Hepatitis C is a serious health problem that requires a multifaceted solution. This bloodborne virus, which can go unnoticed for years, is extremely dangerous to the liver. Understanding its mechanisms of transmission is critical for prevention. 

In this article, we have discussed how, with preventive measures and advances in antiviral drugs, there is hope for effective treatment of this potentially fatal disease.

Hepatitis C, often known as HCV, is a viral infection primarily affecting the liver and a major global health concern. If left untreated, this insidious Flaviviridae family bloodborne infection can cause chronic liver disease, cirrhosis, and even liver cancer. 

Hepatitis C, unlike certain other types of Hepatitis, can be asymptomatic for years, making early detection critical.

The Hepatitis C Virus (HCV) is spread mostly through direct contact with contaminated blood. Understanding the various transmission mechanisms is critical for public health and preventative efforts.

Here's how it typically transmits:

• Injection Drug Use

One of the most prevalent ways HCV spreads is through the sharing of needles or other injecting equipment. This is because even a trace amount of infected blood can transmit the virus. Injecting drug users are at high risk, and harm reduction initiatives such as needle exchange programs try to lessen this danger.

• Inadequate Sterilisation of Medical Equipment

Inadequate sterilisation of medical equipment or the use of contaminated needles and syringes in healthcare settings might result in HCV transmission. This mode of transmission, however, has become less common in wealthy countries due to strong infection control measures.

• Infected Blood

HCV could have been transmitted through blood transfusions and organ transplants before the advent of stringent blood screening methods. Modern blood screening, on the other hand, has significantly reduced this danger.

• Mother-to-kid Transmission

Although uncommon, HCV can be passed from an infected mother to her child during childbirth. If the mother also has HIV, the risk is increased.

• Sharing Personal Objects

Sharing personal objects such as razors or toothbrushes that may have come into touch with infected blood can theoretically transfer the virus. However, it may be less potent.

• Tattoos and Body Piercings

If equipment is not thoroughly cleaned and sterilised, poorly regulated or unsterile tattoo and piercing practices can represent a risk.

Hepatitis C causes a variety of symptoms that vary in severity and course. These are some of the symptoms, which are not exhaustive:

• Fatigue

Persistent and inexplicable tiredness, which is frequently one of the first symptoms.

• Abdominal Pain

Some people may have mild to moderate stomach pain or discomfort, typically in the upper right quadrant.

• Muscle and Joint discomfort

It includes flu-like symptoms of generalised muscle pains and joint discomfort.

• Jaundice

A significant indication is characterised by skin and eye yellowing (jaundice). This is frequently accompanied by dark urine and pale, clay-coloured faeces, both indicating severe liver impairment.

• Gastronomical Issues

Nausea, vomiting, and a loss of appetite can all occur, resulting in weight loss.

• Fever

While not usually present, some people may experience a low-grade fever during an acute infection.

• Itchy Skin

Itchy skin, also known as pruritus, can be a troublesome symptom.

• Excess Bleeding

Hepatitis C can impair blood coagulation, resulting in easy bruising and bleeding.

• Swelling

Swelling in the legs or abdomen (ascites) can indicate severe liver disease.

• Confusion

Severe cases of hepatic encephalopathy may result in cognitive abnormalities.

The Hepatitis C virus (HCV) causes Hepatitis C infection. It spreads when the bloodstream of a healthy individual comes in contact with virus-infected blood. 

Hepatitis C infection occurs in a variety of genotypes around the world. There are 67 subtypes and seven genotypes. In India, genotype 3 of the Hepatitis C virus is the most frequent.

Chronic Hepatitis C takes the same path regardless of the genotype of the infecting virus. However, treatment may differ based on the virus genotype. On the other hand, new antiviral medications can treat a wide range of genotypes.

Chronic HCV sometimes goes undiscovered for decades, remaining asymptomatic until significant liver damage occurs.

• It usually involves a serological test to look for anti-HCV antibodies. This first stage determines viral exposure.
• The next critical stage begins if the anti-HCV antibody test results in a positive result. A nucleic acid test examines the HCV ribonucleic acid (RNA), revealing the presence of an ongoing infection and indicating the necessity for treatment.
• The immunological Enigma test is critical since roughly 30% of HCV-infected people naturally eliminate the virus by a strong immunological response, eliminating the need for therapy. Surprisingly, they will still test positive for anti-HCV antibodies after they have recovered.
• The nucleic acid test for HCV RNA can be conducted in a laboratory setting or more conveniently, at a healthcare facility using a portable point-of-care system. This ease of access simplifies the diagnostic process, facilitating faster diagnosis and treatment for people suffering from chronic HCV infection.

