What is Hepatitis C?

Hepatitis C, instigated by the hepatitis C virus (HCV), instigates a cascade of liver inflammation, potentially culminating in severe hepatic impairments such as cirrhosis, liver failure, or hepatocellular carcinoma. This viral infection presents a spectrum of manifestations, ranging from acute, transient illness to chronic, persistent affliction, posing significant health risks worldwide.

Causes of Hepatitis C

The primary mode of HCV transmission revolves around exposure to infected blood, often occurring through:

• Injection Drug Use: Sharing contaminated needles or syringes perpetuates HCV dissemination within vulnerable populations.
• Blood Transfusions and Organ Transplants: Historical deficiencies in screening protocols precipitated inadvertent HCV transmissions via blood products and donor organs.
• Healthcare-Associated Infections: Lapses in infection control measures within healthcare settings, compounded by inadequate sterilization practices, contribute to iatrogenic HCV transmissions.
• Perinatal Transmission: Although relatively infrequent, vertical transmission of HCV from infected mothers to neonates during childbirth remains a concern.

Symptoms of Hepatitis C

The clinical presentation of hepatitis C is heterogeneous, with symptoms encompassing a spectrum of manifestations, including but not limited to:

• Fatigue: Persistent, debilitating tiredness is a hallmark symptom of hepatitis C, often impairing daily functioning and quality of life.
• Jaundice: Characterised by the yellowing of the skin and sclerae, jaundice denotes underlying hepatic dysfunction and bilirubin accumulation.
• Abdominal Discomfort: Vague abdominal pain, discomfort, or bloating may ensue, often localised in the right upper quadrant.
• Gastrointestinal Disturbances: Nausea, vomiting, and diminished appetite are common gastrointestinal manifestations of hepatitis C, further exacerbating malaise.
• Musculoskeletal Symptoms: Joint pain, myalgias, and arthralgias are prevalent extracutaneous manifestations of hepatitis C, contributing to overall morbidity.

Diagnosis of Hepatitis C

Accurate diagnosis of hepatitis C entails a comprehensive evaluation incorporating:

• Serological Testing: Initial screening for HCV antibodies followed by confirmatory molecular assays to detect viral RNA facilitate definitive diagnosis and staging of infection.
• Liver Function Assessment: Measurement of serum liver enzymes, including alanine aminotransferase (ALT) and aspartate aminotransferase (AST), provides insights into hepatic inflammation and injury.
• Imaging Studies: Radiological modalities such as ultrasound, computed tomography (CT), and magnetic resonance imaging (MRI) aid in assessing liver morphology, identifying complications, and guiding therapeutic interventions.
• Liver Biopsy: Although increasingly supplanted by non-invasive alternatives, liver biopsy may be indicated in select cases to ascertain histological features, evaluate disease severity, and guide therapeutic decisions.

Treatment of Hepatitis C

Recent therapeutic advances have revolutionised the management of hepatitis C, with treatment modalities emphasising:

• Direct-Acting Antiviral Agents (DAAs): The cornerstone of pharmacological therapy, DAAs target specific viral proteins and enzymatic pathways, exerting potent antiviral effects with minimal adverse reactions.
• Combination Regimens: Tailored multidrug regimens comprising DAAs with complementary mechanisms of action optimise treatment efficacy, minimise resistance, and enhance sustained virological response rates.
• Adjuvant Therapies: Adjunctive measures, including hepatoprotective agents, nutritional supplementation, and lifestyle modifications, augment therapeutic outcomes, alleviate symptoms, and promote liver regeneration and functional recovery.

Prevention of Hepatitis C

Strategies to mitigate hepatitis C transmission and prevalence encompass:

• Public Health Education: Heightened awareness campaigns targeting at-risk populations, healthcare providers, and the general public foster understanding of HCV transmission routes, risk factors, and preventive measures.
• Needle Exchange Programs: Provision of sterile injection equipment, syringe exchange services, and opioid substitution therapy initiatives mitigate HCV transmission among injection drug users, curbing disease incidence and prevalence.
• Blood Safety Measures: Stringent screening protocols, donor eligibility criteria, and nucleic acid testing protocols ensure the safety and integrity of blood products, minimizing the risk of transfusion-associated HCV transmission.
• Perinatal Screening: Routine antenatal screening for HCV infection enables timely identification of infected mothers, facilitating targeted interventions to prevent vertical transmission and safeguard neonatal health.
• Harm Reduction Strategies: Implementation of harm reduction interventions, including condom promotion, safe sex practices, and sexual health education initiatives, attenuates the risk of sexual transmission of HCV, particularly among high-risk populations.

Hepatitis C constitutes a multifaceted public health challenge necessitating a comprehensive, multi-pronged approach encompassing prevention, diagnosis, and treatment interventions. Through concerted efforts, heightened awareness, and strategic implementation of evidence-based interventions, we can curtail the burden of hepatitis C, mitigate its adverse sequelae, and improve the overall health outcomes of affected individuals and communities worldwide.