Hepatitis C Virus (HCV)
Dr. med. Hartmut Campe, Dr. med. Hanns-Georg Klein
Hepatitis C Virus (HCV) infection is acquired through blood and sexual contact, although symptoms of acute hepatitis seldom occur. In the majority of cases, infections are chronic. Comorbidities include diabetes mellitus and kidney disease. Possible sequelae of an HCV infection are cirrhosis (loss of function of the liver due to connective tissue replacement of destroyed cells) and hepatocellular carcinoma.
HCV infection is treatable, although the therapy combination with interferon used to date is no longer the first choice for treatment. New medications ("direct acting antivirals"; DAAs) which affect virus replication due to inhibition of viral protease and polymerase were approved in 2014. DAAs enable a high chance of recovery compared to old medication combinations in a considerably shorter therapy time.
HCV infection is diagnosed by a HCV screening test. If reactive, the HCV RNA is quantitatively determined (viral load). The HCV confirmation test is today used only for the detection or exclusion of unspecified screening test reactivity. HCV genotyping / subtyping prior to therapy beginning influences the choice of therapeutic agents.
Since hepatitis C virus infection usually runs for years without serious clinical symptoms, the number of unreported cases in Germany is high. Screening for HCV antibodies is advised in the case of historical blood transfusions (in Germany, blood products have been tested for HCV since the early 90s). People from countries with an elevated HCV prevalence and people who have on at least one occasion injected drugs intravenously should, after consultation with their doctor, be tested for HCV.