1. What is Hepatitis C? How is HCV spread from one person to another?

Hepatitis C is a kind of viral hepatitis, caused by hepatitis C virus(HCV), characterized by liver inflammation, which, if persistent and not cured, could lead to serious liver damage. HCV is an enveloped RNA virus from the Flaviviridae family and genus hepacivirus. Currently, there are seven recognized HCV genotypes, of which genotypes 1 and 3 have the highest incidence worldwide. HCV spreads through contaminated blood.

2. Who is at risk for contracting HCV?

People who inject drugs  remain a high-risk group for HCV infection. People with high-risk sexual practices (multiple sexual partners, men who have sex with men) are another high risk group. Other risk groups include:  healthcare workers who suffer needle-stick accidents; patients who have undergone certain procedures such as hemodialysis in facilities with inadequate infectious control, as well as those who have had blood transfusions or organ donations prior to 1992; people who received a piercing or tattoo in an unclean environment using unsterile equipment; people who were born to a woman with a hepatitis C infection; people who were ever in prison; people who were born between 1945 and 1965, the age group with the highest incidence of hepatitis C infection.

3. What is the difference between acute and chronic HCV?What are the symptoms to be aware of?

The period right after you're infected with hepatitis C virus is known as the acute stage of infection. Acute hepatitis C usually goes undiagnosed because it rarely causes symptoms. When signs and symptoms are present, they may include jaundice, along with fatigue, nausea, fever and muscle aches. Acute symptoms appear one to three months after exposure to the virus and last two weeks to three months.Acute hepatitis C infection doesn't always become chronic; about 15% to 25% of acute cases clear successfully HCV from their bodies.

Long-term infection with the hepatitis C virus is known as chronic hepatitis C. Chronic hepatitis C is usually a "silent" infection for many years, until the virus damages the liver enough to cause the signs and symptoms of liver disease. Signs and symptoms include: bleeding easily, bruising easily, fatigue, poor appetite, jaundice ,dark-colored urine, itchy skin, abdominal fullness or edema in your legs.

4.How is HCV diagnosed?

Checking blood HCV using  the third-generation  EIA can be accurate in the diagnosis of HCV infection. Those who have a positive HCV EIA undergo quantitative HCV RNA testing using nucleic acid amplification technology to diagnose active infection.

5.Is Hepatitis C common in China?

HCV  affects 1.0% of the worldwide population. According to the WHO, there is a global estimate of 71 million chronic HCV cases. About 1.75 million new cases were estimated worldwide in 2015. The five countries with the highest number of individuals chronically infected with HCV are in descending order: China (9.8 million), Pakistan (7.1 million), India (6.2 million), Egypt (5.6 million) and Russia (4.7 million).

6. How is HCV treated? Are there side effects to treatment?

        Early treatment options for HCV  includes IFN and pegylated IFN therapy. Ribavarin was also used alongside IFN therapy for HCV treatment. With the development of direct antiviral agents (DAAs), treatment of HCV has evolved to targeting specific components that dictate HCV processing and replication. The new antiviral agents include Harvoni - sofosbuvir combined with the NS5A inhibitor ledipasvir; Viekira Pak, a combination of ombitasvir, paritaprevir and ritonavir plus dasabuvir; and Olysio (simeprevir) combined with Sovaldi (sofosbuvir). These regimens are effective against genotypes 1a and 1b. The NS5A inhibitor Daklinza (daclatasvir) is approved for use with sofosbuvir for chronic genotype 3 HCV infection. A fourth drug regimen, Technivie -combined ombitasvir, paritaprevir and ritonavir - is approved for treatment of genotype 4 HCV without cirrhosis in combination with ribavirin.

        Anti HCV drugs have unpleasant side effects, include: fatigue, headache and muscle aches, cough,  depression, mood swings and irritability, insomnia, hair loss, nausea,diarrhea or bad taste.

7. Is there a vaccine to prevent HCV like there is for HBV?

       Up to now there is no breakthrough in the development of a successful vaccine for HCV for  several reasons.  Perhaps its variable character is the main obstacle. Hepatitis C occurs in at least seven genetically distinct forms with multiple subtypes. About 60 subtypes have been identified. Different genotypes cause infections in different parts of the world. A global vaccine would have to protect against all variants of the virus, so the challenge is great.

8. Who should  be tested for HCV?

       As HCV carriers often have no symptoms, it is estimated that  half of the people with HCV don’t know they have infected.  WHO  in 2016 recommended that HCV serology testing should be offered to individuals from three different populations:  Individuals from the most affected population, i.e., who are part of a population with high HCV seroprevalence or who have a history of HCV risk ; all individuals from the general population if HCV antibody seroprevalence is ≥2% or 5% ; specific identified birth cohorts of older persons(born between 1945 and 1965 )at higher risk of infection and morbidity within populations that have an overall lower general prevalence.

      9. Can you drink alcohol if you have HCV?

Researches have shown that alcohol worsens chronic hepatitis C-related liver damage and the resulting health risks in lasting ways; so as a rule, you should avoid alcohol if you concern about your liver.