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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 most case of infected people the disease becomes chronic [1]***. Hepatitis C FAQs for the Public | Division of Viral Hepatitis. Centers for Disease Control and Prevention. 2017.. [2]Dhawan VK. Hepatitis C. Gastroenterology. Medscape. 2016 .

Most often, at about 90% of infected people, acute hepatitis C is asymptomatic [5] Holmes J and co. Hepatitis C – an update. Aust Fam Physician. The Royal Australian College of General practitioners; 2013; 42 (7): 452-6. ..

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 [6] ***. Hepatitis C FAQs for the Public | Division of Viral Hepatitis. Centers for Disease Control and Prevention. 2017′...

 

In the case of chronic infection the clinical picture is unspecific, dominant being asymptomatic cases [9] ***. Hepatitis C FAQs for the Public | Division of Viral Hepatitis. Centers for Disease Control and Prevention. 2017:.. [10] Ward JW. Global Elimination of Hepatitis C Virus. Gastroenterol Hepatol (N Y). Millenium Medical Publishing; October 2016; 12 (10): 632-5... The most important complications are cirrhosis that occurs at 10-20% of the cases and hepatocellular carcinoma in 1-5% [11] ***. Recommendations … Hepatitis C Virus … Centers for Disease Control and Prevention. MMWR. 1998; 47 (RR19): 1-39...

Chronic infection may remain asymptomatic for a period of up to 20 years prior to the onset of cirrhosis or hepatic carcinoma [12]***. Hepatitis C FAQs for the Public | Division of Viral Hepatitis. Centers for Disease Control and Prevention. 2017′.. [13]Dhawan VK. Hepatitis C. Gastroenterology. Medscape. 2016~ .

 

For the presence of HCV infection in pregnant:

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 [16]Dhawan VK. Hepatitis C. Gastroenterology. Medscape. 2016` [17] Holmes J and co. Hepatitis C – an update. Aust Fam Physician. The Royal Australian College of General practitioners; 2013; 42 (7): 452-6.,. [18] **. Hepatitis C. World Health Organization; 2017. ..

 

Pregnant:

In the newborn mother infected with hepatitic C virus

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 [29] Moradpour D, Cerny A, Heim MH, Blum he. Hepatitis C: an update. Swiss Med Wkly. 2 June 2001; 131 (21-22): 291-8... The main protein components are represented by the core protein which enters that comes in the composition of nucleocapsid, and the proteins E1 and E2 of ehe viral envelope [30] Moradpour D, Cerny A, Heim MH, Blum he. Hepatitis C: an update. Swiss Med Wkly. 2 June 2001; 131 (21-22): 291-8|... There are at least 6 genotypes and approximately 100 subtypes of HCV [31] ***. Hepatitis C General Information. Centers for Disease Control and Prevention. 2015... The response to antiviral therapy is different depending on the HCV genotype [32]Dhawan VK. Hepatitis C. Gastroenterology. Medscape. 2016.

 

Incidence and prevalence of

HCV infection affects 2-3% of the global population, 130-170 million individuals with chronic infection [33] ***. Hepatitis C. World Health Organization; 2017”...

The prevalence of infection among pregnant women varies from 0.2 to 15%, depending on the geographic region, and the rate of transmission from the parent to the foetus varies between 3-10% [34] ***. Hepatitis C. World Health Organization; 2017.~ . [35] Goyal LD and co. HCV and pregnancy: prevalence,…A case-control study. J Obstet Gynaecol India. Springer October 2014; 64 (5): 332-6.. [36] Tovo P-A and co. Vertically acquired hepatitis C virus infection:… World J Gastroenterol. Baishideng Publishing Group Inc; 28 January 2016; ...continue.

At European level, in 2014, there were 35,321 cases of hepatitis C, the incidence of 8.8 cases in 100,000 inhabitants [37]***. Hepatitis C-Annual epidemiological Report for 2015. Centers for Disease Control and Prevention. 2017...

Between 2006-2014 the number of reported cases increased by 27.8% [38]***. Hepatitis C-Annual epidemiological Report for 2015. Centers for Disease Control and Prevention. 2017.|. [39] ***. Transmission/Exposure-Hepatitis B FAQs for the Public … Centers for Disease Control and Prevention. 2016...

In Romania, 104 cases of infection (84 cases of acute infection and 20 chronic infection) were identified in the year 2014, seeing a slight decrease in the number compared to previous years (2013-126 cases, 2012-127 cases) [40]***. Hepatitis C-Annual epidemiological Report for 2015. Centers for Disease Control and Prevention. 2017|...

Source

Man is the only source [41] Goyal LD and co. HCV and pregnancy:… A case-control study. J Obstet Gynaecol India. Springer October 2014; 64 (5): 332-6...

