Hepatitis C :-

The Hepatitis C virus (HCV) is probably the most common cause of chronic hepatitis, along with cirrhosis and the hepatocellular cancers in the world. It is also a common reason for liver transplants. By viral description, it is a single stranded RNA virus, and a genus of the family Flavaviridae. Of interest, the Flavaviridae also include Yellow fever and the St. Louis encephalitis viruses. The genome of the virus possesses a polyprotein of about 3,000 amino acids. There are six serologic types, as well as a number of subtypes, which can differ in their response to treatment.-

Type 1 is the most common (55% of patients in North America) and is the most resistant to treatment. It is also associated with a more severe form of liver disease along with a heightened risk of chronicity. About 75% of infected individuals cannot eliminate the virus and become chronic carriers. About 35–40% will likely develop cirrhosis and eventual liver failure. Within this category, approximately 15–20% will consequently develop hepatic carcinoma (liver cancer).-

By virological description, and of keen concern, the HCV employs an RNA dependent RNA polymerase during its replication cycle, which is highly vulnerable to making mutational errors. One of its envelop proteins (E2 protein) is especially prone to mutation, most likely because of selective pressure from antibodies developed by the infected host to the virus. What this means in reality is that the virus changes rapidly enough, whereby the immune system cannot efficiently eliminate it. It is for this reason that no immunizing agent (vaccine) is yet available. Of interest, mutational mechanisms of viruses can vary, especially of the RNA forms. The present COVID-19, is a positive sense single stranded RNA, and it has been mutating as it spreads.

However, many of these mutations create little change within the virus itself, and in fact some of these mutations might even block the viruses quest to eventually replicate and spread, regardless of how easily the virus can spread from one individual to another. The present day vaccines, (Moderna, Pfizer) can still efficiently block the viral replication, and offer a comfortable margin of protection. The HCV, it is likely that the wide diversity of genotypes contributes to the pathogencity of the virus, allowing it to escape the actions of host immune mechanisms and in preventing the creation of a developmental vaccine.- Curiously, Hepatitis B for example is cleared naturally by some individuals. A vaccine for HBV is available, yet there is no treatment for it.

The main route of viral transmission of HCV about 30 years ago, was via contaminated blood transfusions, or blood products. Today, this form of infection is close to zero due to HCV testing implementations. Still, unsafe medical procedures, and unscreened blood transfusions are still considered important sources of HCV infection, especially in less developed countries.

Today, the recreational injecting drug use is probably the most common mode of HCV transmission in the US and Canada. In addition, risky sexual behavior, such as with multiple partners, or sex with an HCV positive partner, is probably second in place.- Infants born to HCV positive mothers occurs as well, though this is less than 10% of cases. Accidental needle stick injuries, tattooing, acupuncture and body piercing can all qualify as potential exposure risks. - HCV can take months to years to appear, as this should warn risk takers who could have HCV and not even know it, until symptoms start to surface.

Aside from accidental exposure, it is vital that anyone interested in tattoos, body piercing, or whatever else is out there, employ extreme caution, even if these activities don’t necessarily pose the greatest risk. All establishments should be surveyed and checked by professional review regarding safety history. It is your liver; take care of it, as it has taken care of you.—

In conclusion, and by the way, the good news today is that chronic HCV is treatable with oral medications, usually administered every day for several months. Treatment will depend on genotype classification. Some examples of drug names are Declatasvir, Elbasvir and Glecaprevir, to name but several.-

You might want to read more about HCV regarding the clinical picture.- Other hepatitis viruses of interest are; Hepatitis A, B, C, D, and E.