Hepatitis C virus

Last updated: September 12, 2024

Hepatitis C virus

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Thymus histology
Spleen histology
Lymph node histology
Introduction to the immune system
Cytokines
Innate immune system
Complement system
T-cell development
B-cell development
MHC class I and MHC class II molecules
T-cell activation
B-cell activation, differentiation, and contraction
Cell-mediated immunity of CD4 cells
Cell-mediated immunity of natural killer and CD8 cells
Antibody classes
Somatic hypermutation and affinity maturation
VDJ rearrangement
Contracting the immune response and peripheral tolerance
B- and T-cell memory
Anergy, exhaustion, and clonal deletion
Vaccinations
Type I hypersensitivity
Type II hypersensitivity
Type III hypersensitivity
Type IV hypersensitivity
Sepsis
Neonatal sepsis
Abscesses
Food allergy
Anaphylaxis
Asthma
Immune thrombocytopenia
Autoimmune hemolytic anemia
Hemolytic disease of the newborn
Rheumatic heart disease
Myasthenia gravis
Graves disease
Pemphigus vulgaris
Serum sickness
Systemic lupus erythematosus
Poststreptococcal glomerulonephritis
Graft-versus-host disease
Contact dermatitis
Transplant rejection
Cytomegalovirus infection after transplant (NORD)
Post-transplant lymphoproliferative disorders (NORD)
X-linked agammaglobulinemia
Selective immunoglobulin A deficiency
Common variable immunodeficiency
IgG subclass deficiency
Hyperimmunoglobulin E syndrome
Isolated primary immunoglobulin M deficiency
Thymic aplasia
DiGeorge syndrome
Severe combined immunodeficiency
Adenosine deaminase deficiency
Ataxia-telangiectasia
Hyper IgM syndrome
Wiskott-Aldrich syndrome
Leukocyte adhesion deficiency
Chediak-Higashi syndrome
Chronic granulomatous disease
Complement deficiency
Hereditary angioedema
Asplenia
Thymoma
Ruptured spleen
Immunodeficiencies: T-cell and B-cell disorders: Pathology review
Immunodeficiencies: Combined T-cell and B-cell disorders: Pathology review
Immunodeficiencies: Phagocyte and complement dysfunction: Pathology review
Glucocorticoids
Bacterial structure and functions
Staphylococcus epidermidis
Staphylococcus aureus
Staphylococcus saprophyticus
Streptococcus viridans
Streptococcus pneumoniae
Streptococcus pyogenes (Group A Strep)
Streptococcus agalactiae (Group B Strep)
Enterococcus
Clostridium perfringens
Clostridium botulinum (Botulism)
Clostridium difficile (Pseudomembranous colitis)
Clostridium tetani (Tetanus)
Bacillus cereus (Food poisoning)
Listeria monocytogenes
Corynebacterium diphtheriae (Diphtheria)
Bacillus anthracis (Anthrax)
Nocardia
Actinomyces israelii
Escherichia coli
Salmonella (non-typhoidal)
Salmonella typhi (typhoid fever)
Pseudomonas aeruginosa
Enterobacter
Klebsiella pneumoniae
Shigella
Proteus mirabilis
Yersinia enterocolitica
Legionella pneumophila (Legionnaires disease and Pontiac fever)
Serratia marcescens
Bacteroides fragilis
Yersinia pestis (Plague)
Vibrio cholerae (Cholera)
Helicobacter pylori
Campylobacter jejuni
Neisseria meningitidis
Neisseria gonorrhoeae
Moraxella catarrhalis
Francisella tularensis (Tularemia)
Bordetella pertussis (Whooping cough)
Brucella
Haemophilus influenzae
Haemophilus ducreyi (Chancroid)
Pasteurella multocida
Mycobacterium tuberculosis (Tuberculosis)
Mycobacterium leprae
Mycobacterium avium complex (NORD)
Mycoplasma pneumoniae
Chlamydia pneumoniae
Chlamydia trachomatis
Borrelia burgdorferi (Lyme disease)
Borrelia species (Relapsing fever)
Leptospira
Treponema pallidum (Syphilis)
Rickettsia rickettsii (Rocky Mountain spotted fever) and other Rickettsia species
Coxiella burnetii (Q fever)
Ehrlichia and Anaplasma
Gardnerella vaginalis (Bacterial vaginosis)
Viral structure and functions
