Summary

Hepatitis C is a viral infection that causes liver inflammation and damage, transmitted through contaminated blood. It is caused by the Hepatitis C virus (HCV). This infection may not show symptoms initially but can lead to serious health problems if left untreated, including cirrhosis and liver cancer.

‍

Introduction

Hepatitis C has a global presence and is especially prevalent in regions where healthcare practices are inadequate or unsafe medical procedures are common.^[1]

The disease is primarily contracted through exposure to small quantities of infected blood, often through drug use and needle sharing, unsafe medical procedures, unscreened blood transfusions, or through sexual contact. It can also be passed from a mother to her baby during birth. The infection typically progresses in two stages: acute and chronic. 

During the acute stage, which occurs within the first 6 months after exposure to the virus, a person may or may not experience symptoms. These can include fever, fatigue, loss of appetite, nausea, vomiting, abdominal pain, dark urine, joint pain, and jaundice. In the chronic stage, which develops in the majority of people with the virus, the disease can silently attack the liver for many years without causing symptoms.^[2-4] It can lead to serious health problems, including cirrhosis (scarring of the liver), liver cancer, and even death.

‍

Diagnosing Hepatitis C can be challenging due to its asymptomatic nature in many individuals. It is often discovered during routine blood tests or after the person has developed severe liver damage.

Despite its potentially severe consequences, Hepatitis C is curable with antiviral medications that stop the virus from multiplying within the body, thereby preventing further liver damage.

Possible Test Results 

HCV infection has an incubation period of 14 to 180 days, but symptoms or liver damage may not appear until several months to years after exposure. Therefore, it's recommended to test for HCV around 6-9 weeks after potential exposure, with repeat testing at 6 months if high-risk exposure has occurred. Regular testing is also crucial for those with ongoing risk factors to ensure early detection and treatment.^[1,3,5]

There are two possible states of your blood test result: positive or negative.

• Your hepatitis C test is positive. Make sure to get in touch with a healthcare provider immediately for further investigations and to discuss treatment strategies. Hepatitis C can be treated effectively with the proper care. 
• Your hepatitis C test results are negative. Keep it that way by practicing safe behaviors, such as avoiding needle sharing. Regular testing is recommended if you're at risk.

‍

Treatment Options

Treatment for Hepatitis C has significantly improved over the years, shifting from interferon-based therapies to directly acting antivirals (DAAs). Some commonly used DAAs include sofosbuvir, ledipasvir, velpatasvir, daclatasvir, simeprevir, and others.^[6] 

There are several types of DAAs, including:

• Protease inhibitors, which block a protein HCV needs to replicate.
• NS5A inhibitors, which interfere with a protein the virus uses to assemble itself.

These medications are often combined, and the goal of treatment is to achieve a sustained virologic response (SVR). This is characterized by the absence of detectable virus in the blood 12 to 24 weeks after the treatment completion.^[1,3] 

‍

The Science Behind

Below, you can dive into more detailed information about HCV. Find out how genetics can influence the development of the disease and the molecular mechanisms behind it.

‍

Molecular Mechanisms

A key factor in the persistence and pathogenesis of the Hepatitis C virus (HCV) is its complex life cycle, which is intrinsically tied to the liver cells, or hepatocytes, of the host. Understanding this life cycle is essential for the development of effective antiviral treatments.

HCV begins its life cycle by interacting with specific protein receptors on the surface of a hepatocyte. Afterward, the virus is internalized into the cell through a process known as endocytosis.

When a virus enters a liver cell, it sheds its outer layer, exposing its genetic code, a single-stranded RNA. This genetic code is released into the cell's interior, where the cell uses it to create a large protein.  

The viral RNA is used as a template to synthesize a complementary negative-strand RNA, which in turn serves as a template for generating new positive-strand viral RNA. The newly synthesized positive-strand RNA can be used for translation (forming more viral proteins) or packaged into new viral particles.

The assembly phase begins with the newly formed viral RNA and proteins coming together to form immature viral particles. These particles are then sent to the endoplasmic reticulum, which is an organelle involved in the synthesis and transport of proteins and lipids within the cell. Here, they are enveloped in a layer of the host cell membrane. This process matures the virus particles, which are subsequently released from the liver cell to begin the cycle again, invading other hepatocytes.^[7]

If you are interested in a more detailed explanation of the HCV life cycle, there are many useful resources on the internet. For example: The Hepatitis C Lifecycle

Genetics and HCV

Some individuals may have a stronger or weaker immune response to viruses due to genetic differences. Research has discovered that a variation in the gene for Interleukin-28B (IL28B) can affect one's susceptibility to chronic Hepatitis C infection.^[8,9]

For instance, one study confirmed that genetic variations can influence the likelihood of HCV infection in a high-risk Chinese population after exposure.^[10]

‍

Recommendations

• Prevention is the key. This includes practicing safe injection behaviors by using clean needles and not sharing them.^[1,3,4]
• Regular testing for Hepatitis C, especially for those in high-risk groups, is a crucial aspect to control the disease. 
• Practicing safe sex is also crucial to prevent the spread of infection. 
• For individuals who test positive for Hepatitis C, it's advised to begin antiviral treatment as soon as possible. The treatment regime typically involves directly acting antivirals (DAAs), and the choice of specific drugs depends on various factors, including the HCV genotype and the patient's liver health status.
• Regular medical check-ups are recommended for monitoring the progression of the disease and early detection of potential complications. Healthy lifestyle choices such as abstaining from alcohol and illicit drugs, avoiding smoking, and maintaining a balanced diet can prevent further liver damage.
• Pregnant women with Hepatitis C should receive appropriate treatment and follow-up care, as the infection can be transmitted to the baby.

‍

The information and tests provided on our website are for educational purposes only and are not a substitute for professional medical advice. Always consult with your healthcare provider before making health decisions. Our tests do not diagnose or treat diseases. Individual results may vary and should be discussed with a healthcare provider.