How does the virus spread?

The virus can be transmitted through various infection routes. In almost half of the cases, however, the source or route of infection is unknown. However, the main route of transmission of the virus is parenterally (i.e. immediately through the digestive or gastrointestinal tract).

This is often done by so-called “needle sharing” in drug addicts. Since the viruses enter the bloodstream directly, infection is more likely. The virus can also be transmitted by so-called needle-stick injuries, which affect medical personnel in particular.

In this case, an injury occurs with a needle that was previously in the patient (for example when taking blood samples). Likewise a transmission can take place by infected needles during piercing or tattooing. In emerging countries, the risk of transmission through blood preserves, where blood is not yet consistently tested due to the high costs, is much higher.

On the other hand, the virus can be transmitted “vertically”. This means that an infected mother transmits the virus to her child. How likely an infection is, depends on the viral load in the mother’s blood.

In Germany, vertical infection occurs in about 1-6% of cases. The sexual transmission of the hepatitis C virus plays a somewhat subordinate role. Open wounds in the genital and oral area also result in an increased risk of infection.

What does the virus load mean?

The virus load or “viral load” simply describes the amount of virus. It determines quantitatively how many virus particles are in the blood of an infected patient. The viral load of the hepatitis C virus is measured by means of PCR (polymerase chain reaction, direct virus detection), whereby the number of HCV-RNA is determined and correlates with the amount of virus.

The RNA of the hepatitis C virus can usually be detected 1-2 weeks after infection. However, the viral load is not only determined to see if an infection has occurred, but also to monitor therapy and the course of the disease and to determine how infectious a patient is. For example, a low viral load at the beginning of the disease may indicate a shorter therapy duration. In addition, the decrease in HCV RNA in the blood under therapy is an indication of successful therapy.If HCV-RNA is no longer detectable 6 weeks after the end of therapy, this indicates that the therapy has been successful and healed hepatitis C. If there is no decrease in viral load within six months, this is referred to as chronic hepatitis C infection. However, the level of viral load does not correlate with the severity of liver cell damage.