Definition & Phase
Definition:
– Blood-borne virus, like hepatitis B
– Less associated with vertical transmission, more with blood-borne issues
– Can remain asymptomatic for years, leading to underdiagnosis
Phases:
– Acute phase: First 6 months after infection
– Chronic phase: More than 6 months after infection
Progression:
– 15-45% of acute cases regress
– 55 %+ progress to a chronic state
Transmission:
– Parenteral routes (most common is sharing of needs in IVDU’s)
– Rarely through vertical or sexual transmission
Complications of chronic liver changes:
– Spider nevi
– Finger clubbing
– Jaundice
– Hepatosplenomegaly
– Skin thinning
– Bruising
– Ascites
Further complications:
– Portal hypertension
– Variceal haemorrhages
– Hepatic encephalopathy
Testing:
– Active infection: Positive antibody test AND positive HCV RNA test
– Recent/past infection: Positive antibody test only
Referral:
– Acute cases: Same-day referral
– Chronic cases: Urgent referral
Additional information:
– Notifiable disease
– Tests to assess progression: Viral load, coagulation, autoantibodies
– Transient elastography: Used for diagnosing cirrhosis
– Liver ultrasound: Used in cirrhosis and fibrosis patients to screen for HCC