Roingeard, P., & Hourioux, C. (2007). Hepatitis C virus core protein, lipid droplets and steatosis. Journal of Viral Hepatitis, 15(3), 157-164. doi:10.1111/j.1365-2893.2007.00953.x
Normal Physiology
The liver is the largest solid organ in the human body. Under healthy conditions the liver plays a large role in digestion. It creates bile to help with fat emulsion and absorption in the intestines and filters the blood as it comes from the digestive tract. Once inside the liver the nutrients are then synthesized before they are distributed throughout the body. The liver is also responsible for creation of proteins called albumins that help maintain the plasma intravascular colloid osmotic pressure. Lastly the liver helps create clotting factors, maintain blood glucose levels, metabolize drugs, and store vitamins and minerals.
Pathophysiology of Hepatitis C Virus
Hepatitis C Virus (HCV) disrupts this system and causes permanent, irreversible harm to the liver. While some individuals exposed to HCV are able to clear the virus from their system about 85% will develop a chronic infection. Early on the symptoms are generally mild or absent, children especially are asymptomatic. However, as the virus advances and starts to cause harm to the liver many manifestations of liver disease begin to appear. This is due to the process known as cirrhosis, or scarring of the liver, which is an irreversible change to the tissues of the liver resulting in a loss of function of the cells involved. This loss of function manifests in symptoms such as jaundice, fatigue and malaise, nausea and anorexia, portal hypertension, and many other liver failure symptoms. Cryoglobulinemia vasculitis and lymphoproliferative disorders may also be present due to the progression of the liver disease process. HCV is diagnosed via blood work with detection of anti-HCV IGG. Persistent infections, with acute symptoms, and elevated aminotransferase levels may also accompany a clinical presentation. There is currently no vaccine for HCV, this is due to viral mutations and genetic diversity between genotypes, post treatment reinfection is also likely.
Progression of disease to cirrhosis is the most common cause of hepatocellular carcinoma in the United States and of liver transplant worldwide (McCance & Huether, 2019).