Hepatitis C virus (HCV)

Hepatitis C virus (HCV) is an enveloped, single-stranded RNA virus of the Flaviviridae family.

Initial infections with HCV are asymptomatic in approximately 80% of people. In acute courses, symptoms may include fever, fatigue, nausea, vomiting, joint pain, and jaundice.

Because initial infections are often not recognized, there is a high risk of chronicity. Chronic infection occurs when the genetic material of the pathogen (HCV RNA) is detectable for more than six months.

In chronic courses, cirrhosis of the liver occurs in 10 to 40% of affected individuals within 20 to 30 years. There is also an increased risk of developing liver cancer.

An effective vaccination against HCV is not yet available.

Humans are the only reservoir for the hepatitis C viruses.

Relevance of the pathogen in transmission in endoscopy

  • Gastroenterology: Low

  • Pulmonology: Not relevant

  • Ear, nose, and throat: Not relevant

  • Urology: Not relevant

Relevance for endoscope surveillance

  • Low or moderate concern organism

Transmission route

Hepatitis C virus is a blood-borne virus and is most commonly transmitted through:

  • Injecting drug use when sharing injection equipment;

  • Use of contaminated medical equipment, especially syringes and needles in health care facilities;

  • Transfusion of untested blood and blood products;

  • sexual practices that result in mucosal injury and contact with blood.

During childbirth, the virus can also be transmitted from infected women to their babies.

There is insufficient data to conclude how much of a risk of HCV transmission is associated with inadequate endoscope reprocessing. There are few cases of HCV transmission documented in the literature. There is a risk of transmission if biopsy forceps are not adequately reprocessed.

Sources and further readings

  1. Gries O, Ly T: Infektologie – Kompendium humanpathogener Infektionskrankheiten und Erreger, Springer-Verlag Berlin Heidelberg 2019.

  2. Hepatitis C, Centers for Disease Control and Prevention, https://www.cdc.gov/hepatitis/hcv/index.htm. Accessed on 05.14.2021.

  3. Hepatitis C, World Health Organization, https://www.who.int/news-room/fact-sheets/detail/hepatitis-c. Accessed on 05.14.2021.

  4. Kovaleva J. et al. Infectious complications in gastrointestinal endoscopy and their prevention, / Best Practice & Research Clinical Gastroenterology 30 (2016) 689-704.

  5. Petignat C. Infektionsübertragungsrisiko bei einer Endoskopie, Schweizerische Gesellschaft für Sterilgutversorgung. Journal Forum 2008; 3: 36–40.