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Overview

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Hepatitis C is an infectious disease caused by the hepatitis C virus, that primarily affects the liver.[1]

Initial symptoms

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During the initial infection, people often have mild or no symptoms.[2] Occasionally they will have a fever, dark urine, abdominal pain, or yellow tinged skin called jaundice.[2]

Failing to fight-off the virus

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About 80% of people who get the initial infection, will never completely fight off the hepatitis C virus, and it will persist in their liver.[2]

Late stage effects

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Over many years, the chronic infection of the liver, can lead to complications like a fatty liver, cirrhosis, and liver cancer.[2] Worldwide hepatitis C is the cause of 27% of cirrhosis cases, and 25% of hepatocellular carcinomas.[3]

Other effects

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Liver failure will also cause other problems, such as confusion, accumulation of fluid in the abdomen, and enlarged blood vessels in the esophagus or stomach that can cause serious bleeding.[1]

Spread

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Hepatitis C is spread primarily by blood-to-blood contact, associated with intravenous drug use, poorly sterilized medical equipment, needlestick injuries in healthcare, and transfusions.[2][4] It may also be spread from an infected mother, to her baby during birth.[2]

Casual contact and blood screening

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It is not spread by superficial contact, and the risk of being infected through a blood transfusion, can be reduced to one per two million, with proper blood screening.[2]

Hepatitis family

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It is one of five known hepatitis viruses: A, B, C, D, and E.[5]

Diagnosis

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Diagnosis is by blood testing to look for either antibodies to the virus or its RNA.[2] Testing is recommended in all people who are at risk.[2]

Prevention

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There is no vaccine against hepatitis C[2][6]. Prevention includes harm reduction efforts for intravenous drug users, universal precautions for health care workers, condom use, and proper screening of donated blood.[7]

Treatment

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About 95% of people can be cured of the chronic infection, with antiviral medications such as sofosbuvir, or simeprevir.[2][7] These drugs are effective but can be expensive.[7]

Early generation treatments

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Earlier generation treatments such as peginterferon, and ribavirin are more affordable, but have cure rates of less than 50%, and greater side effects.[7][8]

Treatment of liver failure

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Those who develop cirrhosis or liver cancer, may require a liver transplant.[9] Hepatitis C is the leading reason for liver transplantation, though the virus usually recurs after transplantation.[9]

Epidemiology

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As of 2015, about 2% of the worlds population was infected with the hepatitis C virus, causing 167,000 deaths due to liver cancer, and 326,000 deaths due to cirrhosis.[10][11] It occurs most commonly in Africa, Central, and East Asia.[7]

History

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The existence of hepatitis C (originally identifiable only as a type of non-A, non-B hepatitis) was suggested in the 1970s, and proven in 1989.[12] Hepatitis C infects only humans and chimpanzees.[13]

References

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  1. ^ a b Ryan KJ, Ray CG, eds. (2004). Sherris Medical Microbiology (4th ed.). McGraw Hill. pp. 551–2. ISBN 978-0-8385-8529-0.
  2. ^ a b c d e f g h i j k "Hepatitis C FAQs for Health Professionals". CDC. January 8, 2016. Archived from the original on 21 January 2016. Retrieved 4 February 2016.
  3. ^ Alter, MJ (2007-05-07). "Epidemiology of hepatitis C virus infection". World Journal of Gastroenterology. 13 (17): 2436–41. doi:10.3748/wjg.v13.i17.2436. PMC 4146761. PMID 17552026.[permanent dead link]
  4. ^ Maheshwari, A; Thuluvath, PJ (February 2010). "Management of acute hepatitis C". Clinics in Liver Disease. 14 (1): 169–76, x. doi:10.1016/j.cld.2009.11.007. PMID 20123448.
  5. ^ "Viral Hepatitis: A through E and Beyond". National Institute of Diabetes and Digestive and Kidney Diseases. April 2012. Archived from the original on 2 February 2016. Retrieved 4 February 2016.
  6. ^ Webster, Daniel P; Klenerman, Paul; Dusheiko, Geoffrey M (2015). "Hepatitis C". The Lancet. 385 (9973): 1124–1135. doi:10.1016/S0140-6736(14)62401-6. ISSN 0140-6736. PMC 4878852. PMID 25687730.
  7. ^ a b c d e "Hepatitis C Fact sheet N°164". WHO. July 2015. Archived from the original on 31 January 2016. Retrieved 4 February 2016.
  8. ^ Kim, A (September 2016). "Hepatitis C Virus". Annals of Internal Medicine (Review). 165 (5): ITC33–ITC48. doi:10.7326/AITC201609060. PMID 27595226. S2CID 95756.
  9. ^ a b Rosen, HR (2011-06-23). "Clinical practice. Chronic hepatitis C infection". The New England Journal of Medicine. 364 (25): 2429–38. doi:10.1056/NEJMcp1006613. PMID 21696309.
  10. ^ GBD 2015 Disease and Injury Incidence and Prevalence, Collaborators. (8 October 2016). "Global, regional, and national incidence, prevalence, and years lived with disability for 310 diseases and injuries, 1990-2015: a systematic analysis for the Global Burden of Disease Study 2015". Lancet. 388 (10053): 1545–1602. doi:10.1016/S0140-6736(16)31678-6. PMC 5055577. PMID 27733282. {{cite journal}}: |first1= has generic name (help)CS1 maint: numeric names: authors list (link)
  11. ^ GBD 2015 Mortality and Causes of Death, Collaborators. (8 October 2016). "Global, regional, and national life expectancy, all-cause mortality, and cause-specific mortality for 249 causes of death, 1980-2015: a systematic analysis for the Global Burden of Disease Study 2015". Lancet. 388 (10053): 1459–1544. doi:10.1016/S0140-6736(16)31012-1. PMC 5388903. PMID 27733281. {{cite journal}}: |first1= has generic name (help)CS1 maint: numeric names: authors list (link)
  12. ^ Houghton M (November 2009). "The long and winding road leading to the identification of the hepatitis C virus". Journal of Hepatology. 51 (5): 939–48. doi:10.1016/j.jhep.2009.08.004. PMID 19781804.
  13. ^ Shors, Teri (2011-11-08). Understanding viruses (2nd ed.). Burlington, MA: Jones & Bartlett Learning. p. 535. ISBN 978-0-7637-8553-6. Archived from the original on 2016-05-15.