In India, effective treatments are available to address Hepatitis C, with the primary goal of curing the disease and preventing long-term liver damage. 

Here are some crucial information and pointers:

• Antiviral Drugs

Antiviral drugs such as sofosbuvir and daclatasvir are routinely used to treat Hepatitis C in India. These medications have demonstrated high efficiency in battling the virus.

• Natural Immune Response

Some people can naturally eliminate the infection through their immune system; not all new infections require rapid treatment. However, therapy is required for chronic Hepatitis C cases.

• Lifestyle Adjustments 

People with Hepatitis C in India can benefit from lifestyle adjustments such as abstaining from alcohol and maintaining a healthy weight. These modifications can help to supplement medical treatment.

• Direct-acting Antivirals

The World Health Organisation (WHO) recommends pan-genotypic direct-acting antivirals (DAAs) for all age groups with chronic Hepatitis C infection, from adults to children as young as three years old. These oral, curative DAA therapy regimens typically have few adverse effects and short durations, ranging from 12 to 24 weeks, depending on the extent of cirrhosis.

Hepatitis C prevention is critical, especially because there is no effective vaccine. Comprehensive methods and increased attention are essential for protecting against this viral illness.

1. Optimised Measures in Healthcare Settings

• Injections

To reduce the danger of transmission within healthcare institutions, strict precautions must be implemented to ensure the safe and appropriate use of healthcare injections.

• Needle and Medical Waste Handling

Proper and secure needle and medical waste handling and disposal are crucial in preventing unintentional exposures.

2. Focusing on High-Risk Populations

• Injecting Drug Users

People who inject drugs are at a higher risk. Harm-reduction services, such as needle exchange programmes, substance abuse counselling, and opiate agonist therapy (OAT), help to promote safer practices.

• Individuals with HIV-positive Diagnosis

Individuals Living with HIV are at a higher risk of Hepatitis C co-infection and demand special care.

• Blood Safety Certification

To minimise transfusion-related transmission, it is critical to ensure the safety of donated blood by comprehensive testing for the Hepatitis C virus and other possible diseases.

3. Healthcare practitioner Training

Comprehensive training of healthcare personnel is required to establish best practices in infection control within healthcare settings.

4. Sexual Education

Promoting safe sexual practices, such as the regular use of barrier techniques, is critical for lowering the risk of sexual transmission.

Hepatitis C screening is an important public health precaution, and the US Preventive Services Task Force recommends thorough screening standards. Individuals should examine the following key points:

• Age Range: The suggested screening is for anyone aged 18 to 79, emphasising the need for early detection and intervention.
• Individuals at High Risk: Screening is especially important for people who are at high risk of contracting Hepatitis C. These are the high-risk groups:

1. Drug Use

Anyone who has ever injected, snorted, or inhaled illegal narcotics, as sharing drug paraphernalia, offers a considerable risk.

2. Unexplained Abnormal Liver

People with unexplained atypical liver test findings should be screened for Hepatitis C.

3. Babies Born to Infected Mom

Hepatitis C-infected moms' newborns should be tested to ensure timely diagnosis.

4. Healthcare and Emergency Services Personnel

Those working in healthcare or emergency services who have come into touch with blood or have had needlestick injuries are at risk.

5. Dialysis or Hemophilia

People with haemophilia who were treated with clotting factors before 1987, as well as those receiving long-term hemodialysis, are at an increased risk.

6. Organ Transplant

Individuals who have received blood or organ transplants before 1992 should consider screening.

7. Sexual Partners

Sexual partners of Hepatitis C patients should be tested.

8. Co-Infections

People with HIV or those about to begin pre-exposure prophylaxis (PrEP) for HIV prevention should be checked for co-infections.

9. Incarceration History

Anyone with a history of incarceration should consider screening.

Thus, screening is critical for early detection, especially in high-risk groups. Infections are diagnosed in two steps, using serological and nucleic acid assays. 

Prevention is still the most important factor, with healthcare and harm reduction efforts playing critical roles. Raising awareness and screening rates can help to lessen the impact of Hepatitis C on individuals and society.