Acute hepatitis C: prevention and treatment

Abstract

HCV can cause acute or chronic hepatitis and is a health problem all over the world. It is one of the leading causes of cirrhosis and hepatocellular carcinoma, and is a common indication for liver transplantation. Unrecognized patients with HCV infection may transmit the virus to uninfected people. The acute form of the disease leads to chronic hepatitis in the majority of cases. Since the success rate of treatment given in the chronic phase is much lower than that given in the acute phase, recognizing acute hepatitis is critical. Although HCV is less prevalent since 1990s in the Western world after improved blood-donor screening programs, needle-exchange facilities and education among intravenous drug users, it is still endemic in some regions, including African countries, Egypt, Taiwan, China and Japan. Acute HCV infection may be a challenge for the clinician; since it is often asymptomatic, detection and diagnosis are usually difficult. After an incubation period of 7 weeks (2-12 weeks), only a minority of patients (10-15%) report symptoms. The spontaneous clearance of the virus is more frequent primarily during the first 3 months of clinical onset of the disease, but may occur anytime during the 6 months of acute infection. This spontaneous resolution seems to be more frequent in symptomatic cases. Viremia persisting more than 6 months is accepted as chronic infection. The virus is transmitted more frequently through infected blood or body fluids. Detection of antibodies against HCV is not a reliable method of diagnosing acute HCV infection since the appearance of antibodies against HCV can be delayed in up to 30% of patients at the onset of symptoms. Thus, the diagnosis of acute hepatitis C relies on the qualitative detection of HCV RNA, which may appear as early as 1-2 weeks after exposure quickly followed by highly elevated alanine aminotransferase. After a follow-up period of 8-12 weeks for allowing spontaneous resolution, treatment should be initiated. Pegylated interferon monotherapy for 24 weeks seems effective, and the therapy can be individualized according to the characteristics of the patient.

A Study on the Biological activity of Hepatitis C Analogs Prediction by QSAR -An Insilco Approach

“…Hepatitis C is the cause of 27% of cirrhosis cases and 25% of hepatocellular carcinoma worldwide 10 .Liver cirrhosis may lead to portal hypertension, ascites (accumulation of fluid in the abdomen), easy bruising or bleeding, varices (enlarged veins, especially in the stomach and esophagus),jaundice, and a syndrome of cognitive impairment known as hepatic encephalopathy. It is a common cause for requiring a liver transplant 11 .…”

Prevenção do carcinoma hepatocelular

“…A infecção é predominantemente adquirida na idade adulta, como resultado do uso ilícito de drogas endovenosas e transfusões sanguíneas ou fluidos corporais contaminados. Oitenta por cento ou mais dos infectados agudamente se tornam portadores crônicos 19,20,23 da doença, e aproximadamente 20% evolui com cirrose. A relação do VHC com o CHC é provavelmente o resultado da necroinflamação hepática induzida pelo vírus (pois não há integração viral aos genomas do hospedeiro), e há evidências recentes que sugerem que o vírus possa agir também como fator carcinogênico direto.…”

“…Ainda não há vacina disponível contra o vírus da hepatite C, portanto, a prevenção primária consiste em redução do comportamento de risco, práticas seguras de uso de seringas e extenso controle de sangue, plasma e hemoderivados a serem transfundidos 11,19 .…”

Perspectives on the management of chronic hepatitis B and C

“…Acute hepatitis C is discussed by Ozaras and Tahan [21]. HCV can be transmitted via three routes: parenterally (usually intravenous drug use [IDU] or blood product transfusion), permucosally (usually sexually) or vertically.…”