Hep C

Question 1

Define

Answer 1

C - chronic
Small enveloped ss-RNA virus
chronic case in 80%

Question 2

Transmission

Answer 2

Percutaneous: 
parenteral (sexual and vertical (mum to baby))
IV needles
Organ transplant
Blood transfusion
Contaminated medical equipment

Question 3

Pathogenesis

Answer 3

Not directly hepatotoxic, humoural and cell mediated, leading to hepatic inflammation necrosis

Poor fidelity of replication and high mutation rate i.e. you get many HCV genotypes in the same patient

Question 4

Epidemiology

Answer 4

Common

Question 5

Aetiology

Answer 5

Non sterile acupuncture
IVDU
same as hep b/d/a/e

Question 6

Signs

Answer 6

none unless
chronic LD
extrahepatic skin rashes
renal glomeulonephritis

Question 7

Investigations - bloods

Answer 7

Acute: High ALT , AST, bili

Chronic - elevation of ask and alt but this is not correlated with the histology

Question 8

Serology

Answer 8

Anti-HCV antibodies
IgM - acute
IgG - chronic

Question 9

Biopsy

Answer 9

??????

Question 10

Management

Answer 10

No vaccination !

Prevention - keep blood products safe

Question 11

Complications of hep C

Answer 11

Fulminant hepatic failure
Chronic carriage of HCV

Porphyria cutanea tarda - sensitive to light such that you get blisters
Cryoglobulinamiea
glomerulonerphritis

Question 12

Prognosis

Answer 12

80% of those exposed become chronic carriers

20-30% of those with chronic will become cirrhosed