients develop porphyria), and glomerulonephritis. Glomerulonephritis The mechanisms are uncertain. Up to 20% of patients with alcoholic liver disease at the same time have an HCV infection. The reasons for this high association are not clear, because a simultaneous alcohol and drug abuse explains only part of the time. In these patients, HCV and alcohol act synergistically in the sense of worsening liver inflammation and fibrosis. Transmission of hepatitis C. The infection is usually transmitted by blood, especially for common use of needles at i.v. but drug addicts, moreover, by tattoos and body piercing. Sexual transmission and vertical mother-to-child transmission is relatively rare. Transmission through blood transfusions are an absolute rarity, as the blood donors are carefully examined. Sporadic cases with no obvious risk factors occur repeatedly HCV prevalence varies depending on the geographical area and various risk factors. Symptoms and signs Hepatitis C can be asymptomatic during the acute phase. Their severity fluctuates, sometimes with recurrent hepatitis and fluctuating transaminases over years and decades. Fulminant hepatitis is extremely rare. HCV infection has the highest Chronizitätsrate (about 75%). The resultant chronic hepatitis is usually asymptomatic and shows a benign course, but also performs frequently develops over decades in 20-30% of patients to cirrhosis. In HCV-infected liver hepatocellular carcinoma can develop, usually the cancer education goes cirrhosis development ahead (unlike hepatitis B). Diagnosis Serological tests should Therefore, in the early diagnosis of acute hepatitis, viral hepatitis are the differential diagnosis, distinguished from other diseases that cause jaundice (Simplified diagnostic approach to potential acute viral hepatitis.). If an acute viral hepatitis is suspected, the following tests to screen for hepatitis viruses A, B and C are carried out: IgM antibody to hepatitis A virus (anti-HAV) hepatitis B surface antigen (HBsAg) IgM antibodies against hepatitis B core (anti-HBc IgM) antibodies against HCV (anti-HCV) If the anti-HCV test is positive, HCV RNA is measured to distinguish active from a previous hepatitis C infection (see Table : hepatitis C serology). In hepatitis C serum anti-HCV is a chronic, acute or previous infection; the antibody is not protective. In unclear cases, HCV RNA should be determined. Anti-HCV usually appears within 2 weeks after the acute infection, but can also occur later, but HCV-RNA is positive earlier. Hepatitis C serology markers Acute HCV infection Chronic HCV infection Previous HCV infection * Anti-HCV + + + HCV RNA + + – * patients who had HCV infection and are spontaneously cured or treated successfully. Anti-HCV = Antibodies to HCV; HCV = hepatitis C virus. Other function tests Liver function tests be determined if that has not happened before. These include serum transaminases (ALT and AST), alkaline phosphatase and bilirubin. Other tests should be performed to assess the severity of the disease; they include serum albumin, platelet count and PT / INR. Therapy Supportive treatment No specific treatment softens the course of acute hepatitis, including hepatitis C. There are a number of new, highly effective direct-acting antiviral drugs for chronic hepatitis C, which reduce the likelihood of developing chronic infection. However, the schemes have been studied very expensive and not in acute infection; Current recommendations are to observe the patient for 6 months to allow spontaneous clearance and then treat those who have a persistent viremia (d. e. a chronic hepatitis C). Alcohol should be avoided because it increases the liver damage. Restrictions in diet or physical activity incl. The often prescribed bed rest have no scientific basis. Most patients can resume safe to work after the jaundice has subsided, even if the transaminases are still increased. In the cholestatic hepatitis, the administration of cholestyramine can be 8 g p.o. 1 to 2 times reduce the itching daily. The presence of a viral hepatitis is reportable. Prevention Patients should be counseled to avoid behavior at high risk (eg. As can sharing needles to inject drugs sting tattoos and piercings). Blood and other body fluids (eg. As saliva, semen) are considered infectious. The risk of infection after contact with a single injection needles is about 1.8%. Protective measures are recommended, but isolation of the patient does not contribute to the prevention of acute hepatitis C. The risk of transmission by HCV-infected medical personnel appears to be low, and there is no limit CDC recommendations health workers with hepatitis C infection. The risk of post-transfusion hepatitis is minimized by avoiding unnecessary transfusions and all blood donors are tested for HBsAg and anti-HCV. This screening has reduced the incidence of post-transfusion hepatitis to about 1: reduced 100,000 units of transfused blood components. Vaccines for immune prophylaxis of HCV do not exist. The ability of HCV to change its genome complicates vaccine development. Important points hepatitis C is generally transmitted through parenteral contact with infected blood; Transmission of mucous membrane contact with other body fluids and perinatal transmission from infected mothers are rare. Approximately 75% of patients with acute hepatitis C develop chronic hepatitis, which can change at 20 to 30% in cirrhosis. In some patients with cirrhosis further development into a hepatocellular carcinoma occurs. Diagnosis by testing for antibodies against HCV and other serological markers. Treatment is supportive. There is no vaccine against hepatitis C. For more information, CDC Hepatitis C FAQs