Hepatitis C

Hepatitis C

Kusa Terianm, MD

Hematoxylin & eosin stain shows dense portal inflammation composed primarily of lymphocytes.

Trichrome stain demonstrates portal fibrous expansion image and periportal fibrous extension image.



  • Hepatitis C virus infection (HCV)


  • Hepatitis, usually chronic, secondary to hepatitis C virus infection


Infectious Agents

  • Enveloped, single-stranded RNA virus of Flaviviridae family

    • Positive-sense RNA encodes a single polypeptide

    • Polypeptide post-translationally cleaved to form structural, nonstructural, and envelope proteins

  • Inherent high mutation rate generates viral heterogeneity

    • 6 viral genotypes and over 50 subtypes

      • Vary in geography, mode of transmission, and response to treatment

Modes of Transmission

  • Blood transfusion

  • Needlestick inoculation

  • Perinatal exposure probably occurs with low efficiency

  • Efficiency of sexual transmission is controversial but probably low


  • Virus is directly cytopathic and induces immunemediated cellular injury



  • Incidence

    • Worldwide seroprevalence of HCV antibodies (anti-HCV) estimated at 3%

    • Estimated 3-4 million persons infected in United States


  • Fatigue

  • Nausea and anorexia

  • Depression and difficulty concentrating

  • May be asymptomatic

Laboratory Tests

  • Antibodies (anti-HCV) indicate exposure

  • Detection of HCV RNA indicates virus persistence

  • Liver biopsy performed to grade and stage disease and exclude other liver diseases

Natural History

  • Acute infection is often subclinical

  • Fulminant hepatitis is rare

  • Produces persistent (chronic) infection in 85% of infected persons

    • Defined as failure to clear virus in 6 months

    • Remaining 15% have self-limited infection


  • Drugs

    • Standard therapy is pegylated interferon-α in combination with ribavirin

Jul 7, 2016 | Posted by in PATHOLOGY & LABORATORY MEDICINE | Comments Off on Hepatitis C
Premium Wordpress Themes by UFO Themes
%d bloggers like this: