Diagnosis

Diagnosis of Hepatitis C

This week I will be blogging about how Hepatitis C is diagnosed. I will include information from a variety of sources addressing the diagnosis of the disease and the disease process.

Diagnosing Hepatitis C can be difficult because an acute infection is often asymptomatic. In order to diagnose Hepatitis C, the lab will draw samples of blood in order to test for certain blood components specific to an HCV infection.

How is an infection of the Hepatitis C Virus (HCV) detected?

• Antibodies specific to the HCV may be present in the blood of an infected person
• Other markers indicating the presence of HCV include specific enzymes and proteins that can also be observed in a blood test

What happens after a test for HCV returns positive?

• After one of the markers of HCV mentioned above is detected, a more specific test is performed to detect  the presence of RNA specific to the HCV. This will confirm that a person is infected with the virus. 

Here is an example of a tool for providers to follow when diagnosing Hepatitis C:

If you think you have been exposed to the Hepatitis C Provider it is important to talk with a health care provider so they can perform an assessment and if necessary, perform blood tests to determine a diagnosis. If you would like additional information about the different forms of Hepatitis as well as some signs and symptoms of the disease, visit this website: http://www.nakedtruth.idaho.gov/hepatitisb.aspx.

The following website has resources for patients with Hepatitis C: http://www.cdc.gov/hepatitis/C/PatientEduC.htm

Reference List:

http://www.nakedtruth.idaho.gov/hepatitisb.aspx
http://www.cdc.gov/hepatitis/C/PatientEduC.htm
http://depts.washington.edu/hepstudy/hepC/clindx/virus/discussion.html
http://www.jgld.ro/2006/3/7.pdf

Pathophysiology

The Pathophysiology of Hepatitis C Explained

How does someone get Hepatitis C?

Hepatitis C Virus (HCV) is typically spread when an uninfected person's blood is exposed to the blood of someone infected with Hepatitis C. This can happen as a result of sharing needles, if a health care worker or someone is accidentally stuck with a needly that is contaminated with HCV, a baby born to a mother with Hepatitis C, or, much less commonly, if a person receives a blood transfusion with HCV infected blood. Hepatitis C is rarely transferred person to person via sexual contact or by sharing personal items like a razor or toothbrush. 

In what ways is Hepatitis C not spread from person to person?

• HCV is not spread through food or water
• HCV is not spread through breast milk
• HCV is not spread through hugging, kissing, or holding hands
• HCV is not spread by coughing or sneezing

How long can Hepatitis C survive outside of a human body?

• Hepatitis C can survive outside of a body on a surface for 3 weeks. 

What does Hepatitis C Virus look like?

An image of the Hepatitis C Virus viewed under an electron microscope.

What is the pathophysiology of Hepatitis C?

• Much is still unknown about the Hepatitis C Virus (HCV) and its role in the human body
• The HCV is sometimes able to evade the body's immune system, leading to a chronic infection
• Though the body creates an immune response to the HCV, the virus may be able to survive as a result of rapid replication
• Ultimately, the body continues to try to destroy the HCV and as a result causes damage to the body's own liver cells

For more information about Hepatitis C Virus visit this website:
http://nursing.advanceweb.com/Article/Hepatitis-C-Focus-on-Pathophysiology-amp-Treatment.aspx

Sources:
http://nursing.advanceweb.com/Article/Hepatitis-C-Focus-on-Pathophysiology-amp-Treatment.aspx
http://www.cdc.gov/hepatitis/C/cFAQ.htm
http://www.theguardian.com/science/2013/nov/05/hope-hepatitis-cure-drugs-success-sofosbuvir-ledipasvir

Epidemiology

How prevalent is the Hepatitis C Virus around the world?

Hepatitis C Virus (HCV) affects people around the globe. About 130-170 million people in the world are infected with HCV. Most individuals who are infected with chronic HCV are unaware of their infection. Here are some global HCV statistics:

• The World Health Organization estimates over 170 million people are chronic carrier of HCV and that globally about 3% have been infected with HCV
• Egypt has the highest known prevalence of individuals infected with HCV at over 10% of the population. Egypt also has a high rate of chronic liver disease, liver cancer, and cirrhosis. 
• In the United States, up to 2-4 million people may be chronically infected with HCV
• In Europe 5-10 million people may be chronically infected with HCV
• In India, about 12 million people may be chronically infected with HCV
• In the U.S. and Western Europe, about 150,000 new cases of HCV occur annually
• In Japan, about 350,000 new cases occur annually

Of the new cases of HCV diagnosed each year, only about a quarter of them are symptomatic but 60-80% may ultimately develop chronic liver disease. The mortality rate of those diagnosed each year is around 5-7%.

This map shows the prevalence of individuals chronically infected with the Hepatitis C Virus.

This graph depicts the number of acute Hepatitis C Virus infections in the United States between 1992 and 2009.

Watch this video to learn more about who has HCV around the world and how it is primarily spread from person to person:

References:
1. Chapter 3 Infectious Diseases Related To Travel. (n.d.). Retrieved April 12, 2015, from http://wwwnc.cdc.gov/travel/yellowbook/2014/chapter-3-infectious-diseases-related-to-travel/hepatitis-c
2. Clinical Infectious Diseases. (n.d.). Retrieved April 12, 2015, from http://cid.oxfordjournals.org/content/55/suppl_1/S3/F1.expansion.html
3. Hepatitis C. (n.d.). Retrieved April 12, 2015, from http://www.who.int/csr/disease/hepatitis/whocdscsrlyo2003/en/index8.html#94