HEPATITIS C VIRUS

The hepatitis C virus (HCV) is an RNA virus closely related to the Flavivirus group.

Disease

• most cases of acute hepatitis C are asymptomatic
• symptomatic disease is usually mild
• 75% of cases progress to chronic infection
• 8% of patients with chronic infection go on to develop cirrhosis, liver failure or hepatocellular carcinoma

Mode of transmission

HCV is predominantly transmitted via contaminated blood. The risk of infection following needle stick injury with HCV positive blood is around 3%
Human body fluids including saliva, ascites and urine, all contain significant concentrations of HCV in infected patients.
Standard Precautions are the principal means of preventing transmission of HCV.

Significance in endoscopy

There is convincing evidence of transmission of HCV associated with endoscopic procedures, in many cases this seems related to inadequate cleaning. In most reports of endoscopic transmission of HCV there have been clear and gross deficiencies in the endoscope and accessory reprocessing.
At present the overwhelming evidence is that cleaning and disinfection protocols, when properly applied during endoscope and accessory reprocessing, will render instruments and accessories free of the risk of transmission of HCV. Failure to prevent endoscopic transmission of HCV has been due to wilful or inadvertent deficiencies in appropriate cleaning and disinfection protocols or (possibly) inadequate anaesthetic techniques.
-----------------------------------------------------
This mode of action video shows the hepatitis c virus cycle, from entry into the cell to the release of the viral particle