Highlights
- Hepatitis C affects over 58 million globally, often leading to severe liver disease and death.
- Early detection and treatment are vital; explore current offers for testing and care solutions.
Summary and Overview
Hepatitis C is a liver infection caused by the hepatitis C virus (HCV), affecting over 58 million people worldwide and causing around 290,000 deaths annually. It is mainly transmitted through infected blood, particularly via injecting drug use, unsafe medical practices, and less often through sexual contact or from mother to child. The infection is often asymptomatic early on, leading to many undiagnosed cases. Chronic infection can cause liver fibrosis, cirrhosis, liver cancer, and extrahepatic conditions like vasculitis and lymphoproliferative disorders, impacting overall health and quality of life. Diagnosis relies on serological and molecular tests, allowing early treatment with direct-acting antivirals (DAAs) that can cure most patients. Prevention focuses on harm reduction, safe medical practices, and screening high-risk groups, as no vaccine exists. Efforts align with global health goals to control the epidemic by 2030.
Symptoms and Disease Progression
Hepatitis C symptoms vary by infection phase. The acute phase may be asymptomatic or present mild flu-like symptoms, jaundice, or gastrointestinal issues, typically resolving within weeks. Chronic infection is often silent for years but may cause fatigue, malaise, depression, and eventually signs of liver dysfunction such as jaundice and swelling. Extrahepatic manifestations include vasculitis, lymphoproliferative disorders, and autoimmune diseases. Liver damage progresses silently, with cirrhosis leading to complications like bleeding, encephalopathy, and increased liver cancer risk. Comorbidities such as HIV, diabetes, and obesity can accelerate progression. Because symptoms are often subtle, blood testing is critical for early detection.
Diagnosis
Diagnosis combines antibody and viral RNA testing, with PCR confirming active infection and guiding treatment by identifying viral genotype. Elevated liver enzymes may suggest infection even without symptoms. Differentiating acute from chronic infection remains challenging with standard tests, though newer immunoassays improve accuracy. Medical history helps identify risk factors and coexisting conditions. Guidelines recommend at least one lifetime test for adults, with earlier or repeated testing for at-risk individuals. Early diagnosis enables timely treatment to prevent severe liver disease.
Emotional and Psychological Impact
HCV infection significantly affects mental health, often causing anxiety, depression, and cognitive decline, exacerbated by disease progression and medical treatments. Psychological distress is common, worsened by social stigma and socioeconomic challenges. Mental health disorders hinder treatment adherence, especially in vulnerable groups. A multidisciplinary care approach including psychosocial support is essential to improve outcomes and quality of life.
Complications
Chronic HCV can cause liver fibrosis, cirrhosis, and hepatocellular carcinoma. Cirrhosis leads to complications like portal hypertension, jaundice, bleeding, and encephalopathy. Extrahepatic complications include vasculitis, kidney disease, lymphomas, and autoimmune conditions. Comorbidities such as HIV and metabolic disorders worsen liver damage. Treatment varies by disease stage, with specialized care needed for decompensated cirrhosis.
Treatment
Direct-acting antivirals (DAAs) have revolutionized HCV treatment, offering high cure rates with short, well-tolerated oral regimens suitable for most patients, including those with compensated cirrhosis. Management of extrahepatic manifestations requires addressing both viral eradication and symptom control. Patients with decompensated liver disease need specialized care. Integrating mental health support improves treatment adherence. Challenges remain in treatment access, particularly in low-resource settings, underscoring the need for comprehensive public health strategies.
Prevention
Prevention focuses on avoiding blood exposure through harm reduction in drug use, safe medical and cosmetic procedures, and avoiding sharing personal items. Blood transfusions and organ transplants now carry minimal risk due to advanced screening methods. Public health efforts emphasize education, early diagnosis, and equitable treatment access, as no vaccine is available.
Prognosis
HCV infection outcomes range from asymptomatic to severe liver disease and liver cancer. Comorbidities accelerate progression and worsen prognosis. Symptoms of advanced liver disease indicate poor outcomes. Beyond physical effects, HCV reduces quality of life through fatigue, depression, and social challenges. Treatment aims to eradicate the virus, prevent complications, and improve quality of life and survival.
The content is provided by Sierra Knightley, Scopewires
