Unspecified Viral Hepatitis C Without Hepatic Comab1920
Chapter 1 – Certain infectious and parasitic diseases » Viral hepatitis » Unspecified viral hepatitis C without hepatic coma
Related MeSH Terms
Diseases » Digestive System Diseases » Liver Diseases » Hepatitis » Hepatitis, Viral, Human » Hepatitis C
INFLAMMATION of the LIVER in humans caused by HEPATITIS C VIRUS, a single-stranded RNA virus. Its incubation period is 30-90 days. Hepatitis C is transmitted primarily by contaminated blood parenterally and is often associated with transfusion and intravenous drug abuse. However, in a significant number of cases, the source of hepatitis C infection is unknown. MeSH
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Whats The Difference Between Acute And Chronic Hepatitis C
Hepatitis C is a contagious disease caused by HCV, which is spread through contact with blood and bodily fluids that contain HCV. This disease damages your liver. There are two types of hepatitis C infection: acute and chronic.
Acute hepatitis C is a short-term viral infection. People with acute hepatitis C carry the infection for a small window of time, often just several months . Most people with the acute form of hepatitis C will experience illness and mild symptoms such as fatigue and vomiting within the first six months after exposure. In many cases, the disease causes no symptoms at all.
Acute hepatitis C may improve or resolve without treatment. It leads to chronic infection in 75 to 85 percent of cases. The chronic form may cause long-term problems in your liver, including liver damage and liver cancer.
HCV is spread through direct contact with blood or certain bodily fluids that contain HCV. Its safe to engage in the following activities without worry of transmission:
- hugging
- light, clay-colored bowel movements
- jaundice, or yellowing of the skin and eyes
If your doctor suspects that you have hepatitis C, they will draw blood to check for HCV antibodies. Antibodies are substances your body produces when its fighting an infection. If you have them, your doctor may order a second test to confirm that the virus is still present.
When A Transplant Is Needed
Sometimes, the only treatment for fulminant hepatitis is liver transplantation. A person’s prognosis after the transplant depends on:
- Their age
- Severity of the disease before the transplant
- Amount of confusion present in the patient
- Effects on other organ systems, like the kidneys
For those who do qualify for a transplant, the chance of survival is excellent, at 92%.
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How Is Hepatitis C Spread
Hepatitis C is spread person-to-person usually by direct contact with another person’s blood who is infected with hepatitis C virus. Individuals that share needles are at a high risk to become infected. Surgical and other instruments that are not properly decontaminated can also spread hepatitis C to others. Moreover, some patients that receive organ transplants from individuals that have the virus, but no symptoms, can transmit the disease to the organ transplant recipient.
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What Are The Complications Of Hepatic Encephalopathy
Liver disease needs treatment, such as medications and lifestyle changes, including not drinking alcohol. If the underlying cause of liver disease isnt treated, liver function deteriorates, and toxins continue to build. Some people with advanced hepatic encephalopathy lose consciousness and go into a hepatic coma.
Who Should Be Tested
Testing for hepatitis A is not routinely recommended.
CDC recommends hepatitis B testing for:
- Men who have sex with men
- People who inject drugs
- Household and sexual contacts of people with hepatitis B
- People requiring immunosuppressive therapy
- People with end-stage renal disease
- People with hepatitis C
- People with elevated ALT levels
- Pregnant women
- Infants born to HBV-infected mothers
CDC recommends hepatitis C testing for:
- All adults aged 18 years and older
- All pregnant women during each pregnancy
- About 24,900 new infections each year
- About 22,600 new infections in 2018
- Estimated 862,000 people living with hepatitis B
- About 50,300 new infections in 2018
- Estimated 2.4 million people living with hepatitis C
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Is Chronic Viral Hepatitis C Contagious
Hepatitis C can be passed from person to person. Most people with HCV get it through direct contact with blood containing the virus.
People with hepatitis C can pass on the virus to others by sharing needles and syringes. Hepatitis C is easily transmitted among people who use intravenous drugs.
Its also possible, but much less common, to acquire the HCV by:
- sharing a razor with a person who has the virus
- sharing a toothbrush with a person who has the virus at the same time that you have bleeding gums
- having sexual contact with a person who has the virus
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Viral Hepatitis Definition And Overview
Hepatitis means inflammation of the liver. Many illnesses and conditions can cause inflammation of the liver, for example, drugs, alcohol, chemicals, and autoimmune diseases. Many viruses, for example, the virus causing mononucleosis and the cytomegalovirus, can inflame the liver. Most viruses, however, do not attack primarily the liver the liver is just one of several organs that the viruses affect. When most doctors speak of viral hepatitis, they are using the definition that means hepatitis caused by a few specific viruses that primarily attack the liver and are responsible for about half of all human hepatitis. There are several hepatitis viruses they have been named types A, B, C, D, E, F , and G. As our knowledge of hepatitis viruses grows, it is likely that this alphabetical list will become longer. The most common hepatitis viruses are types A, B, and C. Reference to the hepatitis viruses often occurs in an abbreviated form The focus of this article is on these viruses that cause the majority of human viral hepatitis.
