Two Different Cases Of Hepatitis C Virus

Hepatitis is a term that means inflammation of the liver. It can be caused by many different things, one of which can be from a virus. Let’s take a retrospective look at two people who unknowingly had a Hepatitis C virus. 

Jacob was in his twenties when he was seriously injured in a car accident. Through his long recovery, he became addicted to his pain medication. It became quite severe and when the doctor stopped prescribing his pain medication, he turned to heroine. That’s how he met Anna. They both struggled with heroine addiction, injecting the drug at least once daily. 

As their lives spiraled out of control, they resorted to riskier practices of drug use and were sharing needles with people they didn’t even know. Several weeks after this began, Anna became ill with flu-like symptoms and Jacob did not. It was a common illness and not too much thought was given to it. 

Thankfully after a series of events, both Jacob and Anna successfully completed rehab and led a successful life. Now, Jacob was in his forties and he became ill. His skin was yellow in color and his abdomen was distended. 

Both Jacob and Anna had the Hepatitis C virus. Anna’s illness was acute meaning that it lasted less than six months. Although she never knew she had Hepatitis C, she was part of the small percentage that fully recover without treatment. Jacob had a chronicinfection meaning that it lasted more than six months, in fact it lasted twenty years for him. Even though he had the infection all of this time, he was unaware of it until he developed symptoms from his advanced liver damage.

It is bloodborne, meaning it is spread from one person to another in the blood. The majority of cases are due to injected drug use in which needles are shared.

Since 1992, donated blood has been tested for Hepatitis C but prior to this people could contract a Hepatitis C virus through receiving blood transfusions. Inadequate medical equipment sterilization can also spread Hepatitis C from one person to another. It can be passed from mother to baby during childbirth but it is not passed through breast milk. It can be passed from one to another through sexual intercourse. 

Unique Features

• most common cause of cirrhosis is HCV
• most common cause of acute viral hepatitis leading to chronic hepatitis ( Risk of conversion)
• Hallmark feature = pauci inflammatory reaction in acute phase
• Virus that comes in acute phase causes chronicity
• HCV inhibit insulin function leading to post receptor signalling of insulin resistance

The majority of Hepatitis C infections do not have any symptoms present. As we saw with Jacob, he didn’t show any symptoms and was unaware that he had Hepatitis C. With chronic Hepatitis C, a person can remain asymptomatic for decades. They are usually only diagnosed after they start having symptoms from advanced liver disease as a result of the Hepatitis C virus. 

Serology

• HCV RNA = Gold standard marker for diagnosis of HCV
• Anti HCV = Screening test of choice (IgG)