Varicella zoster virus
Cytomegalovirus
Epstein-Barr virus (Infectious mononucleosis)
Human herpesvirus 8 (Kaposi sarcoma)
Herpes simplex virus
Human herpesvirus 6 (Roseola)
Adenovirus
Parvovirus B19
Human papillomavirus
Poxvirus (Smallpox and Molluscum contagiosum)
BK virus (Hemorrhagic cystitis)
JC virus (Progressive multifocal leukoencephalopathy)
Poliovirus
Coxsackievirus
Rhinovirus
Hepatitis A and Hepatitis E virus
Hepatitis D virus
Influenza virus
Mumps virus
Measles virus
Respiratory syncytial virus
Human parainfluenza viruses
Dengue virus
Yellow fever virus
Zika virus
Hepatitis C virus
West Nile virus
Norovirus
Rotavirus
Coronaviruses
HIV (AIDS)
Human T-lymphotropic virus
Ebola virus
Rabies virus
Rubella virus
Eastern and Western equine encephalitis virus
Lymphocytic choriomeningitis virus
Hantavirus
Prions (Spongiform encephalopathy)
Coccidioidomycosis and paracoccidioidomycosis
Histoplasmosis
Blastomycosis
Pneumocystis jirovecii (Pneumocystis pneumonia)
Candida
Mucormycosis
Aspergillus fumigatus
Sporothrix schenckii
Cryptococcus neoformans
Malassezia (Tinea versicolor and Seborrhoeic dermatitis)
Plasmodium species (Malaria)
Babesia
Giardia lamblia
Entamoeba histolytica (Amebiasis)
Cryptosporidium
Acanthamoeba
Naegleria fowleri (Primary amebic meningoencephalitis)
Toxoplasma gondii (Toxoplasmosis)
Trypanosoma brucei
Trypanosoma cruzi (Chagas disease)
Trichomonas vaginalis
Leishmania
Loa loa (Eye worm)
Toxocara canis (Visceral larva migrans)
Onchocerca volvulus (River blindness)
Ascaris lumbricoides
Anisakis
Angiostrongylus (Eosinophilic meningitis)
Ancylostoma duodenale and Necator americanus
Strongyloides stercoralis
Guinea worm (Dracunculiasis)
Wuchereria bancrofti (Lymphatic filariasis)
Trichinella spiralis
Enterobius vermicularis (Pinworm)
Trichuris trichiura (Whipworm)
Echinococcus granulosus (Hydatid disease)
Diphyllobothrium latum
Paragonimus westermani
Clonorchis sinensis
Schistosomes
Pediculus humanus and Phthirus pubis (Lice)
Sarcoptes scabiei (Scabies)
Protein synthesis inhibitors: Aminoglycosides
Antimetabolites: Sulfonamides and trimethoprim
Antituberculosis medications
Miscellaneous cell wall synthesis inhibitors
Protein synthesis inhibitors: Tetracyclines
Cell wall synthesis inhibitors: Penicillins
Miscellaneous protein synthesis inhibitors
Cell wall synthesis inhibitors: Cephalosporins
DNA synthesis inhibitors: Metronidazole
DNA synthesis inhibitors: Fluoroquinolones
Mechanisms of antibiotic resistance
Integrase and entry inhibitors
Nucleoside reverse transcriptase inhibitors (NRTIs)
Protease inhibitors
Hepatitis medications
Non-nucleoside reverse transcriptase inhibitors (NNRTIs)
Neuraminidase inhibitors
Herpesvirus medications
Azoles
Echinocandins
Miscellaneous antifungal medications
Anthelmintic medications
Antimalarials
Anti-mite and louse medications
Advanced cardiac life support (ACLS): Clinical
Supraventricular arrhythmias: Pathology review
Ventricular arrhythmias: Pathology review
Heart blocks: Pathology review
Coronary artery disease: Clinical
Heart failure: Clinical
Syncope: Clinical
Pericardial disease: Clinical
Valvular heart disease: Clinical
Chest trauma: Clinical
Shock: Clinical
Peripheral vascular disease: Clinical
Leg ulcers: Clinical
Aortic aneurysms and dissections: Clinical
Cholinomimetics: Direct agonists
Cholinomimetics: Indirect agonists (anticholinesterases)
Muscarinic antagonists
Sympathomimetics: Direct agonists
Sympatholytics: Alpha-2 agonists
Adrenergic antagonists: Presynaptic
Adrenergic antagonists: Alpha blockers
Adrenergic antagonists: Beta blockers
ACE inhibitors, ARBs and direct renin inhibitors
Loop diuretics
Thiazide and thiazide-like diuretics
