Hepatitis C for Primary Care Physicians
Jaundice, abdominal pain, or, more commonly, nonspecific flu-like symptoms such as fatigue, muscles aches, and nausea occur in 25% to 30% of patients when they are infected with hepatitis C, but most patients are asymptomatic. During this period, alanine aminotransferase and aspartate aminotransferase levels increase rapidly, often to 10 times the upper limit of normal.
Approximately 50% to 80% of patients infected with hepatitis C progress to chronic infection, defined as a persistence of the virus for >6 months after the initial infection. Chronic hepatitis C is usually asymptomatic and often is found during investigation for an incidental finding of elevated liver transaminases. When symptomatic, patients with chronic hepatitis C present with nonspecific symptoms such as nausea, anorexia, and fatigue or signs of cirrhosis on examination.
Hepatitis C has been reported to cause numerous extrahepatic manifestations, although the association for many of the conditions has been questioned. Hepatitis C can cause both mixed cryoglobulinemia and B-cell non-Hodgkin's lymphoma and may have a role in certain rheumatologic, endocrine, and dermatologic conditions such as rheumatoid arthritis and dermatomyositis.
Clinical Presentation
Jaundice, abdominal pain, or, more commonly, nonspecific flu-like symptoms such as fatigue, muscles aches, and nausea occur in 25% to 30% of patients when they are infected with hepatitis C, but most patients are asymptomatic. During this period, alanine aminotransferase and aspartate aminotransferase levels increase rapidly, often to 10 times the upper limit of normal.
Approximately 50% to 80% of patients infected with hepatitis C progress to chronic infection, defined as a persistence of the virus for >6 months after the initial infection. Chronic hepatitis C is usually asymptomatic and often is found during investigation for an incidental finding of elevated liver transaminases. When symptomatic, patients with chronic hepatitis C present with nonspecific symptoms such as nausea, anorexia, and fatigue or signs of cirrhosis on examination.
Hepatitis C has been reported to cause numerous extrahepatic manifestations, although the association for many of the conditions has been questioned. Hepatitis C can cause both mixed cryoglobulinemia and B-cell non-Hodgkin's lymphoma and may have a role in certain rheumatologic, endocrine, and dermatologic conditions such as rheumatoid arthritis and dermatomyositis.