Presentation
HCV-RNA was documented at the time of presentation and 2 months later. [saudijgastro.com]
[…] on newer assays) probable case - has clinical presentation of acute illness with positive test for HCV antibodies but no positive virus detection test no report of test conversion or no test conversion within past 12 months clinical presentation of acute [dynamed.com]
Individuals who are Asian or Caucasian, female, young, and HIV-negative, as well as presenting a rapid drop in HCV RNA levels and presenting specific human leukocyte antigen class II alleles, together with the previously mentioned T cytotoxic response [scielo.br]
Two (3%) of 70 patients admitted for overt acute hepatitis C who were not chronic HBsAg carriers in the present series had FHF. [gut.bmj.com]
It may also be present in people with chronic hepatitis B when flares of disease activity occur. Hepatitis B surface Ag—this is a protein present on the surface of the hepatitis B virus. [labtestsonline.org]
Entire Body System
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Rigor
[…] virus (HCV) prevalence differs among hemodialysis units according to their geographical location, health care procedures, socioeconomic factors, reuse of lines, hygiene and sterilization of equipment, patient rotation of machines and the undertaking of rigorous [bmcpublichealth.biomedcentral.com]
[…] to 40%, have explored complementary and alternative medicines (CAM) often without the knowledge of their healthcare providers. 67 The usefulness of most CAM therapies, including dietary supplements, herbs, and unconventional treatments, has not been rigorously [clevelandclinicmeded.com]
Respiratoric
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Aspiration
Monitoring intrahepatic CD8 T cells by fine-needle aspiration cytology in chronic hepatitis C infection. J Viral Hepat. 2004; 11 :342–348. [ PubMed ] [ Google Scholar ] 99. Koziel MJ, Walker BD. [ncbi.nlm.nih.gov]
Gastrointestinal
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Nausea
In the small proportion of people who get sick during the acute infection, signs and symptoms include: Jaundice Dark urine White-colored stool Nausea Pain in the upper right part of the abdomen These signs and symptoms last for two to 12 weeks. [mayoclinic.org]
The CDC requires that a confirmed case of acute HCV meet both clinical criteria (discrete onset of symptoms such as nausea or malaise plus either jaundice or a peak elevated serum alanine aminotransferase (ALT) level 200 IU/L) and laboratory criteria [hepatitis.va.gov]
Patients with severe nausea and/or vomiting may need to be hospitalized for treatment and intravenous fluids. Acute HBV is not treated with antiviral drugs. [medicinenet.com]
They include: nausea vomiting loss of appetite fever fatigue abdominal pain joint pain dark urine light, clay-colored bowel movements jaundice, or yellowing of the skin and eyes If your doctor suspects that you have hepatitis C, they will draw blood to [healthline.com]
In the less common situation when patients do develop symptomatic acute HCV infection, they most often present with jaundice, dark urine, nausea, abdominal pain, and malaise. [hepatitisc.uw.edu]
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Dyspepsia
The most common symptoms were jaundice 12/30 (40%), fatigue (80%), abdominal pain (50%), loss of appetite (50%), and dyspepsia (40%). Laboratory testing at presentation showed median ALT levels of 803.5 IU/L (range: 400-3,763). [saudijgastro.com]
Skin
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Pruritus
[…] checkup that show abnormal results on liver tests or when someone has acute symptoms associated with liver damage, such as: Fever, fatigue Loss of appetite Nausea, vomiting, abdominal pain Dark urine and/or pale colored stool Joint pain Jaundice Itching ( pruritus [labtestsonline.org]
[…] features Incubation period : 2 weeks to 6 months Acute course Asymptomatic in 80% of cases Symptomatic (see also acute viral hepatitis ) Malaise, fever, myalgias, arthralgias RUQ pain, tender hepatomegaly Nausea, vomiting, diarrhea Jaundice, possibly pruritus [amboss.com]
[…] depression, psychosis), bone marrow suppression (neutropenia, thrombocytopenia) Ribavirin Haemolytic anaemia, nausea, rash Telaprevir Anaemia (additive to RBV), rash (occasionally life threatening), gastrointestinal upset, anorectal symptoms (burning, pruritus [racgp.org.au]
Clinicians should have a high index of suspicion for intrahepatic cholestasis or pregnancy in gravida with HCV and pruritus or jaundice, and evaluate these women with measurements of alanine aminotransferase (ALT), aspartate aminotransferase (AST), and [emedicine.medscape.com]
Workup
[…] clearance occurs, most have clearance within 6 months—failure to clear HCV by 6 months is a strong predictor of chronic HCV infection, except in persons with HIV coinfection, who often have delayed clearance of HCV. [ 18 ] Comprehensive Clinical Care during Workup [hepatitisc.uw.edu]
