Chronic Hepatitis C

Hepatitis C is responsible for chronic hepatitis. It leads to liver damage in a slow progressive manner, eventually leading to liver cancer and cirrhosis.

Route and transmission of virus

• Transfusion of contaminated blood
• Needle sharing amongst untrained healthcare professionals
• Needle sharing amongst drug abusers

Symptoms

Symptoms differ according to disease severity.

Many patients can remain asymptomatic, and are diagnosed based on blood tests. Symptoms include:

• Fatigue and tiredness
• Patients with severe liver disease can complain of altered behavior, blood in vomiting, feet swelling, and ascites.

Diagnosis

Chronic hepatitis C is confirmed based on these investigations:

• Anti HCV antibody
• LFT
• HCV RNA (quantitative and qualitative)

Treatment

Therapy is based on the virus genotype and stage of liver disease.

• Genotype 1: Treated by PEG IFN and Ribavarin, indicated for 48 weeks. The treatment has an efficacy of 50%.
• Genotype 2 and 3: Management is easy, indicated for 24 weeks. The treatment has an efficacy of 70-90%.

Others

• Combination of Telaprevir and Boceprevir to Peg Interferon and Ribavarin (for non-responders)
• Sofosbuvir and Ribavarin are recent treatment modalities that did not show any side-effects and are safe.