Viral Hepatitis C Flashcards
What is hepatitis C?
Infection caused by hepatitis C virus (HCV), often following a chronic course (in 80% of cases)
Describe hepatitis C
Small, enveloped, ss-RNA virus
RNA viruses have poor fidelity of replication + mutation rates are high - so, there are lots of HCV genotypes (which can co-exist in a single pt)
How is hepatitis C transmitted?
PARENTERAL
Sexual transmission
Vertical transmission
List 6 risk factors for hepatitis C
Recipients of blood + blood products IV drug users Non-sterile acupuncture Tattooing Haemodialysis HCPs
Describe the pathogenesis of hepatitis C
Virus NOT thought to be directly hepatotoxic
Humoral + cell-mediated responses to the viral infection that leads to hepatic inflammation + necrosis
Describe the epidemiology of hepatitis C
COMMON
Different genotypes of HCV have different geographical prevalence
How does hepatitis C usually present?
90% of acute infections are ASYMPTOMATIC
May be diagnosed after incidental abnormal LFT or in older patients with complications of cirrhosis
May be NO SIGNS
List symptoms of hepatitis C
10% become jaundiced with mild flu-like illness
List 3 categories of signs of hepatitis C
May be signs of chronic liver disease (if long-standing HCV infection) e.g. jaundice, ascites
May be signs of hepatic encephalopathy if advanced CLD
Extra-hepatic manifestations (rare): Skin rash + Renal dysfunction (due to glomerulonephritis)
Describe the serology of hepatitis C
Anti-HCV antibodies: IgM (acute) or IgG (past exposure or chronic)
Describe LFTs seen in hepatitis C
Acute: High ALT, AST + BR
Chronic: 2-8 x elevation of AST + ALT (often fluctuates over time)
Transaminase (AST + ALT) levels bear little correlation to histological changes
Why may you perform a liver biopsy in hepatitis C?
Assess degree of inflammation + liver damage (NOT for dx)
Useful for diagnosing cirrhosis
List 3 preventative measures against hepatitis C?
Screen blood, blood products + organ donors
Needle exchange schemes for IV drug users
Instrument sterilisation
Can you be completely protected from hepatitis C?
NO VACCINE AVAILABLE
Describe management of acute hepatitis C
Mainly supportive (antipyretics, antiemetics, cholestyramine)