Within 6 months of infection, around 30% (15–45%) of infected people naturally eliminate the virus without any therapy.
Chronic HCV infection will occur in the remaining 70% (55–85%) of people. Cirrhosis risk ranges from 15% to 30% in persons with persistent HCV infection over the course of 20 years.
Transmission
Hepatitis C is a virus that spreads through the bloodstream. The following are the most typical routes of transmission:
medical equipment, particularly syringes and needles, is reused or improperly sterilized in healthcare settings; unscreened blood and blood products are transfused, and injecting drug use is shared injection equipment.
HCV can be given from a mother to her child and through sexual behaviors that expose people to blood (for example, persons who have several sexual partners and men who have sex with men), however, these are less typical means of transmission.
Hepatitis C is not shared by breast milk, food, water, or incidental contact with an infected individual, such as hugging, kissing, or sharing food or drinks.
Signs And Symptoms Of HCV Infection
Acute Virus
Hepatitis C can take anything from two weeks to six months to develop. Approximately 80% of patients do not show any symptoms after the initial infection.
Fever, exhaustion, decreased appetite, nausea, vomiting, abdominal discomfort, dark urine, pale feces, joint pain, and jaundice are common symptoms in those who are acutely sick (yellowing of the skin and the whites of the eyes).
Chronic Virus
The majority of persons with chronic HCV infection are asymptomatic or have vague symptoms like persistent fatigue and depression. Many people eventually acquire the chronic liver disease, which can range from mild to severe and include cirrhosis and cancer of the liver.
Chronic liver disease in HCV-infected persons is largely silent, progressing over decades without showing any signs or symptoms. In fact, HCV infection is frequently overlooked until asymptomatic patients are found to be HCV-positive during blood donation screenings or when high alanine aminotransferase (ALT) levels are revealed during routine exams.
Treatment Updates In The Recent Years
With 8–12 weeks of oral medication, about 90% of persons infected with hepatitis C virus (HCV) can be cured of their infection, independent of HCV genotype (34). The Infectious Diseases Society of America (IDSA) and the American Association for the Study of Liver Diseases (AASLD), in collaboration with the International Antiviral Society–USA (IAS–USA), developed evidence-based, expert-developed recommendations for hepatitis C management to provide healthcare professionals with timely guidance as new therapies become available and integrated into hepatitis C treatment regimens.
All HCV genotypes who are treatment-naive with compensated cirrhosis (CTP A) without a history of decompensation should get 8 weeks of glecaprevir pibrentasvir (Mavyret); 12 weeks should be considered for those with poor prognostic characteristics. In patients with chronic renal disease, particularly those on hemodialysis, treatment has been revised to include SOF-based therapy.
If suitable, patients with acute HCV infection can be treated with DAAs immediately after initial diagnosis (based on detectable HCV RNA) rather than waiting for spontaneous remission. Patients who re-infect with HCV after attaining a prolonged virologic response should be considered for HCV treatment.
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