Hepatitis C Virus (Flaviviridae)

The hepatitis C virus (HCV), a member of the Flaviviridae family, is an enveloped virus with positive-sense, single-stranded, non-segmented RNA. The RNA dependent RNA polymerase of HCV lacks proofreading exonuclease activity, leading to frequent mutations and antigenic variation. HCV can be transmitted through shared needles, blood transfusions, and other routes. In acute HCV infection, fluctuating ALT levels can be observed, while chronic infection may progress to cirrhosis and hepatocellular carcinoma. HCV infection is detected using both an HCV antibody test and an HCV RNA test (PCR), with a positive HCV RNA test indicating active infection. A negative HCV antibody test with a positive RNA test suggests occult HCV infection. Direct-acting antivirals are effective treatments for HCV. When treating HCV, ensure patients are vaccinated for hepatitis A and B unless already immune. For chronic HCV patients, regular monitoring of serum alpha-fetoprotein and liver ultrasounds is recommended to monitor for hepatocellular carcinoma.

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