The infection is caused by a hepatitis C virus (HCV virus). The virus is transmitted by blood and other body fluids; probably the most common form of transmission is sharing needles among intravenous drug addicts. Another possibility is transmission during sexual intercourse, by tattooing with non-sterile needles, transmission from mother to fetus and by contaminated blood transfusion or during dialysis. Direct contact with contaminated blood mainly threatens medical personnel.
There are more than 200 million people infected by hepatitis C virus in the world. Probably the most significant occurrence of HCV virus is in Egypt, when it spread in 20th century during mass vaccination campaign against schistosomiasis, which has been performed by non-sterile medical equipment.
Viral hepatitis C is very insidious and the acute form of infection is mostly so mild that it has virtually no symptoms. Jaundice, which is by laymen considered to be typical for any viral hepatitis, is very rare in acute hepatitis C. In about 20% of infected, their immune system is capable of defeating the infection and these people are cured. However, in the majority of affected, the virus stays in the liver and the disease progresses into a chronic liver inflammation. The main danger is gradual development of liver cirrhosis with all its complications, including progressive liver failure and increased risk of liver cancer.
The clinical symptoms are subtle and the diagnosis can be confirmed incidentally. Virus hepatitis C should be thought about in patients with vague digestive difficulties with elevated liver tests and in patients with newly diagnosed liver cirrhosis of unknown cause. The actual proof of infection requires special serological testing, which finds serum antibodies against the virus. Imaging methods such as abdominal ultrasound do not help in the diagnosis itself, but they may show the signs of liver cirrhosis and liver cancer.
Those 20% of people, who are able to get rid of the virus, have an excellent prognosis. The situation in the rest is complicated. The infection may persist as chronic uncomplicated liver inflammation, or cause progressive liver damage resulting in cirrhosis. The prognosis of patients with developed cirrhosis is much poorer.
There is no vaccine against hepatitis C and therefore, the prevention consists of avoidance of the risk factors. As stated above, intravenous drug abuse and unprotected sexual intercourse are the main ways of infection.
The patients with HCV infection should be monitored. They should avoid alcohol and medications toxic to liver. The therapy includes administration of special anti-HCV drugs such as the pegylated interferon and ribavirin. The treatment is long-term and patients are during regularly monitored to evaluate its effect (liver tests, the number of viral nucleic acids in blood, etc.). Liver transplant should be considered in patient with liver cirrhosis with signs of chronic liver failure.