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
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.