Approach Considerations Please note that the guidelines for the current diagnostic workup and management of hepatitis C (HCV) infection continue to rapidly evolve. [emedicine.medscape.com]
Microbiology
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Toxoplasma Gondii
Immunoglobulin G (IgG) antibodies against Epstein-Barr virus, human herpes virus type 6 and Toxoplasma gondii were detected at the first sampling point, indicating prior exposure. [mja.com.au]
Treatment
The chronic treatment scenario is, however, dominated by immediate treatment, given that chronic treatment was more costly and resulted in fewer QALYs gained than immediate treatment. [journals.plos.org]
Because the duration of treatment in the acute phase is potentially shorter (4‐6 weeks) compared with treatment in the chronic phase (8‐12 weeks), the cost of treatment in the acute phase is lower. [aasldpubs.onlinelibrary.wiley.com]
[…] of the treatment (week 12), and in 73% at 24 weeks after the end of the treatment [9]. [scielo.br]
Acute HCV Treatment Data Overall, treatment of acute HCV infection has been shown to result in high sustained virologic response (SVR) rates, even prior to the modern era of treatment with direct-acting antiviral (DAA) medications. [hepatitisc.uw.edu]
[…] when treatment is started as soon as possible (100% vs. 53% when initiating treatment during the 1 st month compared with delaying treatment). [10], [13], [15] Additionally, another study demonstrated that immediate treatment versus treatment starting [saudijgastro.com]
Prognosis
What is the prognosis of viral hepatitis? The prognosis of viral hepatitis for most patients is good; however, this prognosis varies somewhat depending on the infecting virus. [medicinenet.com]
In contrast, if HCV RNA is still detectable at week 24, the likelihood of an SVR is virtually nil and treatment can be stopped or continued with the only aim to slow liver disease progression in patients with a severe prognosis, without any hope to eradicate [medsci.org]
EASL–ALEH Clinical Practice Guidelines: non–invasive tests for evaluation of liver disease severity and prognosis. J Hepatol 2015; 63:237–264. Gara N Zhao X, Kleiner DE, et al. [clevelandclinicmeded.com]
Prognosis of chronic hepatitis C: results of a large, prospective cohort study. Hepatology. 1998 Dec. 28(6):1687-95. [Medline]. Hu KQ, Tong MJ. [medscape.com]
Etiology
Particular attention was paid to clinical presentation, history of alcohol use, prescription and nonprescription medications, recent hepatotoxic exposures, and the results of other laboratory testing to exclude other etiologies of liver injury. [jamanetwork.com]
Etiology Transmission Parenteral Needle sharing among IV drug users Needlestick injury (e.g., health care workers) Organ transplantation, dialysis, blood transfusion Sexual: rare (in contrast to HBV and HIV ) Perinatal (vertical) High-risk groups for [amboss.com]
Acute sporadic non-A, non-B hepatitis in northeastern Brazil: etiology and natural history. Hepatology 1999 ;30: 289 - 293 10. Pape GR, Gerlach TJ, Diepolder HM, Gruner N, Jung M, Santantonio T. [nejm.org]
Epidemiology
Global epidemiology of hepatitis C virus infection. Lancet Infect Dis 2005;5(9):558–567. 2. Sy T, Jamal MM. Epidemiology of hepatitis C virus (HCV) infection. Int J Med Sci 2006;3(2):41–46. 3. NNDSS Annual Report Writing Group. [www1.health.gov.au]
[…] model to the scenario of unrestricted DAAs by including the epidemiological impact after 2016. [journals.plos.org]
Much is known about the epidemiology, pathogenesis, diagnosis and management of chronic HCV infection. In comparison, knowledge about acute HCV infection is patchy. [eurosurveillance.org]
Principal Investigator: Greg Dore, MB BS FRACP National Centre in HIV Epidemiology and Clinical Research. [clinicaltrials.gov]
Epidemiology 2004;15 (5) 543- 549 PubMed Google Scholar Crossref [jamanetwork.com]
Pathophysiology
Clinical Information Discusses physiology, pathophysiology, and general clinical aspects, as they relate to a laboratory test Hepatitis A: Hepatitis A virus (HAV) is an RNA virus that accounts for 20% to 25% of the viral hepatitis in United States adults [mayocliniclabs.com]
Prevention
Currently, there is no vaccine to prevent infection with HCV. [labtestsonline.org]
An alternative approach is to treat the acute infection early with the goal of preventing progression. Two pieces of evidence suggest that early treatment can prevent the progression of chronic infection. [natap.org]
Early detection and treatment are the best ways to prevent the more serious form of hepatitis C. [healthline.com]
How is viral hepatitis prevented? Prevention of hepatitis involves measures to avoid exposure to the viruses, using immunoglobulin in the event of exposure, and vaccines. [medicinenet.com]
Centers for Disease Control and Prevention, Recommendations for prevention and control of hepatitis C virus (HCV) infection and HCV-related chronic disease. MMWR Recomm Rep 1998;47 (RR-19) 1- 39 PubMed Google Scholar 3. [jamanetwork.com]