Hepatitis C

-CONCEPT

-EPIDEMIOLOGY

-SYMPTOMS

-DIAGNOSIS

-PREVENTION

-TREATMENT

-BIBLIOGRAPHY



THE CONCEPT


The hepatitis C is an infectious disease caused by a virus (HCV), affecting primarily the liver. Normally the infection is asymptomatic (the acute hepatitis causes a liver inflamation during a short period of time), but the chronic disease can lead to scarring the liver andfinally to cirrhosis, that is usually evident after many years. In some of these cases, the cirrhosis can conduce to liver failure or liver cancer. Because of this, patients are usually end up needing a liver transplant.1

The knowledge about this virus, and therefore about this disease, is very recent: until 1989 was known as hepatitis non-A non-B, since most cases of viral hepatitis didn't haveas the etiologic agent virus A or B. It was not until this year that was characterized, cloned and conveyed a segment of viral RNA in animals experimentally, leading to the discovery of the C virus, and consequently of the hepatitis C. 2

The HCV is a single-stranded RNA virus surrounded by an icosahedral capsule and wrapper, belonging to the family of Flaviviridae. It replicates primarily inhepatocytes, joining their membrane receptors, entering in the cell and using the machinery cell for their own cellular replication (this will be more explained later). The virus has a high rate of replication and genetic variability, which gives the disease a high pathogenicity.3


The main route of transmission of hepatitis C is the blood-to-blood contact (during delivery or in a bloodtransfusion), or the contact with objects infected by blood positive to C virus, like syringes, needles, piercings, razors or any object that has been in contact with infected blood (it doesn't have to be sharp objects); for example toothbrushes.4



EPIDEMIOLOGY


The results of the studies would note that the prevalence of the antibodies to hepatitis C virus (HCV) in Spain is between 1 and 2,6%,clearly superior to other Central European countries like Belgium (0,9%), Germany (0,6%) or France (1%), but similar or lower in other countries like Italy (3,2-4,8%)

The surveys done in the general Spanish population show differences between the antibodies prevalence of HCV in different regions: is higher in the most industrialized regions like Madrid or Catalonia (2,5 and 2,6%) and lower inthe rural ones like La Rioja (2%) and Asturias (1,6%).


The prevalence of antibodies of HCV increases with age. There are two groups that have a particularly high prevalence. One at ages from 30 to 44, would include cases that would been infected mainly from the use of intravenous drug when they were young, and the other would be composed for people of over 65 years old, probably infected byblood transfusion or for the use of unsterilized syringes for drugs administration.

The intermediate age group, 45 to 65 years old, was less exposed to those risk factors, because, when they were young the intravenous drugs were not so widespread as later and the use of glass syringes was eliminated.

The immigration could have some influence in the prevalence of HCV, increasing it,because some studies show that the Asian population have a prevalence of 15,3% and the South Saharan population a 8,6-17%. Although, the South American have a lower prevalence than our, just a 0,4% and the North African a 1,9%.

There are some risk groups as the intravenous drogadictes (42-98%), prisoners, hemodialysis (18%), prostitutes that are dorgadictes. A studies of 576 prostitutes of Madrid,98% of them were lationamerican, that they didn’t consume intravenous drugs the prevalence was of 0,8%.5




SYMPTOMS


We should differentiate between acute infection and chronic infection, since they are pretty different. However both are related as the first one precedes the second one.6

ACUTE INFECTION

When the virus of hepatitis C infect someone, apparently this person don't...