Identification

The infection caused by the hepatic C virus (HCV) is called Hepatitis C. Hepatitis C can be acute or chronic, the acute one occurs within the first six months of the liver exposure to C virus, which may be a mild disease, which lasts few weeks. In the case of most infected people the disease becomes chronic.

• To about 10% of infected people acute hepatitis with C virus is characterized by the presence of the following symptoms:
  • Nausea
  • Vomiting
  • Jaundice
  • Myalgia
  • Arthralgia
  • Fatigue
  • Pain in the right hypochondrium.

Most often, at about 90% of infected people, acute hepatitis C is asymptomatic.

In a few cases, after infection, the virus is removed from the body by the action of the immune response. In about 75-85% of cases the infection becomes chronic, evolves slowly, asymptomatic, over several years.

• Chronic hepatitis with C virus occurs in more than 80% of HCV-infected patients and is characterized by viral persistence associated with the occurrence of liver lesions that may lead to cirrhosis or liver cancer.

In the case of chronic infection the clinical picture is unspecific, dominant being asymptomatic cases. The most important complications are cirrhosis that occurs at 10-20% of the cases and hepatocellular carcinoma in 1-5%.

Chronic infection may remain asymptomatic for a period of up to 20 years prior to the onset of cirrhosis or hepatic carcinoma.

For the presence of HCV infection in pregnant:

• There’s a risk of premature childbirth,
• Premature rupture of membranes,
• Congenital anomalies,
• Low birth weight,
• Gestational diabetes.

According to the World Health Organization about 3% of the world’s population was infected at one time with HCV; due to the non-specific or absent symptoms many infected people are not diagnosed. This information highlight how important screening is.

Pregnant:

• Routine screening for HCV infection is not recommended because no antiviral therapy is approved during pregnancy.
• To pregnant patients with risk factors or abnormal liver tests a screening test should be proposed.
• The first stage is to detect anti-HCV antibodies, and then, if the test is positive, the HCV RNA determination.

In the newborn mother infected with hepatitic C virus

• Newborn babies from mothers where the HCV RNA test was positive, should be evaluated in order to highlight the possible transmission of the infection.
• Newborns should be tested at 2-6 months and thereafter at 18-24 months (anti-HCV and HCV RNA antibodies are determined).
• The most faithful screening test is HCV RNA test.
• The presence of anti-HCV antibodies cannot help differentiate between acute, chronic or cured infection.

Nota Bene. In this document, the laboratory diagnosis was not treated in the HCV infection, but only a few elements related to pregnancy and newborn were noted. For the complete diagnosis of this infection, those interested will be addressing infectionists physicians.

Infectious agent

The hepatitis C virus belongs to the genus Hepacivirus, within family Flaviviridae. It is an enveloped virus, single-stranded RNA, with a complex structure. The main protein components are represented by the core protein which enters in the composition of nucleocapsid, and the proteins E1 and E2 of the viral envelope. There are at least 6 genotypes and approximately 100 subtypes of HCV. The response to antiviral therapy is different depending on the HCV genotype.

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