HCV is a positive, single-stranded RNA virus in the Flaviviridae family. The genome is approximately 10,000 nucleotides and encodes a single polyprotein of about 3,000 amino acids. Host cell and viral proteases into three major structural proteins and several non-structural proteins necessary for viral replication process the polyprotein. Several different genotypes of HCV with slightly different genomic sequences have since been identified that correlate with differences in response to treatment with interferon alpha. [Hepatitis C by Howard J. Worman, M.D.]
The productions of drugs for curing HCV have not been produced however, using excellent diagnostic methods we can examine this type.
Risk Factors for HCV Infection
Approximately 170,000,000 people worldwide and 4,000,000 in the United States are infected with HCV. Primarily blood and blood products transmit the virus. The majorities of infected individuals have either received blood transfusions prior to 1990 (when screening of the blood supply for HCV was implemented) or have used intravenous drugs. Sexual transmission between monogamous couples is rare but HCV infection is more common in sexually promiscuous individuals. Perinatal transmission from mother to fetus or infant is also relatively low but possible (less than 10%). Many individuals infected with HCV have no obvious risk factors. Most of these persons have probably been inadvertently exposed to contaminated blood or blood products. [Hepatitis C by Howard J. Worman, M.D.]
Consequences of HCV Infection
Studies indicate that nearly 85% of individuals who are acutely infected with HCV end up as chronically infected patients. HCV is the main cause of chronic hepatitis. The drawback of this phase is that once a person is chronically infected, the virus is in the person till the person dies. This is because in many cases, HCV infection causes clinically acute disease that leads to the malfunctioning of the liver; the problem lies in the fact that the acute infection is undetectable in the early phases.
The history of chronic HCV infections in individuals varies between individuals, since some show hardly any signs of the disease to very low liver disease so they never get into the complicated stage at all. However, in some other cases there are signs of chronic hepatitis. They develop all the signs of the disease and end up developing cirrhosis. Nearly 20% of individuals with hepatitis C who develop cirrhosis end up with the last-stage of the liver disease. Cirrhosis caused by hepatitis C is currently the man cause for orthotopic liver transplantation in the United States. People who develop with cirrhosis from hepatitis C have higher chances of developing hepatocelluar carcinoma, this is type of liver cancer.
Of the major problems doctors' face in discussing diagnosis in patients with chronic hepatitis C is the difficulty in finding those who have a benign course and who have the chances of developing cirrhosis or cancer. It is observed that persistent alcohol abuse can lead to cirrhosis.
History, serological testing and liver biopsy can diagnose chronic hepatitis C Examinations indicate that most patients with chronic hepatitis C will be a symptomatic or show signs such as, fatigue. In some cases, the diagnosis will be done from the results of blood tests.
Individuals suspected of having chronic hepatitis C include:
Those with symptoms of chronic liver disease
Those with risk factors such as past or current intravenous drug use or blood transfusions prior to 1990
Those with abnormal laboratory tests suggesting liver disease [Source: Hepatitis C by Howard J. Worman, M.D.]
Those hose blood samples show the signs of chronic hepatitis should be immediately tested for the presence of serum antibodies against HCV. Chronic hepatitis is seen by the presence of anti-HCV antibodies in a person who has chances of developing the liver disease. If the test does not find anti-HCV antibodies, this means that no further diagnosis is needed. Tests for HCV RNA in blood is done in those people who contain anti-HCV antibodies to validate the diagnosis and in the patient who does not have anti-HCV antibodies but the diagnosis is still done out of suspicion. After the diagnosis, a liver biopsy is done to examine the degree of liver inflammation and fibrosis and also for the presence or absence of cirrhosis.
It is important for patients with chronic hepatitis C to be assessed by a specialist who can predict if there is any room for possible treatment with the remedies available. Doctors say that adults under the age of 70 years, who indicate active inflammation on liver biopsy and without advanced cirrhosis, are good treatment patients. Also, patients with advanced cirrhosis should undergo liver transplantation. [Hepatitis C by Howard J. Worman, M.D.]
Hepatitis is a disease that affects our liver and can also be caused by taking drugs that are taken to treat other illnesses. One of the best ways to evaluate any signs of the disease is through testing an increase in liver enzymes. Once the person has been diagnosed, and undergone for in-depth evaluation, the drugs that were being taken should be discontinued and a regular checkup is to be done.
Prevention is still the best medicine for this illness. It is recommended that condom be used during sexual intercourse since it will decrease the risk of hepatitis B and the usage has shown to be effective. Also, proper washing of hands is important for the prevention and protection from the transmission of most viruses. Even today, we don't have much information available about other causes of hepatitis but there are numerous studies being conducted to evaluate effective treatment for those infected with this chronic disease. [Hepatitis A-B-C]
A Commitment to Global Health - Text version, available at:
http://www.niaid.nih.gov/director/usmed/1999/usmed99text.htm, accessed on:
February 9, 2004
BioE: News and Press Releases, available at: http://www.bioe.com/news.html, accessed on: February 9, 2004
Digestive Disease Library, available at: http://www.hopkins-gi.org/pages/latin/templates/index.cfm?pg=disease1& organ=2& disease=18& lang_id=1, accessed on: February 9, 2004
FDA/CFSAN Bad Bug Book Hepatitis A Virus, available at:
http://vm.cfsan.fda.gov/~mow/chap31.html, accessed on: February 9, 2004
Hepatitis A-B-C, available at: http://www.hiv.bg/hepatitis.engl.htm, accessed on:
February 9, 2004
Hepatitis C, available at: http://cpmcnet.columbia.edu/dept/gi/hepC.html, accessed on: February 9, 2004
The Hepatitis B Story -- Summary, available at:
http://www.beyonddiscovery.org/content/view.article.asp?a=265, accessed on:
February 9, 2004
What I need to know about Hepatitis B, available at:
http://digestive.niddk.nih.gov/ddiseases/pubs/hepb_ez/, accessed on: February