Hepatitis C

Hepatitis C is likely to become a significant public health problem in the UK in the next decade. It is thought around 200,000 people are chronically infected with the virus. At risk groups include intravenous drug users and patients who received a blood transfusion prior to 1991 (e.g. haemophiliacs).

Transmission

• the risk of transmission during a needle stick injury is about 2%
• the vertical transmission rate from mother to child is about 6%
• breast feeding is not contraindicated in mothers with hepatitis C
• the risk of transmitting the virus during sexual intercourse is probably less than 5%

Features

• after exposure to the hepatitis C virus less than 20% of patients develop an acute hepatitis

Complications

• chronic infection (80-85%) - only 15-20% of patients will clear the virus after an acute infection and hence the majority will develop chronic hepatitis C
• cirrhosis (20-30% of those with chronic disease)
• hepatocellular cancer
• cryoglobulinaemia
• porphyria cutanea tarda (PCT): it is increasingly recognised that PCT may develop in patients with hepatitis C, especially if there are other factors such as alcohol abuse

Management of chronic infection