Calcium channel blockers
cGMP mediated smooth muscle vasodilators
Class I antiarrhythmics: Sodium channel blockers
Class II antiarrhythmics: Beta blockers
Class III antiarrhythmics: Potassium channel blockers
Class IV antiarrhythmics: Calcium channel blockers and others
Positive inotropic medications
Antiplatelet medications
Blistering skin disorders: Clinical
Bites and stings: Clinical
Burns: Clinical
Diabetes mellitus: Clinical
Hyperthyroidism: Clinical
Hypothyroidism and thyroiditis: Clinical
Parathyroid conditions and calcium imbalance: Clinical
Adrenal insufficiency: Clinical
Neck trauma: Clinical
Insulins
Mineralocorticoids and mineralocorticoid antagonists
Abdominal pain: Clinical
Appendicitis: Clinical
Gastrointestinal bleeding: Clinical
Peptic ulcers and stomach cancer: Clinical
Inflammatory bowel disease: Clinical
Diverticular disease: Clinical
Gallbladder disorders: Clinical
Pancreatitis: Clinical
Cirrhosis: Clinical
Hernias: Clinical
Bowel obstruction: Clinical
Abdominal trauma: Clinical
Laxatives and cathartics
Antidiarrheals
Acid reducing medications
Blood products and transfusion: Clinical
Venous thromboembolism: Clinical
Anticoagulants: Heparin
Anticoagulants: Warfarin
Anticoagulants: Direct factor inhibitors
Thrombolytics
Fever of unknown origin: Clinical
Infective endocarditis: Clinical
Pneumonia: Clinical
Tuberculosis: Pathology review
Diarrhea: Clinical
Urinary tract infections: Clinical
Meningitis, encephalitis and brain abscesses: Clinical
Skin and soft tissue infections: Clinical
Hypernatremia: Clinical
Hyponatremia: Clinical
Hyperkalemia: Clinical
Hypokalemia: Clinical
Metabolic and respiratory acidosis: Clinical
Metabolic and respiratory alkalosis: Clinical
Toxidromes: Clinical
Medication overdoses and toxicities: Pathology review
Environmental and chemical toxicities: Pathology review
Acute kidney injury: Clinical
Kidney stones: Clinical
Stroke: Clinical
Seizures: Clinical
Headaches: Clinical
Traumatic brain injury: Clinical
Lower back pain: Clinical
Spinal cord disorders: Pathology review
Anticonvulsants and anxiolytics: Barbiturates
Anticonvulsants and anxiolytics: Benzodiazepines
Nonbenzodiazepine anticonvulsants
Migraine medications
Osmotic diuretics
Opioid agonists, mixed agonist-antagonists and partial agonists
Opioid antagonists
Asthma: Clinical
Chronic obstructive pulmonary disease (COPD): Clinical
Acute respiratory distress syndrome: Clinical
Pleural effusion: Clinical
Pneumothorax: Clinical
Bronchodilators: Beta 2-agonists and muscarinic antagonists
Pulmonary corticosteroids and mast cell inhibitors
Joint pain: Clinical
Anatomy clinical correlates: Clavicle and shoulder
Anatomy clinical correlates: Axilla
Anatomy clinical correlates: Arm, elbow and forearm
Anatomy clinical correlates: Wrist and hand
Anatomy clinical correlates: Median, ulnar and radial nerves
Anatomy clinical correlates: Bones, joints and muscles of the back
Acetaminophen (Paracetamol)
Non-steroidal anti-inflammatory drugs
Antigout medications
Pediatric allergies: Clinical
Kawasaki disease: Clinical
Congenital TORCH infections: Pathology review
Pediatric infectious rashes: Clinical
Pediatric bone and joint infections: Clinical
Sjogren syndrome: Clinical
Vasculitis: Clinical
Rheumatoid arthritis: Clinical
Seronegative arthritis: Clinical
Systemic lupus erythematosus (SLE): Clinical
Inflammatory myopathies: Clinical
ECG axis
ECG basics
Normal heart sounds
Abnormal heart sounds
Cardiac conduction system
Cardiac conduction velocity
ECG normal sinus rhythm
ECG intervals
ECG QRS transition
ECG rate and rhythm
ECG cardiac infarction and ischemia
ECG cardiac hypertrophy and enlargement
Vasculitis

