Distinctive Properties Of Hcv
The genome of HCV resembles those of the pestiviruses and flaviviruses in that itcomprises around 10,000 nt of positive sense RNA, lacks a 3 polyAtract and has a similar gene organization. It has been proposed that HCV shouldbe the prototype of a third genus in the family Flaviviridae.
The non-structural region of the HCV genome is divided into regions NS2 to NS5.In the flaviviruses, NS3 has two functional domains, a protease which isinvolved in cleavage of the non-structural region of the polyprotein and ahelicase which is presumably involved in RNA replication. Motifs within thisregion of the HCV genome have homology to the appropriate consensus sequences,suggesting similar functions. NS5 seems to be the replicase and contains thegly-asp-asp motif common to viral RNA-dependent RNA polymerases .
History And Physical Exam
To diagnose hepatitis, first your doctor will take your history to determine any risk factors you may have for infectious or noninfectious hepatitis.
During a physical examination, your doctor may press down gently on your abdomen to see if theres pain or tenderness. Your doctor may also feel to see if your liver is enlarged. If your skin or eyes are yellow, your doctor will note this during the exam.
Treatment And Medication For Hepatitis C
If you have acute hepatitis C, there is no recommended treatment. If your hepatitis C turns into a chronic hepatitis C infection, there are several medications available.
Interferon, peginterferon, and ribavirin used to be the main treatments for hepatitis C. They can have side effects like fatigue, flu-like symptoms, anemia, skin rash, mild anxiety, depression, nausea, and diarrhea.
Now youâre more likely to get one of these medications:
Find out more on treatment options for hepatitis C.
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How Is Hepatitis C Spread
The hepatitis C virus is spread through contact with infected blood and bodily fluids, such as semen and vaginal fluid. You will only be infected if the virus enters your bloodstream.
In Canada, most people are infected by:
- using or sharing drug paraphernalia contaminated with infected blood, including:
If you have hepatitis C, you can pass the virus to your baby during:
- breastfeeding if your nipples are cracked and bleeding, and your baby also has bleeding in or on the mouth
- it can be hard to tell if a baby has bleeding in or on the mouth
- cracked nipples may not be bleeding but may begin to during breastfeeding
You can also be infected if you receive contaminated:
- blood products
Although rare, hepatitis C can also be spread through unprotected sex especially if it involves blood contact, such as:
- contact with:
- open sores, cuts or wounds
- semen or vaginal fluid if blood is present
Unprotected sex means having sex without using a condom or other barrier safely.
Hepatitis C is not spread through:
- breast milk
How Long Before I Have Symptoms
Many people have mild symptoms or no symptoms, which is why hepatitis is sometimes called a âsilentâ disease.
Hepatitis A. The symptoms usually show up 2 to 6 weeks after the virus entered your body. They usually last for less than 2 months, though sometimes you can be sick for as long as 6 months.
Some warning signs that you may have hepatitis A are:
Hepatitis B. The symptoms are the same as hepatitis A, and you usually get them 3 months after you’re infected. They could show up, though, anywhere from 6 weeks to 6 months later.
Sometimes the symptoms are mild and last just a few weeks. For some people, the hep B virus stays in the body and leads to long-term liver problems.
Hepatitis C. The early symptoms are the same as hepatitis A and B, and they usually happen 6 to 7 weeks after the virus gets in your body. But you could notice them anywhere from 2 weeks to 6 months later.
For about 25% of people who get hep C, the virus goes away on its own without treatment. In other cases, it sticks around for years. When that happens, your liver might get damaged.
Remember, it’s possible to spread all the types of hepatitis even if you don’t show any signs of being sick.
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Alterations Of Lipid Metabolism
Lipids are required for the HCV replication and particles assembly. As mentioned above, HCV can modify the host serum lipid profile and this modification can provoke the steatosis. The steatosis is more frequent and more severe in patients with HCV gt 3 and it is correlated with a high HCV RNA levels. On one hand, in HCV-infected patients, the steatosis can be considered as a marker of the liver disease progression and, on the other hand, as an indication of the reduced response to therapy. However, if it is not metabolic or alcoholic steatosis, an efficient antiviral therapy is capable to reduce it.
Hepatitis C Virus Structure
Researchers determined the structure of a protein on the surface of the hepatitis C virus that allows it to gain entry into cells. The finding may aid in the development of a vaccine to prevent the liver disease.
