HEPATITIS C

Question 1

PROPERTIES

Answer 1

ssRNA virus.
Enveloped.
Positive Sense RNA.

Question 2

SOURCES

Answer 2

Blood Transfusion.
Infected needles.
Sex, Placental, Breast-Feeding.

Question 3

Pathogenesis

Answer 3

Infects Hepatocytes and B-cells.
It enters the hepatocytes via LDL Receptor, Membrane fuses with endosomes, Capside degraded by cytoplasm.

Viral RNA is translated by ribosomes to make structural proteins and Replication COmplex containing RNA-DEPENDENT-RNA-POLYMERASE.

This RDRP makes negative senses mRNA which is used by the replication complex to make tons of positive sense ssRNA virus.

RNA-DEPDENT-RNA-POLYMERASE makes lot of mistakes, it lacks 3-5’ polymerase activity, contributing to hepC variability.

Question 4

C/F

Answer 4

Acute: Pain in RUQ, Hepatomegaly, Jaundice (almost never)

Chronic: Fatigue, Jaundice.

if >10y, can causes cirrhosis > Fulminant hepatitis.

Question 5

Acute vs Chronic

Answer 5

Acute: <6 months, Rising and then falling titres of ALT/AST.

Chronic> >6 months, Lymphcytic proliferation of Portal tract > cell destroyed > fibrosis > cirhossis.

Question 6

LABORATORY DIAGNOSIS

Answer 6

ACUTE: hepC antigen < 6 months
Chronic: hepC antigen > 6 months + cryoglobulin [Damaged hepatocytes make those IgM antibodies which can PPT. in COLD temp].

Question 7

Tx:

Answer 7

Ribavirin + INF-alpha
Sofobuvir

Question 8

Vaccine:

Answer 8

NONE due to antigenic variability.