Hepatitis C HCV

Organism Hepatitis C virus (HCV).

Clinical features Similar in many respects to hepatitis B, HCV produces a milder disease, but as many as 10-20% will progress to cirrhosis and 1% to liver cancer in later life.

Diagnosis is difficult, dependent upon detecting antibodies to HCV and confirming by a recombinant immunoblot assay (RIBA). PCR is now commonly used.

Transmission is due to the use of poorly sterilized needles, giving-sets and other methods of parental administration and so is common in developing countries and in those who abuse drugs in developed countries. Sexual or perinatal transmission probably only occurs rarely.

Incubation period 2 weeks to 6 months (usually 6-9 weeks).

Period of communicability Weeks before the start of clinical symptoms to lifelong.

Occurrence and distribution Infection is found worldwide in the general population in developing countries and mainly in drug users sharing equipment in developed countries. However, there are probably many more cases than present figures suggest and WHO estimates that there are 200 million people infected, which amounts to 3% of the world's population. This means that there are about 170 million chronic carriers who could go on to develop cirrhosis or liver cancer.

Control and prevention There is no vaccine for HCV, so all precautions need to be taken to prevent further spread by rigorous adherence to sterilization of needles and instruments.

Treatment and surveillance See hepatitis B above.

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