What is hepatitis C?
Hepatitis C (HCV) is an infectious disease that affects the liver and is caused by the HCV virus.
Around 170 million people worldwide infected with this pathogen are at high risk of developing long-term liver damage, including cirrhosis, chronic hepatitis and cancers.
Italy is one of the European countries where the virus is most present, particularly in the south and on the islands.
How is it transmitted?
The transmission of the HCV virus occurs mainly by blood, through contact with blood or biological fluids infected with the HCV virus.
Risk factors that involve the transmission of the HCV virus can include:
- Sharing dirty needles and filters when taking drugs or medication;
- Birth to an HCV-positive mother;
- Sharing personal items contaminated with infected blood, such as razors and toothbrushes;
- Performing piercings and tattoos with non-sterile needles;
- Receipt of donations of blood, blood products and organs, if the donation took place before 1992;
- Infected needle stick injury in the healthcare sector
- Dental equipment that has not been properly sterilised.
How is hepatitis C treated?
The primary goal of hepatitis C therapy is viral eradication. In recent years, the therapeutic options available against this disease have increased thanks to the marketing of drugs with an innovative mechanism of action, known as direct-acting antiviral agents (DAAs). These drugs have made it possible to considerably increase the percentage of therapeutic success in the chronic form of the infection.
New IFN-free therapeutic schemes (involving the combination of two or more DAAs, sometimes combined with another classic drug, ribavirin) are also emerging, which appear both more effective and considerably safer, based on data from clinical trials.
What damage does hepatitis C cause?
The infection in the course of its evolution can cause progressive damage to the liver, with modification of the normal anatomical structure replaced in the course of the infectious process by fibrotic liver tissue, resulting in:
- liver cirrhosis,
- chronic hepatitis,
- hepatocellular carcinoma.
How long does it take to manifest?
The infection often runs asymptomatically or presents vague and non-specific symptoms. Frequently, people do not know they are infected with HCV until liver damage occurs, which may reveal itself during routine clinical tests, perhaps decades after the time of infection. Hepatitis C can sometimes appear in an acute form, with short-term symptoms, after which there is an improvement in the patient’s clinical condition. The chronic form of hepatitis C affects about 75%–85% of patients infected with the HCV virus.
Diagnosis of hepatitis C
Diagnosis of HCV infection is made by taking blood samples. Considering that the disease is almost always asymptomatic, it is recommended to perform a screening test by searching for anti-HCV antibodies.
In the event of a negative result, no further investigations are necessary; conversely, further investigations are required to specify the type of infection (chronic or acute, active or inactive, current or previous). In particular, the determination of a test to detect the presence of the HCV viral load.
Once the diagnosis of HCV infection is confirmed, it is necessary to determine the genotype to determine the most appropriate therapeutic option. The viral load must be monitored over time to verify that it is reduced and reduced to zero following drug therapy.
Dr Angela Marano
Specialist in Pathology and Clinical Biochemistry
