Hepatitis C

HCV is a member of the Hepacivirus genus in Flaviviridae family that causes over 90% of NANB (non-A, non-B) transfusion-transmitted hepatitis. HCV has a small positive single stranded RNA genome (++ssRNA). There are 6 genotypes.

Epidemiology

1.HCV has a worldwide distribution and is particularly prevalent in the Middle East.
2. Similar toHBV, HCV is transmitted mainly pareterally through skin and mucous membranes. Also there is perinatal transmision.
3.Still 40% of cases shows no definable source or route of infection.
4.50% of HCV infections are associated with development of chronic active hepatitis that ends in cirrhosis o hepatocellular carcinoma.

Lab Diagnosis

1. Detection of anti-HCV antibodies by ELISA, or the more specific RIBA test (recombinant immunoblotting assay). Seroconversion may take up to 6 months.

2. PCR for detection of viral RNA in blood. This useful in:
a) Diagnosis of early cases before seroconversion.
b) Serologically confirmed cases to demonstrate active viral replication and, thus the need for therapy.
c) Follow up the response of treatment.
d) Genotyping of HCV.

Control

No specific vaccine is available. Prevention is mainly directed at minimizing exposure as that of preventing HBV infection.

Treatment

A combnation of alpha-interferon and antiviral chemotherapy (ribavirin)