Hepatitis C is an infectious disease caused by a virus. The hepatitis C virus attacks the liver, leading to inflammation. Most infections become chronic, as the body is unable to get rid of the virus. In the United States, more than 3 million people have chronic HCV infection. Worldwide, approximately 160 million people are estimated to have chronic hepatitis C. Doctors recommend that people who are at higher risk of getting hepatitis C should be tested for HCV infection.
Left untreated, chronic hepatitis C can cause severe liver disease or liver cancer. If the organ becomes extremely damaged, liver failure may occur and require a transplant. Several medicines are available to treat various types of the disease, but the response to treatment can vary.
HCV is not related to hepatitis viruses A, B, D, and E. While vaccines are available for hepatitis A and B, currently no vaccine is available to prevent hepatitis C infection.
The researchers compared the structure of the HCV core domain with other protein structures in the NIH-supported Protein Data Bank. One major region was similar to those commonly found in viral and cellular proteins, but another was novel.
by Carol Torgan, Ph.D.
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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:
What Are Hepatitis C Genotypes
A variable for those with chronic hepatitis C virus is the genotype, or the strain of the virus when they contracted an infection. The genotype is determined by a blood test.
The genotype doesnt necessarily play a role in progression of the virus, but rather as a factor in selecting the right medications for treating it.
According to the
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What Is The Treatment For Viral Hepatitis
Treatment of acute viral hepatitis and chronic viral hepatitis are different. Treatment of acute viral hepatitis involves resting, relieving symptoms, and maintaining an adequate intake of fluids. Treatment of chronic viral hepatitis involves medications to eradicate the virus and taking measures to prevent further liver damage.
In patients with acute viral hepatitis, the initial treatment consists of relieving the symptoms of nausea, vomiting, and abdominal pain . Careful attention should be given to medications or compounds, which can have adverse effects in patients with abnormal liver function . Only those medications that are considered necessary should be administered since the impaired liver is not able to eliminate drugs normally, and drugs may accumulate in the blood and reach toxic levels. Moreover, sedatives and “tranquilizers” are avoided because they may accentuate the effects of liver failure on the brain and cause lethargy and coma. The patient must abstain from drinking alcohol since alcohol is toxic to the liver. It occasionally is necessary to provide intravenous fluids to prevent dehydration caused by vomiting. Patients with severe nausea and/or vomiting may need to be hospitalized for treatment and intravenous fluids.
Medications for chronic hepatitis C infection include:
- oral daclatasvir
Medications for chronic hepatitis B infection include:
- oral entecavir
- oral tenofovir
The 5 Types Of Viral Hepatitis
Viral infections of the liver that are classified as hepatitis include hepatitis A, B, C, D, and E. A different virus is responsible for each type of virally transmitted hepatitis.
Hepatitis A is always an acute, short-term disease, while hepatitis B, C, and D are most likely to become ongoing and chronic. Hepatitis E is usually acute but can be particularly dangerous in pregnant women.
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Virus Release And Extracellular Particles
Analysis of cell supernatant by gradient density centrifugation demonstrated that the MVs subpopulations are different, depending on the cell line. It is known, that MVs are intensively released by primary hepatocytes and immortalized cells of hepatic origin. The release from hepatocytes might be increased by an undergoing lipotoxicity. Thus, MVs are actively used by the hepatocytes as delivery system and the amounts of MVs might be increased in response to lipotoxicity and likely other complications. In this regard, we speculate that during acute phase of infection the virus can trigger the MV release and that might be an additional pathway for the virus. How MVs containing virus particles can influence HCV distribution along the density gradient? In fact, MV containing different amount of viruses may contribute to observed diversity of buoyant densities of HCV, especially when plasma is investigated.
It is known, that the diffusion of spherical particle through a viscous liquid is dependent on the particle diameter. It is described by Stokes-Einstein equation:
D = diffusion constant, k = Boltzmann constant, T = temperature , = solvent viscosity, r = radius of spherical particle.
Another parameter that influences the diffusion is the mass of spherical particle and the equation counting these parameters looks as follows:
where: D = diffusion = radius of the spherical particle M = mass of the particle = viscosity of the medium.
