HEPATITIS C

NATURAL COURSE OF HEPATITIS C

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In patients with hepatitis C infection, 25-50% clears the infection spontaneously. These are diagnosed by positive anti-HCV antibodies and negative HCV RNA. These patients also have normal liver enzyme levels. More women clear the infection then men.

Patients who develop chronic HCV usually have nonspecific symptoms such as malaise and fatigue. On investigation these patients have elevated ALT levels along with positive HCV RNA .These patients may also present with some extra hepatic symptoms and signs such as -diabetes mellitus, rheumatoid arthritis, keratoconjuctivitis sicca, mixed cryoglobulinemia, membranoproliferative glomerulonephritis, nephrotic syndrome, and porphyria cutanea tarda.

Many factors have been seen to be associated with the progression of disease and fibrosis of liver. These include gender (males are more likely to have progressive disease), age (patients more than 40), duration of the infection, alcohol consumption, HCV genotype and level of HCV viremia.

The disease is known to progress in three ways, rapid, intermediate, and slow. When the progression is rapid the patient develops cirrhosis in 10-15 years. The people who progress slowly may not progress to cirrhosis even in 40 years.

Other contributing factor for rapid development of the disease is the presence of fatty liver. Fatty liver may be present in people who have metabolic disorders such as Diabetes Mellitus or lipid disorders.

About 20-30% of patients who develop chronic hepatitis C infection will have cirrhosis in 20-30 years. This leads to the common complications of cirrhosis such as portal hypertension Ascites, Encephalopathy, Variceal bleeding, coagulation dysfunction, bacterial peritonitis and finally hepatocellular carcinoma (HCC) Rapid liver disease progression is not universal, and is affected by a variety of known and unknown factors.

Regular screening and detecting asymptomatic patients and following up these patients will help in controlling the progression and spread of the disease.

For any further questions write to us on lifelinelab@lifelinelaboratory.com or visit us at lifelinelaboratory.com or call us at 7290076339

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