Report on hepatitis C (upper)

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Important factsHepatitis C is a liver disease caused by hepatitis C virus, which causes acute and chronic hepatitis infections, ranging from


Important facts

Hepatitis C is a liver disease caused by hepatitis C virus, which causes acute and chronic hepatitis infections, ranging from a few weeks of minor illness to a lifetime of serious disease.

A blood borne virus hepatitis C virus is the most common mode of infection is unsafe injection practices; disinfection of some medical institutions for medical devices is not thorough enough; and no input after screening of blood and blood products.

The world has 130 million to 150 million people suffer from chronic hepatitis C infection.

A large number of patients with chronic liver cirrhosis or liver cancer.

About 500 thousand people died from hepatitis C-related liver disease 1 year.

Antiviral drugs can make about 90% of HCV infection has been cured, thereby reducing the risk of death of liver cancer and cirrhosis, but the diagnosis and treatment of low.

There is no vaccine for hepatitis C, however, is carrying out research in this area.

The virus can cause acute and chronic infection. Acute hepatitis C virus infection is usually asymptomatic, and only in rare cases with life-threatening diseases. About 15-45% of the infected people in the absence of any treatment can be infected within 6 months of their own virus clearance.

The remaining 55 - 85% infections happen to chronic hepatitis C virus infection. Chronic hepatitis C virus infection in these persons, within 20 years of cirrhosis risk of 15 - 30%.

geographical distribution

C in the world. The worst affected areas are Africa, Central Asia and East asia. Depending on the country, HCV infection can concentrate in some crowd (such as intravenous drug addicts) and / or the general population. There are many strains of hepatitis C virus (or genotype), the distribution of differences between regions.


Hepatitis C is a blood borne virus. The most common mode of transmission is:

Injecting drug use in a shared injection device;

In the case of health care, the use of a medical device or a thorough sterilization of medical devices, especially the use of syringes and needles;

Enter blood and blood products without screening;

The virus can also be spread through sexual way from infected mothers to their babies; however, this mode of transmission is not common.

C not through breast milk, food or drinking water, were hugging and kissing and sharing food or beverage such as accidental contact with an infected person will not be.


C the incubation period of two weeks to six months. About 80% of people do not appear to have any symptoms at first. Acute symptoms of the staff may have fever, fatigue, loss of appetite, nausea, vomiting, abdominal pain, dark urine, stool pale, joint pain and jaundice (yellowing of the skin and the whites of the eyes).

Screening and diagnosis

Due to acute hepatitis C virus infection is usually asymptomatic, therefore early diagnosis of hepatitis C virus infection is not common. For those who have chronic hepatitis C virus infection further personnel, infection is often not to diagnose, because infection in acquired infection after decades still did not appear until the symptoms, causing serious damage to the liver secondary symptoms of.

Two steps to make the diagnosis of hepatitis C virus infection:

Screening of anti hepatitis C virus antibody by serological detection, which can determine the personnel have been infected with the virus.

When the detection of antibody against hepatitis C virus positive, the need for nucleic acid detection of HCV RNA, to determine the presence of chronic hepatitis C virus infection, this is because the virus about 15-45% infection can be carried out under any treatment without immune response by the powerful automatic removal of infection. Although there is no infection, but detection of antibody against hepatitis C virus will still be positive.

When the diagnosis of chronic hepatitis C infection after infection should receive liver damage assessment (fibrosis and sclerosis). This can be achieved by liver biopsy or a variety of noninvasive testing methods.

In addition, these people should accept the laboratory testing, to determine the type of hepatitis C virus gene. There are 6 kinds of hepatitis C virus genotype, they respond differently to treatment. In addition, people may be infected with more than one genotype. Use of liver damage and viral genotype to guide treatment decisions and disease management.

Acceptance testing

Early diagnosis can prevent possible health problems caused by infection and prevent the spread of the virus. Who recommends screening for people with higher risk of infection.

High risk groups include hepatitis C virus infection:

Injecting drug users;

Health care institutions that are not adequately controlled for infection receive infected blood products or those who have a traumatic operation;

Hepatitis C virus infection by the birth of children;

There are sexual partners of hepatitis C virus infection;

HIV infected persons;

A prisoner or former inmate;

A person who uses nasal drops;

People with tattoos or piercings.


Because some people have immune response can be infected so clear, hepatitis C is not always in need of treatment, and some chronic infection did not appear liver damage. When in need of treatment, the goal is to cure hepatitis C treatment. The cure rate depends on a number of factors, including the viral strain and the treatment used.

The standard treatment for hepatitis C is undergoing rapid change. Until recently, hepatitis C treated with interferon and Leigh Bhave Lin therapy, which requires weekly injections of drugs for 48 weeks. About half of the patients can be cured, but often have side effects, sometimes fatal.

Recently, a number of new antiviral drugs have been developed. These drugs, known as direct antiviral drugs (DAA), are more effective, safer and better tolerated than older ones. Direct antiviral therapy can make most HCV infection were cured, and the treatment time is shorter (usually 12 weeks), more security. Although the production cost of direct antiviral drugs is not high, but the price is very high at the beginning of the manufacturers, even in high-income countries, this may also be difficult to obtain such drugs.

There is still a lot of work to be done to make sure that these advances make more people around the world.

(source:, Shanghai public health clinical center, Zhu Cuiyun)


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