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Viral Hepatitis ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Hepatitis C virus (HCV) ,[object Object],[object Object],[object Object],[object Object],[object Object]
Epidemiology ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Sources of Infection: parenteral  ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Sources of infection (CDC USA)
Clinical Manifestation ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Serologic pattern of HCV infection
Natural Hx of hepatitis C ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Diagnosis of hepatitis C ,[object Object],[object Object],[object Object]
Specific Test for HCV ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Anti HCV test  ;  A: EIA   B: RIBA A B
Interpretation of Anti-HCV Test Anti-HCV Anti-HCV HCV-RNA Interpretation EIA   RIBA   Positive  Positive  Positive Current infection Positive  Positive  Negative Intermittent viremia or resolved infection Positive  Negative   - Uninfected Negative   -   - Uninfected Positive  Indeterminate  Negative False positive anti HCV test Positive  Indeterminate  Positive *Recent HCV infection *Persistent finding in some  chronic HCV
Anti HCV screening test, RIBA and HCV RNA result In groups with different HCV prevalence HCV prevalence  Total test No(%)   RIBA result(%) HCV RNA positive  Neg Ind. Pos  positive (%) 0.8-4.4%   24,012  689   27  7  66   41* 9.5%   2,936  351   10  7  83   80 24.9%   498  124   2  4  94   NA+ *: only 214 sample were test for HCV RNA *: Not assess
Treatment of Chronic Hepatitis C Indication : ALT level >1.5 x upper normal limit on  three consecutive occasions  ≥  3 months : Liver Bx indicate active disease  Regimen : Combination of Interferon alpha 3 MU TIW and ribavirin  1000-1200  mg/d   x 24 weeks for genotye 2 and 3 and 48 weeks for genotype 1 Successful treatment : clearance of HCV RNA from  serum 6 month after therapy

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Viral Hepatitis

  • 1.
  • 2.
  • 3.
  • 4.
  • 6.
  • 7. Serologic pattern of HCV infection
  • 8.
  • 9.
  • 10.
  • 11. Anti HCV test ; A: EIA B: RIBA A B
  • 12. Interpretation of Anti-HCV Test Anti-HCV Anti-HCV HCV-RNA Interpretation EIA RIBA Positive Positive Positive Current infection Positive Positive Negative Intermittent viremia or resolved infection Positive Negative - Uninfected Negative - - Uninfected Positive Indeterminate Negative False positive anti HCV test Positive Indeterminate Positive *Recent HCV infection *Persistent finding in some chronic HCV
  • 13. Anti HCV screening test, RIBA and HCV RNA result In groups with different HCV prevalence HCV prevalence Total test No(%) RIBA result(%) HCV RNA positive Neg Ind. Pos positive (%) 0.8-4.4% 24,012 689 27 7 66 41* 9.5% 2,936 351 10 7 83 80 24.9% 498 124 2 4 94 NA+ *: only 214 sample were test for HCV RNA *: Not assess
  • 14. Treatment of Chronic Hepatitis C Indication : ALT level >1.5 x upper normal limit on three consecutive occasions ≥ 3 months : Liver Bx indicate active disease Regimen : Combination of Interferon alpha 3 MU TIW and ribavirin 1000-1200 mg/d x 24 weeks for genotye 2 and 3 and 48 weeks for genotype 1 Successful treatment : clearance of HCV RNA from serum 6 month after therapy