Hepatitis viruses replicate primarily in the liver cells. This can cause the liver to be unable to perform its functions. The following is a list of major functions of the liver:
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How Long Does It Last
Hepatitis A can last from a few weeks to several months.
Hepatitis B can range from a mild illness, lasting a few weeks, to a serious, life-long condition. More than 90% of unimmunized infants who get infected develop a chronic infection, but 6%10% of older children and adults who get infected develop chronic hepatitis B.
Hepatitis C can range from a mild illness, lasting a few weeks, to a serious, life-long infection. Most people who get infected with the hepatitis C virus develop chronic hepatitis C.
Hcv Infection And Cerebrovascular Events
In chronic HCV infection, cerebrovascular acute and chronic events have been reported with a higher prevalence than that observed in the general population in many cases, such neurologic conditions were associated with the presence of mixed cryoglobulinemia. Enger et al, in the largest retrospective study to date, including 21919 HCV-positive subjects and 67109 HCV-negative control subjects, reported a strict association between HCV and stroke, with a higher adjusted estimated risk of stroke for anti-HCV positive subjects . Gutierrez et al showed a close association between HCV infection and stroke in a retrospective study of subjects from the NHANES cohort during the period 2005-2010. However, it should be underscored that the two above studies have thus far been published only in an abstract form. Nonetheless, in a prospective study, involving a large population cohort from Taiwan, Liao et al established an association between HCV infection and stroke . Recently, in a large retrospective cohort from Taiwan, Hsu et al also found a higher risk of stroke in HCV infected subjects. Likewise, we recorded a higher prevalence of HCV infection in patients with stroke when compared with a large age- and gender-matched control group . In addition, HCV infection turned out to be an independent risk factor for stroke .
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Unspecified Viral Hepatitis C Without Hepatic Coma
- 2016201720182019202020212022Billable/Specific Code
- B19.20 is a billable/specific ICD-10-CM code that can be used to indicate a diagnosis for reimbursement purposes.
- The 2022 edition of ICD-10-CM B19.20 became effective on October 1, 2021.
- This is the American ICD-10-CM version of B19.20 other international versions of ICD-10 B19.20 may differ.
- Applicable To annotations, or
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Function Of The Liver
The liver has many essential functions. In fact, almost all of our blood passes through the liver.
The liver also:
- Helps convert nutrients in the diet into useful substances
- Converts toxic substances into harmless substances that are eventually eliminated through the bowels
- Functions as a storage unit for fats and helps break them down to produce energy
- Breaks down proteins to create the building blocks of cells
- Produces proteins that are important in blood clotting to stop regular bleeding
When the liver malfunctions, the body suffers from a buildup of toxins, fails at producing needed proteins for other organ systems to work, and cannot remove waste products through the process of metabolism.
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Chronic Phase Of Hepatitis C
After six months 70% to 85% of those infected will have failed to clear the virus spontaneously. After this period the hepatitis C virus enters what is known as the chronic phase. This is when hepatitis C becomes a chronic or long-term infection. The diagnosis is confirmed when over a six month period hepatitis C RNA viral presence is detectable on at least two occasions.
A diagnosis of chronic hepatitis C means the battle between the virus and the immune system that occurs during the acute stage has finally been won by the virus. It is now highly unlikely that the virus can be cleared without treatment.
How the disease then progresses varies significantly from person to person. After many years some people will have minimal liver damage with no scarring while others can progress to cirrhosis within less than ten years. On average it takes about twenty years for significant liver scarring to develop. It is still not known whether chronic hepatitis C infection inevitably leads to cirrhosis. At present it is thought that this is a very likely outcome, although for some people it may take at least 50 years or more. They may well die of other unrelated diseases or conditions before cirrhosis develops. The rate of progression of liver damage cannot be accurately determined by liver enzyme levels, viral load or by genotype.
Liver damage and fibrosis during the chronic stage
Free Radicals and Fibrosis
How Can I Prevent Hepatic Encephalopathy
Proper management and treatment of liver disease is key to lowering the chances of developing hepatic encephalopathy. These steps can lower your risk:
- Avoid alcohol, which damages liver cells.
- Avoid medications that affect the nervous system, such as sleeping pills and antidepressants.
- Eat a nutritious diet, exercise and maintain a healthy weight .
- Take your prescribed medications to treat liver disease.
