Hepatitis C: Causes

Pathogenesis (disease development)

After infection with the hepatitis C virus, it reaches the liver through the bloodstream. There it damages hepatocytes (liver cells). This cell-damaging effect is further enhanced by the body’s immune defenses.

Etiology (causes)

Biographic causes

  • Occupations – health care workers; employees of care facilities.
  • Socioeconomic factors – low socioeconomic status.
  • Geographic factors – high prevalence countries (Far East, tropical countries).

Behavioral causes

  • Consumption of stimulants
    • Alcohol (woman: > 40 g/day; man: > 60 g/day).
  • Drug use
    • Intranasal (“through the nose”)
    • Intravenously (“through the vein”); long-term drug addicts in Germany are chronically infected with hepatitis C in 23-54% of cases
  • Nail and foot care (not yet clearly proven).
  • Ear piercing (very likely, but not yet clearly documented).
  • Piercings (very likely, but not yet clearly documented).
  • Tattoos (very likely, but not yet clearly documented).
  • Sexual transmission (still rare, but increasing).
    • Promiscuity (sexual contact with relatively frequently changing different partners or with parallel multiple partners).
    • Prostitution
    • Men who have sex with men (MSM).
    • Sexual contacts in the vacation country
    • Unprotected coitus (sexual intercourse)
  • Sexual practices with high risk of mucosal injury (e.g., unprotected anal intercourse/anal sex).

Disease-related causes

  • Dialysis patients – individuals who require dialysis (blood washing) as renal replacement therapy due to kidney disease.
  • HIV infection

Medication

  • Blood products (e.g. blood transfusion from 1992).

Other causes

  • Horizontal infection (non-sexual) – pathogen transmission from host to host of the same generation:
    • Health care workers
    • Residents and employees of care facilities
    • Inmates

    The risk of infection from a needle stick injury with virus positive blood is 3%.

  • Vertical infection – pathogen transmission from a host (here. the mother) to its offspring (here: the child):
    • Transmission of infection during birth from mother to child (perinatal) [risk of transmission: about 5% in a birth without complications].
  • Iatrogenic transmission – transmission during medical activity, for example, in the course of surgery in the event of inadequate hygiene.