Acute HCV
The incidence of acute HCV infection is about 1/100,000 per year, but this figure is probably an underestimate because it mainly refers to symptomatic patients. Progression to persistent or chronic infection occurs in about three quarters of cases, is influenced by the IL28B genotype, and is associated with chronic hepatitis of a variable degree and with variable rates of fibrosis progression. Only exceptionally does infection clear spontaneously in the chronic stage (Esteban et al., 2008).
Acute HCV is typically asymptomatic and unrecognized. When present, the symptoms of acute HCV are non specific. The most common symptoms are flu-like and include anorexia, weight loss, abdominal pain, myalgia, arthralgia …show more content…
For the diagnosis of hepatitis C both serologic and nucleic acid-based molecular assays are available (Scott and Gretch, 2007).
Extrahepatic Manifestations
Patients with chronic hepatitis C virus (HCV) infection are at risk of a great number of extrahepatic manifestations (EHMs) up to 40-76% of patients infected with HCV develop at least one EHM during the course of the disease (Cacoub et al., 1999 and Cacoub et al., 2000).
EHMs are often the first and only clinical sign of chronic hepatitis C infection. Evidence of HCV infection should always be sought out in cases of non-specific chronic fatigue and/or rheumatic, hematological, endocrine or dermatological disorders. The pathogenesis of EHM is not fully understood, although most studies suggest that the presence of mixed cryoglobulinemia (MC), particular lymphotropism of the virus, molecular mimicry and non-cryoglobulinemic autoimmune phenomena constitute the major pathogenic factors. The pathogenesis and epidemiology of many EHMs require further investigation (Zignego et al.,