Viral Hepatitis C

Infection requires contact between the blood of an infected person and the blood of an uninfected person:

• Blood transmission: intravenous drug use, hemodialysis, blood transfusion before 1991
• Mother-to-child transmission, which is rare, during childbirth
• Transmission during medical procedures (inadequate sterilization)
• Sexual transmission, which is exceptional

Hepatitis C virus infection always causes acute hepatitis. In 10 to 40% of cases, the body clears the virus spontaneously, with complete recovery without treatment. In 60 to 90% of cases, it progresses to chronic hepatitis, which requires treatment.

Blood tests are enough to determine the severity of the disease. They include viral RNA and a complete liver panel. The degree of fibrosis is assessed with a Fib-4 test (which replaces FibroScan and FibroTest). In case of advanced fibrosis, an upper GI endoscopy is requested. A liver ultrasound is also part of the initial work-up.

Treatment of chronic hepatitis C has changed considerably. It is an oral treatment lasting 8 to 12 weeks, rarely 24 weeks. It is nearly 99% effective and very well tolerated.