Gastrointestinal System > Hepatitis >
Hepatitis C
“Inflammation of the liver caused by an infection with the Hepatitis C virus”
Risk Factors
- IV drug users
- People receiving blood regularly (haemophilia)
- Healthcare workers (needlestick injuries)
- Haemodialysis and chronic renal failure
- Mother-baby transmission
- Tattoos, body piercings, or acupuncture with non-sterile equipment
- People with HIV
- Risk factors for progression to chronic hepatitis:
- Male
- Increasing age
- Chronic alcohol
- HIV
- Previous hepatitis B infection
Aetiology
- RNA virus
- Spread via blood: sexual contact, IV drug abuse, transfusions
- Highly infectious
- Causes both acute and chronic infection
Pathophysiology
- Virus enters the body
- Replicates in hepatocytes
- Interferes with cell function
- Causes inflammation of the liver
Clinical Presentation
- Symptoms:
- Abdominal discomfort
- Nausea
- Anorexia
- Arthralgia
- Dark urine, pale stool
- Pruritus
- Signs:
- Fever
- Jaundice
- RUQ tenderness
- Hepatomegaly
- Chronic Infection:
- Signs of chronic liver disease
- Jaundice
- Hepatosplenomegaly
- Spider naevi
- Severe cases: ascites, liver flap, encephalopathy
Investigations
- LFTs
- FBC
- U&Es
- HbA1c
- Prothrombin time
- Tests for hepatitis A and B
Management
- Notify the Health Protection Unit
- Urgent referral if chronic infection
- Requires specialist management
- Conservative:
- Avoid unprotected sexual intercourse
- Quit alcohol
- Avoid sharing needles
- Medical:
- Analgesia (paracetamol, weak opioid if liver impairment mild)
- Chlorphenamine for itch
- Direct-acting antivirals
- Surgical:
- N/A
- Consider referral to GUM clinic or drug rehabilitation services
- Vaccination
Complications
- Can develop into chronic hepatitis (85% silent chronic infection)
- Glomerulonephritis
- Autoimmune hepatitis
- Liver cirrhosis
- Hepatocellular carcinoma