Hepatitis C Virus

• Hepatitis C Virus (HCV) is a bloodborne pathogen that causes inflammation of the liver, potentially leading to severe liver damage over time.
• Many individuals remain asymptomatic for years, making early detection challenging and contributing to the progression of chronic liver disease.
• The primary mode of transmission is through direct blood-to-blood contact, such as sharing needles or unsterile medical procedures.
• Effective antiviral treatments are available that can cure most HCV infections, highlighting the importance of screening and access to care.
• Early diagnosis and appropriate intervention are vital to prevent long-term complications like cirrhosis, liver failure, and liver cancer.

What is Hepatitis C Virus and How it Spreads?

The Hepatitis C Virus is a small, enveloped RNA virus that primarily infects liver cells, causing inflammation and damage. It is one of several hepatitis viruses, but unlike Hepatitis A and B, HCV often leads to a chronic infection, meaning the virus persists in the body for a long time. Globally, an estimated 58 million people have chronic HCV infection, with approximately 1.5 million new infections occurring each year, according to the World Health Organization (WHO).

Understanding how is hepatitis c transmitted is fundamental to preventing its spread. HCV is primarily transmitted through blood-to-blood contact. This means that for the virus to spread, infected blood must enter the bloodstream of an uninfected person. While less common, sexual transmission is possible, particularly among individuals with multiple partners or co-existing sexually transmitted infections, though it is not the primary route.

Common routes of transmission include:

• Sharing contaminated needles or syringes: This is the most common way HCV is transmitted, especially among people who inject drugs.
• Unsafe medical procedures: Inadequate sterilization of medical equipment, transfusions of unscreened blood, or organ transplants prior to widespread screening (before 1992 in many countries) are significant historical causes.
• Needlestick injuries: Healthcare workers are at risk if accidentally pricked by a needle contaminated with infected blood.
• Mother-to-child transmission: An infected mother can pass the virus to her baby during birth, though this is less frequent than other routes.
• Sharing personal items: Rarely, sharing razors, toothbrushes, or nail clippers that may have traces of blood can transmit the virus.

It is important to note that HCV is not spread through casual contact such as hugging, kissing, sharing food or drinks, or sneezing.

Symptoms, Diagnosis, and Treatment for HCV

The insidious nature of hepatitis c symptoms and causes makes it a challenging disease to detect early. Many individuals with acute HCV infection (the first six months after exposure) experience no symptoms or only mild, non-specific ones such as fatigue, nausea, or abdominal pain, which can easily be mistaken for other illnesses. When symptoms do occur, they may include fever, dark urine, clay-colored stools, joint pain, and jaundice (yellowing of the skin or eyes). Because of this lack of distinct early symptoms, up to 80% of people develop chronic HCV infection, which can silently progress over decades, leading to severe liver damage.

Chronic HCV can result in serious complications, including cirrhosis (scarring of the liver), liver failure, and hepatocellular carcinoma (liver cancer). Diagnosis typically involves a two-step process: first, a blood test to screen for anti-HCV antibodies, which indicates past or present infection. If antibodies are detected, a second test, an HCV RNA test (viral load test), is performed to confirm active infection and measure the amount of virus in the blood. Further tests, such as liver function tests, imaging, and sometimes a liver biopsy, help assess the extent of liver damage.

Fortunately, hepatitis c treatment options have revolutionized in recent years. Modern treatments primarily involve direct-acting antiviral (DAA) medications. These oral medications are highly effective, with cure rates exceeding 95% for most genotypes of HCV, often within 8 to 12 weeks of treatment. DAAs work by directly targeting specific steps in the HCV life cycle, preventing the virus from replicating. The choice of DAA regimen depends on the HCV genotype, the extent of liver damage, and any prior treatment history. Successful treatment not only clears the virus but also significantly reduces the risk of developing liver cirrhosis, liver cancer, and other HCV-related complications, improving the overall quality of life for patients.