Hepatitis C is a common cause of chronic hepatitis. It is often asymptomatic until manifestations of chronic liver disease occur. Treatment is with direct-acting antiviral drugs; permanent elimination of detectable viral RNA is possible.
(See also Causes of Hepatitis, Overview of Chronic Hepatitis, and Acute Hepatitis C.)
Hepatitis lasting gt; 6 months is generally defined as chronic hepatitis, although this duration is arbitrary.
There are 6 major genotypes of hepatitis C virus (HCV), which vary in their response to treatment. Genotype 1 is more common than genotypes 2, 3, 4, 5, and 6; it accounts for 70 to 80% of cases of chronic hepatitis C in the US.
Acute hepatitis C becomes chronic in about 75% of patients. The Centers of Disease Control and Prevention (CDC) estimates that about 2.4 million people in the US have chronic hepatitis C infection (1). Worldwide, 71 million people are estimated to have chronic hepatitis C (2).
Chronic hepatitis C progresses to cirrhosis in 20 to 30% of patients; cirrhosis often takes decades to appear. Hepatocellular carcinoma can result from HCV-induced cirrhosis but results only rarely from chronic infection without cirrhosis (unlike in chronic HBV infection).
Up to 20% of patients with alcoholic liver disease harbor HCV. The reasons for this high association are unclear because concomitant alcohol and drug use accounts for only a portion of cases. In these patients, HCV and alcohol act synergistically to worsen liver inflammation and fibrosis.
Chronic paronychia
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Chronic paronychia is recurring or persistent inflammation of the nail fold, typically of the fingernails.
(See also Acute Paronychia.)
Chronic paronychia occurs almost always in people whose hands are chronically wet (for example, dishwashers, bartenders, and housekeepers), particularly if they have hand eczema, diabetes, or an impaired immune system. The yeast Candida is often present, but its role in causing chronic paronychia is unclear because eliminating the yeast completely does not always cure the condition. Chronic paronychia may be the result of an irritant skin inflammation (dermatitis) in addition to the presence of Candida.
The nail fold (the fold of hard skin at the sides of the nail plate where the nail and skin meet) is painful, tender, and red as in acute paronychia, but pus usually does not accumulate. Often there is loss of the cuticle (the skin at the base of the nail) and separation of the nail fold from the nail plate (the hard part of the nail). A space then forms that allows irritants and microorganisms to enter. The nail can become distorted.
The doctor makes the diagnosis of chronic paronychia by examining the affected finger.
Chronic paronychia meaning & definition 1 of Chronic paronychia.