Method of transmission

The main route of transmission is parenteral and is involved:

  • Blood transfusions or blood products from untested donors,
  • Parenteral exposure to blood by means of suitable unsterilized instruments and those used in medical or dental procedures
  • Use of unsterilized objects for different rituals (circumcision, scarifying) or in traditional medicine (“taking/Leaving Blood”),

Sexual or vertical transmission (from mother to fetus) were both documented but there is a low percentage of reports.

 

Risk groups

The Center for Disease Control and Prevention in the United States of America (Centers for Disease Control and Prevention, CDC) recommends testing of patients falling within the following groups:

 

Incubation period

The average incubation period is 6-9 weeks (varies from 2 weeks to 6 months), and the mean period of seroconversion (i.e. antibody appearance) is 8-9 weeks (approximately 50-100 days) [53] Dhawan VK. Hepatitis C. Gastroenterology. Medscape. 2016`\.

 

Infectiousness Period

 

The prophylaxis

 

Vaccination

There is no vaccine against hepatitis C.

Prevention in the absence of vaccination

There are numerous studies with promising results that offer hope that a vaccine will be available in the future. In this context, at the present time, the most important prevention strategy is screening to identify infected people [57] ***. Recommendations for Prevention and Control of Hepatitis C Virus (HCV) infection and … Centers for Disease Control and Prevention. MMWR. ...continue [58] Dunkelberg JC and co. Hepatitis B and C in pregnancy: a review … J Perinatol. NIH Public Access; 2014; 34 (12): 882-91.~`. [59] ***. Hepatitis C. World Health Organization; 2017._ ..

It is necessary to inform the population about the infection, the ways of transmission and the need for screening. The campaigns must aim in particular at the population groups at risk [60] Hesamizadeh K and co. Next steps towards eradication of Hepatitis C … HEPA Mon. Kowsar Medical Institute; April 2016; 16 (4): e37089.+..

It should be taken into account that the main route of transmission is the blood route and occurs by blood transfusion incorrectly evaluated for the presence of the virus. Thus, improving the screening of blood samples is very important.

Another source of infection is represented by injecting drug users [61] Ward JW. Global Elimination of Hepatitis C Virus. Gastroenterol Hepatol (N Y). Millenium Medical Publishing; October 2016; 12 (10): 632-5.~|.. That is why implementing programmes to prevent drug use is essential. If the drug use exists, it is advisable to allow these subjects to access sterile syringes and needles. Studies have shown that, by combining access to sterile syringes and treatment programs, the risk of drug users to become infected with HCV can be reduced by 80% [62] Ward JW. Global Elimination of Hepatitis C Virus. Gastroenterol Hepatol (N Y). Millenium Medical Publishing; October 2016; 12 (10): 632-5.. [63] Roberts it, Yeung L. Maternal-infant transmission … Hepatology. W.B. Saunders; 1 November 2002; 36 (S1): S106-13.. [64] Moradpour D and co. Hepatitis C: an update. Swiss Med Wkly. 2 June 2001; 131 (21-22): 291-8...

 

Administration of Immunoglobulins against hepatitis C

Prophylaxis with Immunoglobulins is not effective [65] Mr. Heymann. Management Manual of communicable diseases. Cdc. 2012;.`.

 

Birth to HCV-infected woman

A caesarean is recommended to avoid perinatal transmission of the infection. Pregnant women with positive HCV RNA are at risk of transmitting infection to the fetus, therefore newborns should be tested for HCV-RNA [66] Ward JW. Global Elimination … Millenium Medical Publishing; October 2016; 12 (10): 632-5.. [67] ***. Recommendations for Prevention … Centers for Disease Control and Prevention. MMWR. 1998; 47 (RR19): 1-39.. [68] Dunkelberg JC and co. Hepatitis B and C in pregnancy: a review … J Perinatol. NIH Public Access; 2014; 34 (12): 882-91.. [69] Goyal LD and co. HCV and pregnancy … J Obstet Gynaecol India. Springer October 2014; 64 (5): 332-6. . [70] Tovo P-A and co. Vertically acquired hepatitis C … World J Gastroenterol. Baishideng Publishing Group Inc; 28 January 2016; 22 (4): 1382-92. ..

 

Breast-feeding

Breastfeeding is not theoretically a risk factor in the transmission of HCV infection, especially if there are no lesions in the nipple. Basically, analyzing the benefit/risk ratio will make a particular recommendation in each case [71] Dhawan VK. Hepatitis C. Gastroenterology. Medscape. 2016|' [72] Roberts it, Yeung L. Maternal-infant transmission of hepatitis C virus infection. Hepatology. W.B. Saunders; 1 November 2002; 36 (S1): S106-13. [73]Tovo P-A and co. Vertically acquired hepatitis C virus infection … World J Gastroenterol. Baishideng Publishing Group Inc; 28 January 2016; 22 ...continue.