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What Is Hepatic Encephalopathy
Hepatic encephalopathy is an often-temporary neurological disorder due to chronic, severe liver disease. A diseased liver struggles to filter toxins from the bloodstream. These toxins build up in the body and travel to the brain. Toxicity affects brain function and causes cognitive impairment.
People with hepatic encephalopathy may seem confused or have difficulty processing their thoughts. Treatments can remove the toxins and reverse the problem. As liver disease progresses, the condition may worsen and become less treatable. Hepatic encephalopathy is also known as portosystemic encephalopathy .
What Causes Fulminant Hepatitis
There are many causes of hepatitis. Not all are associated with fulminant hepatitis, but there is a lot of overlap.
The most common causes of fulminant hepatitis are:
Generally, viruses are the most common cause of fulminant hepatitis worldwide, whereas Tylenol overdose is more common in the United States and the United Kingdom. Overdose can be both accidental or intentional.
In general, the causes of fulminant hepatitis can be divided into viruses, toxins, and other rare causes.
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Recommended Testing For Diagnosing Acute Hcv Infection
RECOMMENDED RATING HCV antibody and HCV RNA testing are recommended when acute HCV infection is suspected due to exposure, clinical presentation, or elevated aminotransferase levels . I, C
Recommendations for HCV testing are also found in the Testing and Linkage to Care section.
Diagnosis of acute HCV infection enables estimation of annual incidence rates and transmission patterns, thereby facilitating implementation and assessment of prevention programs. At the individual level, a diagnosis of acute infection expedites linkage to care, counseling regarding high-risk behavior, and timely interventions to reduce virus transmission and liver disease progression . Some persons involved in high-risk behaviors practice serosorting, defined as using HCV antibody serostatus to determine whether to engage in high-risk behaviors with certain individuals . Thus, undiagnosed acutely infected persons may be at greater risk of transmitting HCV to their presumably seronegative contacts than would be expected by chance.
The best laboratory evidence to support a diagnosis of acute HCV infection is a positive HCV RNA test in the setting of a negative HCV antibody test , or a positive HCV antibody test after a prior negative HCV antibody test . There are rare instances in which these approaches may be misleading, such as in immunosuppressed individuals with impaired antibody production .
Discrete Exposure
No Discrete Exposure
How Is Viral Hepatitis Prevented
Prevention of hepatitis involves measures to avoid exposure to the viruses, using immunoglobulin in the event of exposure, and vaccines. Administration of immunoglobulin is called passive protection because antibodies from patients who have had viral hepatitis are given to the patient. Vaccination is called active protection because killed viruses or non-infectious components of viruses are given to stimulate the body to produce its own antibodies.
Avoidance of exposure to viruses
Prevention of viral hepatitis, like any other illness, is preferable to reliance upon treatment. Taking precautions to prevent exposure to another individual’s blood , semen , and other bodily secretions and waste will help prevent the spread of all of these viruses.
Use of immunoglobulins
Immune serum globulin is human serum that contains antibodies to hepatitis A. ISG can be administered to prevent infection in individuals who have been exposed to hepatitis A. ISG works immediately upon administration, and the duration of protection is several months. ISG usually is given to travelers to regions of the world where there are high rates of hepatitis A infection and to close or household contacts of patients with hepatitis A infection. ISG is safe with few side effects.
Hepatitis A
Individuals at increased risk of acquiring hepatitis A are:
Some local health authorities or private companies may require hepatitis A vaccination for food handlers.
Hepatitis B
Hepatitis B vaccine is recommended for:
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What Are The Treatments For Hepatitis C
Treatment for hepatitis C is with antiviral medicines. They can cure the disease in most cases.
If you have acute hepatitis C, your health care provider may wait to see if your infection becomes chronic before starting treatment.
If your hepatitis C causes cirrhosis, you should see a doctor who specializes in liver diseases. Treatments for health problems related to cirrhosis include medicines, surgery, and other medical procedures. If your hepatitis C leads to liver failure or liver cancer, you may need a liver transplant.
Blood And Vessel Problems
People with hepatitis C often get a condition called cryoglobulinemia. This happens when certain proteins in your blood stick together in cold weather. They can build up in vessels and block blood flow, which causes swelling and damage. The condition can affect your skin, organs, nerves, and joints.
Hepatitis C also can cause problems with blood itself. You may not make enough white blood cells, which fight infections, or platelets, which help your blood clot.
The infection can also make you bruise easily or get red or purple spots under your skin. Those are signs of a bleeding disorder called immune thrombocytopenic purpura.
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Joint And Muscle Pain
A condition called arthralgia causes joint pain and is common in people with hepatitis C. Itâs different from arthritis, which causes pain and swelling in joints. But infected people can also get hepatitis C-related arthritis.
Fibromyalgia, which causes body aches and muscle pain, is also common in people with hepatitis C.
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