HEPATITIS C INFECTION

Having known Hepatitis A and B for decades,  it becomes most beneficial to know about  HEPATITIS C infection , as it is not possible to prevent it,  because no VACCINE  has been invented till date,  unlike  A and B Hepatitis viruses.

  How does it  happen :
  • Sharing injectable Drugs and Needles 
  • Having SEX – rough sex or anal sex,  where blood contact happens. 
  • HIV or STD in either sexual partner / polygamy. 
  • Child at birth,  getting it from an infected mother. 
  • Breast feeds are safe,  except for cracked nipples, that can bleed. 
  • Sharing personal care items like Toothbrushes or Razors 
  • Lastly, getting a TATTOO done ,  with unsterile equipment.

Blood transfusion products and Organ Transplants were the source of Hep-C earlier ,  but stringent screening for the Hep-C is now mandatory.  

Hemodialysis  still caries a minimal risk.

Chances of Hep-C transmission are many.  But, following activities are never the cause

  • Coughing / Sneezing 
  • Hugging / Kissing
  • Mosquito bites 
  •  Sharing Food/utensils 
  • Hepatitis C spreads when blood or body fluids (  Hep-C contaminated )  enter your bloodstream. From two weeks to twelve weeks,  after entry of the virus – symptoms appear as displayed 
  • Fever / Fatigue 
  •  Dark urine 
  •  Clay-colored stool 
  •  Nausea/loss of appetite 
  •  Jaundice/joint pain

 LAB. TESTING FOR  HEP-C infection

ANTI-HCV Antibodies :  They show up 12 weeks after infection. If one is reactive or positive,  he needs to repeat the test. If positive,  go for the next test 

  •  HCV RNA:  This test measures the genetic material from the  HCV virus  ( viral RNA particles)  If you test positive here,  routine LFT be done to define the state of Liver functions.. 
  •  HCV RNA is detectable earlier, a couple of weeks after getting infected with HEP-C virus.

TREATMENT

  •  No treatment is recommended for Acute Hepatitis C. 
  • However , if it turns into Chronic Hepatitis  (  6 months later )  treatment is recommended
  •  Earlier ,  Interferon,  Peginterferon and Ribavirin were the main treatment. 

Current Medications ( Direct Acting Antivirals, DAA ) are the following, given  singly or in combination  

  • Daclatasvir
  • Elbasvir + Grazoprevir
  •  Glecaprevir + Pibrentasvir 
  • Ledipasvir + Sofosbuvir
  • Ombitasvir + Paritaprevir
  •  Ribavirin  (  brand names  Rebetol & Virazole) 
  • Sofosbuvir + Interferon + Ribavirin 

 (  Plus few other antiviral drugs )

Most of the times, the newer Anti-viral medicines remove all traces of the virus within 12 weeks. This is called SUSTAINED VIROLOGICAL RESPONSE (  SVR ).  Success rate is 90 % , if the drug is selected as per the Viral Genotype, in the index case.

 Complications  of HEP-C :

  •  About 80 percent of Hep-C infected patients end up with CHRONIC HEPATITIS . If this phase is not treated,  as stated above,  the infected Liver ends up with the following in a serial manner 
  1. Liver Cirrhosis 
  2. Liver Cancer 
  3. Liver Failure.
 
Dr . Dhananjay Shah 
Ped. Practice of 40 years 
@ Rajkot.  Gujarat.

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