 

Bibliography

  1. ***. Hepatitis C FAQs for the Public | Division of Viral Hepatitis. Centers for Disease Control and Prevention. 2017. Retrieved from: https://www.cdc.gov/hepatitis/hcv/cfaq.htm
  2. Dhawan VK. Hepatitis C. Gastroenterology. Medscape. 2016
  3. Mr. Heymann. Management Manual of communicable diseases. Cdc. 2012;
  4. Holmes J, Thompson A, Bell S. Hepatitis C – an update. Aust Fam Physician. The Royal Australian College of General practitioners; 2013; 42 (7): 452-6. Retrieved from: http://www.racgp.org.au/afp/2013/july/hepatitis-c/
  5. Hesamizadeh K, Sharafi H, Rezaee-Zavareh MS, Behnava B, Alavian SM. Next steps towards eradication of Hepatitis C in the Era of Direct Acting antivirals. HEPA Mon. Kowsar Medical Institute; April 2016; 16 (4): e37089. Retrieved from: http://www.ncbi.nlm.nih.gov/pubmed/27275164
  6. Ward JW. Global Elimination of Hepatitis C Virus. Gastroenterol Hepatol (N Y). Millenium Medical Publishing; October 2016; 12 (10): 632-5. Retrieved from: http://www.ncbi.nlm.nih.gov/pubmed/27917078
  7. ***. Recommendations for Prevention and Control of Hepatitis C Virus (HCV) infection and HCV-related Chronic Disease. Centers for Disease Control and Prevention. MMWR. 1998; 47 (RR19): 1-39. Retrieved from: https://www.cdc.gov/mmwr/preview/mmwrhtml/00055154.htm
  8. Dunkelberg JC, Berkley EMF, Thiel KW, Leslie KK. Hepatitis B and C in pregnancy: a review and recommendations for which. J Perinatol. NIH Public Access; 2014; 34 (12): 882-91. Retrieved from: http://www.ncbi.nlm.nih.gov/pubmed/25233195
  9. Roberts it, Yeung L. Maternal-infant transmission of hepatitis C virus infection. Hepatology. W.B. Saunders; 1 November 2002; 36 (S1): S106-13. Retrieved from: http://doi.wiley.com/10.1002/hep.1840360714
  10. ***. Hepatitis C. World Health Organization; 2017. Retrieved from: http://www.who.int/mediacentre/factsheets/fs164/en/
  11. Virology C. Medical. Medical publishing house; 2008.
  12. Goyal LD, Kaur S, Jindal N, Kaur H. HCV and pregnancy: prevalence, risk factors, and pregnancy outcome in North Indian population: A case-control study. J Obstet Gynaecol India. Springer October 2014; 64 (5): 332-6. Retrieved from: http://www.ncbi.nlm.nih.gov/pubmed/25368456
  13. Moradpour D, Cerny A, Heim MH, Blum he. Hepatitis C: an update. Swiss Med Wkly. 2 June 2001; 131 (21-22): 291-8. Retrieved from: http://www.ncbi.nlm.nih.gov/pubmed/11584690
  14. ***. Hepatitis C General Information. Centers for Disease Control and Prevention. 2015. Retrieved from: https://www.cdc.gov/hepatitis/HCV/PDFs/HepCGeneralFactSheet.pdf
  15. Tovo P-A, quality C, Scolfaro C, Gabiano C, Garazzino S. Vertically acquired hepatitis C virus infection: Correlates of transmission and disease progression. World J Gastroenterol. Baishideng Publishing Group Inc; 28 January 2016; 22 (4): 1382-92. Retrieved from: http://www.ncbi.nlm.nih.gov/pubmed/26819507
  16. ***. Hepatitis C-Annual epidemiological Report for 2015. Centers for Disease Control and Prevention. 2017. Retrieved from: https://ecdc.europa.eu/en/hepatitis-c-annual-epidemiological-report-for-2015
  17. ***. Transmission/Exposure-Hepatitis B FAQs for the Public | Division of Viral Hepatitis. Centers for Disease Control and Prevention. 2016. Retrieved from: https://www.cdc.gov/hepatitis/hbv/bfaq.htm#transmission
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About Corneliu Zaharia


TORCH.RO nu îsi propune sa înlocuiasca consultul medical de specialitate, informatia prezentata pe acest site are un caracter informativ. Pentru mai multe informatii consultati Principii de Etica