Transcript

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Hepatitis C virus is a part of the flaviviridae family, and it can be broken down in hepat- which refers to the liver, and -itis, which means inflammation.

So this virus affects the liver, causing hepatitis.

Hepatitis C virus is enveloped, meaning that it is surrounded by a membrane.

It also has a lipoprotein envelope that’s very similar in structure to two lipoproteins that normally transport cholesterol through the blood: low density lipoprotein, or LDL and very-low-density lipoprotein, or VLDL.

Underneath the membrane, there’s an icosahedral capsid, which is a spherical protein shell made up of 20 equilateral triangular faces.

The capsid holds a single strand positive-sense RNA, meaning that it has positive polarity, which is why it can be used directly by the host ribosomes to synthesize viral proteins.

Now, hepatitis C virus can be transmitted through contaminated blood or through sexual contact.

Once inside the body, hepatitis C virus circulates the blood and reaches the liver, where it infects the main liver cells called hepatocytes; and B lymphocytes, which are a type of immune cells that create antibodies.

First, the virus binds to the cells using its envelope, which is very similar to LDL and VLDL, so it can attach to specific LDL receptors.

Then, the virus enters the cell by endocytosis, which is when it’s wrapped by the cell membrane and brought inside the cell in a bubble called an endosome.

Next, the viral membrane fuses with the endosome and releases the capsid which dissolves in the cytoplasm, leaving only viral RNA.

Then, viral RNA binds to the host ribosomes and is used to create structural and non-structural proteins.

Structural proteins will be used to make the viral particle, while the non-structural proteins make the replication complex that contains an enzyme called RNA dependent RNA polymerase.

This enzyme uses the positive-sense viral RNA to create a negative-sense template.

And the replication complex can use the newly made negative-sense template to create more copies of the positive-sense viral RNA, which can be packaged into viral particles, along with structural proteins, in the host cell endoplasmic reticulum.

However, RNA polymerase makes a lot of mistakes, so each viral particle is a bit different.

This contributes to viral variability, and it’s what makes it so hard to create a vaccine against hepatitis C.

Finally, the viral particles exit the cell through exocytosis, which is like reverse endocytosis.

About two thirds of affected people can develop complications like: cryoglobulinemia, when the blood contains temperature sensitive antibodies called cryoglobulins; autoimmune hemolytic anemia; glomerulonephritis, or inflammation of the kidneys’ glomeruli, leukocytoclastic vasculitis, which is an inflammation of the blood vessels; diabetes; hypothyroidism; and skin conditions like porphyria cutanea tarda and lichen planus.

It’s not clear why these complications arise; however, since hepatitis C virus infects B-lymphocytes, one explanation may be that it affects the production and function of antibodies.

Since hepatitis C is transmitted through blood or sexual contact, individuals at higher risk for infection include people who use intravenous drugs, individuals who have had tattoos and/or piercings done, recipients of transfusion and organ transplants; and individuals who have unprotected sex and multiple sexual partners.

The virus can’t be transferred from an infected pregnant individual to the baby during pregnancy, but there is a 1 in 20 chance to pass it to the baby during childbirth for both vaginal delivery and c-section.

Hepatitis C virus causes three types of disease: most commonly, chronic hepatitis; but it can also cause acute hepatitis; and rarely fulminant hepatitis that quickly progresses to liver failure.

Key Takeaways

The hepatitis C virus (HCV) is an enveloped, single-stranded RNA virus of the Flaviviridae family. It infects the liver cells and causes chronic hepatitis. HCV is highly infectious and can be transmitted through contact with blood or body fluids from an infected person. HCV is most commonly spread through sharing contaminated needles or other injection equipment among people who inject drugs and from mother to child during birth. Hepatitis C infection can progress to cirrhosis and liver failure after many years, and it also poses a risk of developing hepatocellular carcinoma.