Nucleic Acid Testing For Hcv
Since the HCV RNA is detectable within a few days of infection the nucleic acid-based tests are efficient in an early diagnostic of acute hepatitis C and should be considered as mandatory. The HCV RNA measurement is furthermore important in determination of the HCV genotype, selection of treatment strategy, therapy duration and evaluation of the treatment success. For a number of antiviral combination therapies, the HCV RNA follow-up studies are essential to define the outcome of the treatment and further therapeutic strategies, if necessary. Traditionally, the tests should be repeated 24 wk after treatment completion to assess whether a sustained virologic response has been achieved. However, as the probability of a virologic relapse is similar after 12 and 24 wk, the new time point for assessment of final virological treatment outcome is 12 wk after the end-of-treatment. Both qualitative and quantitative PCR-based detection assays are available. Qualitative PCR tests are sensitive and are used for initial diagnostic of hepatitis C, for screening of blood and organ donations and for confirming SVR after treatment completion .2). Quantitative reverse transcriptase real-time PCR-based assays can detect and quantify the HCV RNA over a very wide range, from approximately 10 IU/mL to 10 million IU/mL. The measurements are essential in the treatment monitoring when the virus load is gradually reducing.
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Hepatitis C Testing And Diagnosis
Doctors will start by checking your blood for:
Anti-HCV antibodies: These are proteins your body makes when it finds the hep C virus in your blood. They usually show up about 12 weeks after infection.
It usually takes a few days to a week to get results, though a rapid test is available in some places.
The results can be:
- Nonreactive, or negative:
- That may mean you donât have hep C.
- If youâve been exposed in the last 6 months, youâll need to be retested.
If your antibody test is positive, youâll get this test:
HCV RNA: It measures the number of viral RNA particles in your blood. They usually show up 1-2 weeks after youâre infected.
- The results can be:
- Negative: You donât have hep C.
- Positive: You currently have hep C.
You might also get:
Liver function tests: They measure proteins and enzyme levels, which usually rise 7 to 8 weeks after youâre infected. As your liver gets damaged, enzymes leak into your bloodstream. But you can have normal enzyme levels and still have hepatitis C. Learn the reasons why you should get tested for hepatitis C.
Complications Of Hepatitis C
If the infection is left untreated for many years, some people with hepatitis C will develop scarring of the liver .
Over time, this can cause the liver to stop working properly.
In severe cases, life-threatening problems, such as liver failure, where the liver loses most or all of its functions, or liver cancer, can eventually develop.
Treating hepatitis C as early as possible can help reduce the risk of these problems happening.
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How Is Viral Hepatitis Diagnosed
Diagnosis of viral hepatitis is based on symptoms and physical findings as well as blood tests for liver enzymes, viral antibodies, and viral genetic materials.
Symptoms and physical findings
Diagnosis of acute viral hepatitis often is easy, but the diagnosis of chronic hepatitis can be difficult. When a patient reports symptoms of fatigue, nausea, abdominal pain, darkening of urine, and then develops jaundice, the diagnosis of acute viral hepatitis is likely and can be confirmed by blood tests. On the other hand, patients with chronic hepatitis due to HBV and HCV often have no symptoms or only mild nonspecific symptoms such as chronic fatigue. Typically, these patients do not have jaundice until the liver damage is far advanced. Therefore, these patients can remain undiagnosed for years to decades.
There are three types of blood tests for evaluating patients with hepatitis: liver enzymes, antibodies to the hepatitis viruses, and viral proteins or genetic material .
Liver enzymes: Among the most sensitive and widely used blood tests for evaluating patients with hepatitis are liver enzymes, called aminotransferases. They include aspartate aminotransferase and alanine aminotransferase . These enzymes normally are contained within liver cells. If the liver is injured , the liver cells spill the enzymes into the blood, raising the enzyme levels in the blood and signaling that the liver is damaged.
Examples of tests for viral antibodies are:
Types Of Hepatitis: Hepatitis A
Hepatitis A is the mildest of this group of viral infections. Its transmitted through the fecal-oral route. In other words, an infected person expels it through their feces, contaminates food or water that another person eats or drinks, and the virus finds a new host.
Hepatitis A patients suffer from gastroenteritis symptoms with liver involvement. Thus, fever, abdominal pain, diarrhea, and vomiting appear.
As the liver is inflamed, the bile stagnates and doesnt circulate. As a result, the skin turns yellowish . This occurs because bilirubin impregnates the skin and mucous membranes, which is why the whites of the eyes also turn yellow. Excess bilirubin is eliminated through the urine, which also becomes darker.
The usual symptoms last about 15 days. Although the disease can last for a month or more, this isnt common. Patients tend to recover without any major problems and, if there was no dehydration, they wont suffer from any lasting effects.
The most dangerous symptom is fluid loss, especially in young children. Due to how fast it spreads, extreme precautionary measures should be taken when there are outbreaksin closed populations, such as schools.
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Questions For Your Doctor
When you visit the doctor, you may want to ask questions to get the information you need to manage your hepatitis C. If you can, have a family member or friend take notes. You might ask: