Brief presentation on Hepatitis C Virus which is best for medical students.

2. Submitted To : Dr. Muhammad Shafique
Submitted By : Shaheer Shahryar
Roll No. : 7734

3. VIRUS
Virus is an obligatory intracellular parasite and it is
made up of complexes consisting of protein and
RNA/DNA genome. It lacks both cellular structure and
independent metabolic process. Replicate solely by
exploiding the living host cells based on the
information in the viral genome.

4. Introduction of HCV
HCV cause liver disease both chronic and acute
hepatitis.
Most common chronic blood borne infection.
Small enveloped RNA virus.
Belonging to family Flaviviridae and genus hepacivirus.
Positive sense single stranded RNA virus.
Classified into 11 genotype.

5. Structure of HCV

6. Life Cycle of HCV

7. HCV Infection Rate
 Approximately, HCV infects 170 millions individuals
worldwide.
 15%-20% cases of acute hepatitis.
 50% to 80% of HCV patient will develop chronic
infection.
 15% to 40% of them could clear the virus.
 Approximately 399,000 people die each year from
Hepatitis C.

8. Route of Transmission
The hepatitis C virus is a bloodborne virus. It is most
commonly transmitted through:
• Surgical/dental procedures.
• the transfusion of unscreened blood and blood
products.
• Contaminated syringes and needles.
• Razors/blades and other sharp instruments.
• Drug abusers.
HCV can also be transmitted sexually and can be
passed from an infected mother to her baby.

9. Symptoms
Incubation period of Hepatitis C is 2 weeks to 6
months.
Approximately 80% of people does not exhibit any
symptoms.
 Those who are acutely symptomatic may exhibit :
fever, fatigue, nausea, decreased appetite, vomiting,
abdominal pain, dark urine, grey-coloured faeces, joint
pain and jaundice (yellowing of skin and the whites of
the eyes).

10. Diagnosis
HCV infection is diagnosed in following ways :
Serological Techniques :
• Screening of anti-HCV antibodies.
• ELISA (Enzyme Linked Immunosorbent Assay)
• RIBA (Recombinant Immunoblot Assay)
Molecular Techniques :
• Polymerase Chain Reaction (PCR)
• Ligase Chain Reaction (LCR)
• Branched Chain DNA Amplification (bDNA)
Tissue Biopsy

11. Treatment
 Around 50% to 80% of person with acute hepatitis C
will develop CHC infection, and 5% to 25% of them
reportedly progress to cirrhosis after 20 to 25 years.
 Goal of antiviral treatment for CHC is to halt disease
progression, prevent cirrhosis decompensation and
reduce the risk of HCC.
 SVR is the primary endpoint of successful therapy and
is associated with durable clearance of virus.

12. Drugs
 In early 2000s, combination of pegylated interferon
plus ribavirin (PR).
 In 2011, boceprevir (trade name Victrelis) and
telaprevir (trade name Incivek) for the traetment of
chronic HCV genotype 1 infection.
 In 2013, simeprevir ; NS3/4A protease inhibitor.
 In 2013, sofosbuvir in combination with ribavirin for
oral dual therapy of HCV genotype 2 and 3 and for
triple therapy with PR for treatment-naïve patients
with HCV genotype 1 and 4.

13. Guidelines for Hepatitis C
treatment
 Without taking resource used into consideration, WHO
provides the following guidelines :
1. Pegylated interferon in combination with ribavirin is
recommended for the treatment of CHC.
2. Treatment with DAAs telaprevir and boceprevir, given in
combination with PR, is sugested for genotype 1 chronic
HCV infection.
3. Sofosbuvir, given in combination with ribavirin with or
without pegylated interferon, is recommended in
genotypes 1, 2, 3 and 4 HCV infection.
4. Simeprevir, given in combination with PR, is recommended
for persons with subtype 1b HCV infection and for person
with subtype 1a HCV infection without the Q80K
polymorphism.

14. Prevention from HCV
There is no vaccine for HCV.
Prevention of HCV depending on the reducing to the
risk of exposure to virus.
Some preventions are following :
• Safe and appropriate use of injection.
• Disposal of sharps and blade.
• Screening of donated blood.
• Training of health personnel.
• Regular monitoring for early diagnosis of chronic liver
disease.