Vaccsbook

Type of Disease

Hepatitis C is an infectious disease affecting the liver.

Type of Microbe

A virus, in the Flaviviridae family, which also includes Zika, West Nile, Dengue, etc.

Also known as

HepC or HCV. Until the virus was precisely identified around 1990, it was known as non-A, non-B hepatitis.

Vaccination

As of 2020, there is no vaccine. HepC has main strains which frequently mutate making identificaion of reliable antigens difficult.

Transmission & Acquisition

HepC is acquired though a patient's blood mixing with the blood of an infected person, most commonly from sharing needles during intravenous drug use, blood transfusions (now rare in developed countries) and needle-stick or scalpel injuries in a health care setting.
It can also occur during any cosmetic procedure on the skin (tattoos) or nails (mani/pedicure) when instruments are not thoroughly sterilized.
Transmission from an infected mother to her unborn child may occur in a small percentage of cases. Sexual transmission is rare, and can only occur with truama causing bleeding.

Timeline

Incubation, between exposure and symptoms (if/when they occur) is 1 to 3 months (range 2 weeks to 6 months). In 80% of patients, regardless of initial symptoms, lifelong infection persists.

Contagion

All patients must be considered contagious (can affect others) for at least 6 months and until blood tests for the virus become negative. However, 80% of patients develop chronic HepC infection, and must be considered contagious for ever, unless they are successfully treated with anti-viral medication.

Diagnosis

Diagnosis is made on the basis of signs and symptoms, a history of blood-blood contact, and confirmed with blood tests for HepC antibodies.

Body Systems Affected

HepC affects only the liver.

Signs and Symptoms

About 25% of infected people develop signs and symptoms.
Signs are jaundice (yellowing of the skin and eyes), and dark urine but light coloured stools, which is due to the build up of a biochemical called bilirubin that the liver cannot process and gid rid of during the infection.
Symptoms include nausea, fever, abdominal pain, fatigue, muscle and joint pain.
Although about 75% have no immediate symptoms, they are still at high risk for developing a chronic (long-lasting) infection.

Treatment

Avoidance of alcohol is mandatory. Patients should be vaccinated against Hepatits A and B to prevent such infections compounding the liver damage. Most patients with chronic HepC infection can be cured by prolonged treatment with antiviral medications, where these are available and affordable. Liver transplantation is an option for complete liver failure due to cirrhosis, but the virus usually persists and cirrhosis can gradually recur.

Prevention

Avoidance of blood-blood contact with infected patients. Avoidance of liver-toxic subtances e.g. alcohol is vital in those who develop chronic infection. Screening of blood and organ donations is mandatory.

Complications

60% to 80% of patients develop a chronic infection, evidenced by active virus in the liver and/or blood. Many patients have no symptoms for many years, but most have reduced life expectancy due to complications of progressively poor liver function.
20% of patients progress to cirrhosis (destruction) of the liver, or primary cancer of the liver.

Fatalities

In those who develop severe symptoms (less than 20%), the fatality rate is 1% to 2.5%.

Epidemics & Pandemics

As of 2020, there are estimated to 100+ million patients worldwide with chronic HepC infection. This increases by 3+ million every year, with about 200,000 deaths due to cirrhosis and primary liver cancer. However, epidemics and pandemics, with extensive disease transmission from person to person, do not occur.

Geography

HepC is worldwide, currently affecting over 3% of the population in some countries but less than 1% in others with no obvious geograpgical pattern of distribution.