Health

Hepatitis C: The World’s Deadliest Silent Killer

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Hepatitis C is an infectious disease caused by the Hepatitis C Virus (HCV) that primarily affects the liver. During the initial infection people often have mild or no symptoms. Occasionally a fever, dark urine, abdominal pain, and yellow tinge skin occurs. With blood screening, the risk from a blood transfusion is less than one per two million. It may also be spread from an infected mother to her baby during birth. It is not spread by superficial contact. It is one of five known hepatitis viruses: A, B, C, D, E. Diagnosis is by blood testing to look for either antibodies to the virus or it’s RNA. Testing is recommended in all people who are at risk.

There is no vaccine against hepatitis C and it infects only humans and chimpanzees.

Key facts

* Hepatitis C is a liver disease caused by the hepatitis C virus: the virus can cause both acute and chronic hepatitis infection, ranging in severity from a mild illness lasting a few weeks to a serious, lifelong illness.

* The hepatitis C virus is a blood borne virus and the most common modes of infection are through unsafe injection practices, inadequate sterilization of medical equipment, and the transfusion of unscreened blood and blood products.

* Globally, between 130-150million people globally have chronic hepatitis C infection.

* A significant number of those who are chronically infected will develop liver cirrhosis or liver cancer.

* Antiviral medicines can cure approximately 90% of persons with hepatitis C infection, thereby reducing the risk of death from liver cancer and cirrhosis, but access to diagnosis and treatment is low.

Hepatitis C is found worldwide. The most affected regions are Africa and Central and East Asia.

The hepatitis C virus is a blood borne virus. It is most commonly transmitted through:

* injecting drug use through the sharing of injection equipment;

* the reuse or inadequate sterilization of medical equipment, especially syringes and needles in healthcare settings; and

* The transfusion of unscreened blood and blood products.

HCV can also be transmitted sexually and can be passed from an infected mother to her baby; however these modes of transmission are much less common.

Hepatitis C is not spread through breast milk, food, water or by casual contact such as hugging, kissing and sharing food or drinks with an infected person.

The incubation period for hepatitis C is 2 weeks to 6 months. Following initial infection, approximately 80% of people do not exhibit any symptoms.

HCV infection is diagnosed in 2 steps:

1. Screening for anti-HCV antibodies with a serological test identifies people who have been infected with the virus.

2. If the test is positive for anti-HCV antibodies, a nucleic acid test for HCV ribonucleic acid (RNA) is needed to confirm chronic infection because about 15–45% of people infected with HCV spontaneously clear the infection by a strong immune response without the need for treatment. Although no longer infected, they will still test positive for anti-HCV antibodies.

Early diagnosis can prevent health problems that may result from infection and prevent transmission of the virus. WHO recommends screening for people who may be at increased risk of infection.

Populations at increased risk of HCV infection include:

* people who inject drugs

* people who use intranasal drugs

* recipients of infected blood products or invasive procedures in health-care facilities with inadequate infection control practices ;

* children born to mothers infected with HCV

* people with sexual partners who are HCV-infected

* people with HIV infection;

* prisoners or previously incarcerated persons; and

* People who have had tattoos or piercings.

Treatment

Hepatitis C does not always require treatment as the immune response in some people will clear the infection, and some people with chronic infection do not develop liver damage. When treatment is necessary, the goal of hepatitis C treatment is cure. Until recently, hepatitis C treatment was based on therapy with interferon and ribavirin, which required weekly injections for 48 weeks, cured approximately half of treated patients, but caused frequent and sometimes life-threatening adverse reactions.

Recently, new antiviral drugs have been developed. These medicines, called Direct Antiviral Agents (DAA) are much more effective, safer and better-tolerated than the older therapies.

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