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Section 3. Summaries of Infectious Diseases
Hepatitis C
Clinical ManifestationsEtiology
Epidemiology
Diagnostic Tests
Treatment
Isolation of the Hospitalized Patient
Control Measures
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CLINICAL MANIFESTATIONS
Signs and symptoms of hepatitis C virus (HCV) infection are indistinguishable from signs of hepatitis A or hepatitis B virus infections. Acute disease tends to be mild and insidious in onset, and most infections are asymptomatic. Jaundice occurs in fewer than 20% of patients, and abnormalities in liver transaminase concentrations generally are less pronounced than those in patients with hepatitis B virus infection. Persistent infection with HCV occurs in 50% to 60% of infected children, even in the absence of biochemical evidence of liver disease. Most children with chronic infection are asymptomatic. Although chronic hepatitis develops in approximately 70% to 80% of infected adults, limited data indicate that chronic hepatitis and cirrhosis occur less commonly in children. Infection with HCV is the leading indication for liver transplantation among adults in the United States.
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ETIOLOGY
HCV is a small, single-stranded RNA virus and is a member of the Flavivirus family. Multiple HCV genotypes and subtypes exist.
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EPIDEMIOLOGY
The incidence of acute symptomatic HCV infection in the United States was 0.2 per 100 000 in 2005; after asymptomatic infection and underreporting were considered, approximately 20 000 new cases were estimated to have occurred. For all age groups, the incidence of HCV infection decreased in the United States during the 1990s and has remained low and stable since then. Nevertheless, a substantial burden of disease still exists in the United States because of the propensity of HCV to establish chronic infection and the high incidence of acute HCV infection through the 1980s. The prevalence of HCV infection in the general population of the United States is estimated at 1.3%, equating to an estimated 3.2 million people in the United
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