Viral Hepatitis C Flashcards
def
hepatitis by infection with HCV
often follows a chronic course (80%)
what sort of virus is HCV
small, enveloped, ssRNA virus of flavivirus family
aetiology
1 transmission -parenteral route 2 pathogenesis -HCV not directly hepatotoxic -humoral + cell-mediated response leads to hepatic inflammation + necrosis
what groups are at risk of HCV
1 IV drug users
2 tattooing
3 those on haemodialysis
what is a characteristic feature of HCV
lymphoid follicles in portal tracts
epi
common
prevalence is <2% in developed countries
prevalence is higher in developing countries (middle east)
history
1 asymptomatic (90%)
2 mild flu-like illness (<10%)
3 may be diagnosed incidentally with abnormal LFTs or in elderly with cirrhosis
examination
1 no signs/signs of CLD
2 extra-hepatic manifestations
-skin rash
-renal dysfunction
what is a skin rash caused by in HCV and what does it cause
mixed cryoglobulinaemia causing small-vessel vasculitis
what are cryglobulins
proteins which become insoluble at low temperature
what causes renal dysfunction
glomerulonephritis
investigations
1 bloods -HCV serology -reverse transcriptase PCR -LFTs 2 liver biopsy -assesses inflammation + liver damage
what would you look for in HCV serology for
acute: anti-HCV antibodies (igM)
past exposure/chronic: anti-HCV antibodies (igG)
why is reverse transcriptase PCR used
to confirm infection following serology
what would be found on LFTs with acute HCV
raised AST + ALT