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Chronic Hepatitis C infection Title Ñ Chronic Hepatitis C infection Definition Ñ Chronic infection With the: Ñ Hepatitis C virus Aetiology Ñ RNA virus (Flavivirus) Ñ 6 Genotypes Pathogenesis Transmission Ñ Blood and blood products Ñ Intravenous drug abuse Ñ Limited role of sexual transmission in long-term heterosexual relationships Ñ Increased risk in homosexuals Ñ Vertical transmission from mother to child uncommon Ñ 20% mode of transmission unknown Aggravating factors The course of the illness is adversely affected by: Ñ Alcohol consumption Ñ Male sex Ñ Acquiring infection after the age of 40 years Ñ Genotype 1 or 4 Pathological Process Ñ Chronic hepatitis in > 50 % of those infected Ñ Half progress to cirrhosis Clinical Features Ñ Most acute infections are asymptomatic Ñ 10 % of patients have a flu like illness with jaundice and elevated serum aminotransferases E&M Ñ Higher incidence of diabetes mellitus Ñ Fatigue IS Ñ Porphyria cutanea tarda GIT Ñ Abnormal serum aminotransferases Ñ Chronic liver disease KUS Ñ Glomerulonephritis associated with cryoglobulinaemia LMS Ñ Arthritis Ñ Sjögren’s syndrome Complications GIT Ñ Cirrhosis of the liver Ñ Hepatocellular carcinoma Investigations Fluids Blood Microbiology Ñ HCV RNA: May be detected 1 or 2 weeks after infection Ñ Anti-HCV antibody: Usually positive 6 weeks after infection Management Cure Drugs Ñ Ribavarin Biological Agents Ñ Pegylated interferon Support Biological Agents Ñ Liver transplantation for end stage cirrhosis Prognosis Ñ Genotype 1 is the most difficult to treat
Chronic Hepatitis C infection
Title
Ñ Chronic Hepatitis C infection
Definition
Ñ Chronic infection
With the:
Ñ Hepatitis C virus
Aetiology
Ñ RNA virus (Flavivirus)
Ñ 6 Genotypes
Transmission
Ñ Blood and blood products
Ñ Intravenous drug abuse
Ñ Limited role of sexual transmission in long-term heterosexual relationships
Ñ Increased risk in homosexuals
Ñ Vertical transmission from mother to child uncommon
Ñ 20% mode of transmission unknown
Aggravating factors
The course of the illness is adversely affected by:
Ñ Alcohol consumption
Ñ Male sex
Ñ Acquiring infection after the age of 40 years
Ñ Genotype 1 or 4
Pathological Process
Ñ Chronic hepatitis in > 50 % of those infected
Ñ Half progress to cirrhosis
Clinical Features
Ñ Most acute infections are asymptomatic
Ñ 10 % of patients have a flu like illness with jaundice and elevated serum aminotransferases
E&M
Ñ Higher incidence of diabetes mellitus
Ñ Fatigue
IS
Ñ Porphyria cutanea tarda
GIT
Ñ Abnormal serum aminotransferases
Ñ Chronic liver disease
KUS
Ñ Glomerulonephritis associated with cryoglobulinaemia
LMS
Ñ Arthritis
Ñ Sjögren’s syndrome
Complications
Ñ Cirrhosis of the liver
Ñ Hepatocellular carcinoma
Investigations
Blood
Microbiology
Ñ HCV RNA:
May be detected 1 or 2 weeks after infection
Ñ Anti-HCV antibody:
Usually positive 6 weeks after infection
Management
Drugs
Ñ Ribavarin
Biological Agents
Ñ Pegylated interferon
Support
Ñ Liver transplantation for end stage cirrhosis
Prognosis
Ñ Genotype 1 is the most difficult to treat
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