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Hepatitis C Virus, Clinical Trials and Important Information

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Hepatitis-C is contagious

Hepatitis C is a blood-borne contagious disease of the liver caused by the Hepatitis- C virus. It may lead to severe disease of the liver and even liver cancers.

It is mostly seen in people who inject recreational drugs through unsterilized needles. 

Transmission of Hepatitis C

Hepatitis C is usually a blood-borne disease that may spread via:
  • Reuse and sharing of unsterilized needles especially by intravenous drug abusers
  • Sharing razor and toothbrush of a person infected with hepatitis C
  • Vertical transmission from a pregnant mother to her unborn baby
  • Unprotected sexual intercourse with an infected person, particularly male to male intercourse with an infected person (rare) 

It however does not spread from kissing, hugging, or sharing foods with an infected person. It also does not spread through breast milk.

Signs and Symptoms of Hepatitis C

Four-fifth of the people infected with the virus remains asymptomatic. However, for the people who do develop symptoms of the disease, they do so after 2 weeks to 6 months. These patients present with:
  • Passage of a pale, clay-colored stool
  • Dark urine
  • Increased body temperature
  • Yellowish discoloration of the skin and the sclera (white part of your eyes)
  • Joint pain
  • Abdominal discomfort
  • Loss of appetite
  • Nausea and vomiting
  • Tiredness and general body weakness

These symptoms after appearing may persist for 2 to 12 weeks.

Diagnosis  of Hepatitis C

For the diagnosis of Hepatitis-C your doctor will order you two tests:
  • Antibody Test: This test involves detecting the presence of Anti-HBC Antibodies in the blood. Antibodies are produced in the body in response to the infection to fend it off. A positive antibody test signifies that you have been infected with the virus at some stage; however, a negative test does not always rule out infection as it may take some time for your body to develop these antibodies against the virus.
  • PCR: PCR test is indicated in cases with positive antibody test to detect if the virus is still present in the body and multiply. It does so by measuring the viral nucleic acid in the blood. A positive result for the PCR test signifies the presence of active Hepatitis-C infection.

Other tests indicated to detect liver damage include 
  • Liver function test: It helps to assess the levels of liver enzymes that indicate liver damage.
  • Magnetic resonance electrography (MRE): It helps in detecting Hepatitis-C induced scarring of the liver using the MRI technique.
  • Liver biopsy: The test involves taking out a small sample of liver tissue and sending it for investigations to check for liver damage. It is an invasive method of diagnosing liver disease.
 

Management of Hepatitis C

Most cases of HCV remain asymptomatic and your body clears out most of the infection, thus medical management of the condition is not always required. It is needed in cases where your body is unable to fend off the infection and the disease has gone to chronicity.
  • Antiviral drugs: These drugs are used to remove viral pathogens from the bloodstream. These drugs are effective in treating more than 95% of patients with HCV infection. These drugs do not however provide immunity from the disease, so the risk factors should be avoided even after treatment. Newly developed antivirals like Simeprevir, Sofosbuvir, and Daclatasvir have shorter treatment courses and have been shown to make the treatment even more effective.  
  • Liver transplant: It is indicated in patients in whom hepatitis C has led to irreversible liver damage. It involves removing the infected liver and transferring healthy liver from a donor. Antiviral medications are still required after liver transplant to prevent infection of the transplanted liver.
 

Recent Advances Currently Undergoing Clinical Trials

Ezetimibe: Though antivirals have shown to be more than 90% effective in treating cases of HCV infection, the drugs in use are pretty expensive. The drug Ezetimibe is currently undergoing clinical trial for its safety and efficacy in treating HCV infection as a monotherapy and in combination with the current drugs. The researchers have hypothesized that it will help clear viral load from the blood early, reducing the need for prolonged medication and decrease the cost associated with chronic HCV treatment. The drug ezetimibe is currently in Phase-2 of its clinical trial. 

Sofosbuvir/Velpatasvir: A clinical trial is currently underway to assess the efficacy and safety of the drugs Sofosbuvir/Velpatasvir in treating hepatitis C infection in pregnant women. Sofosbuvir/Velpatasvir are FDA approved antivirals for the treatment of Hepatitis C infection. The safety and efficacy of the drug during pregnancy will be assessed via the outcomes in the mother and the child. It is currently in Phase 1 of the clinical trial. 

Hepatitis-C vaccine: There is no vaccine currently that helps prevent HCV infection. A clinical trial is currently underway which aims at assessing the safety and efficacy of lentiviral-based HCV immunotherapy in patients suffering from chronic hepatitis C infection. It aims at assessing the immunological responses of the body to the vaccine. It is currently in phase-1 of its clinical trial.

HCV therapy on CNS outcome: An observational study to assess the effects of Directly acting antiviral drugs in the central nervous system functions is currently underway. The study aims at determining the safety of antivirals used in treating HCV infection.

Vertical transmission of HCV: Hepatitis C infection has shown to get transferred from pregnant mother to her unborn. However how common of a cause it is, is not yet known completely. An observational study is currently underway which aims at assessing the natural history of Hepatitis C infection in pregnancy and the rate of HCV transmission from an infected mother to her newborn. All the participants of the study will be given anti-viral medications after cessation of breastfeeding.

Thoracic organ transplant: A clinical trial is currently underway to assess the safety and efficacy of heart and lung transplant of a previously HCV infected person to a healthy recipient. Before the transplant, the donors will be screened for active infection through PCR. In case of the presence of active infection, the recipients will receive a course of Directly acting antivirals before the treatment. PCR negative donors will go continuous monitoring and antivirals will be started only in case active infection begins. It is currently in phase 4 of its clinical trial
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This content is for informational and educational purposes only. It is not intended to provide medical advice or to take the place of such advice or treatment from a personal physician. All readers/viewers of this content are advised to consult their doctors or qualified health professionals regarding specific health questions. CenTrial Data Ltd. does not take responsibility for possible health consequences of any person or persons reading or following the information in this educational content. Treatments and clinical trials mentioned may not be appropriate or available for all trial participants. Outcomes from treatments and clinical trials may vary from person to person. Consult with your doctor as to whether a clinical trial is a suitable option for your condition.