Viral Hepatits: C

• Single-stranded RNA (Flaivirus): Prevalence US 1.8% exposed

• Genotype 1a and 1b most common

• Percutaneous and sexual

• Acute: 80 % Asymptomatic

• Chronic: 80% of infections

• CAH 80% of chronic infections

• Cirrhosis 20 chronic infections over 20 years (progression increased in patients with ETOH, Hemochromatosis

• Complications:

• HCC in cirrhotic patients 5%/year

• DM

• Thyroididtis

• Type 2 Cryoglobins 40%

• Essential Mived Cryoglobinemia 2-3%: Palpable Purpura 80%, Neuropathy 50%, Type 1 Membranoproliferative glomerloneohtitis 30%

• Porphyria cutanea tarda

• Treatment: Pegylated Alpha Interferon and Ribavirin

• Response: Genotype 1 and 4 52 weeks 55%

• Genotype 2and 3 26 weeks 80%